ASPO Abstracts
Health-related quality of life in adolescents and young adults with and without cancer, using propensity score matching
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2022
Abstract Body:
The number of adolescents and young adults (AYAs) cancer survivors are growing because of the increased cancer incidence and survival rate in this population. This age group is often aggregated with older or younger cancer populations, which hides critical differences in tumor biology, cancer distribution, and cancer survivorship. AYAs with cancer are more likely to have a high risk of late and long-term effects. Yet despite this high risk of late and long-term effects, little is known about developing chronic comorbidities, health practices, and health services utilization among AYAs with cancer. Therefore, the aim of this study is to assess chronic comorbidities, health practices, health services, and HRQOL among AYAs with and without cancer, using Andersen's behavioral model of health services use.We used a cross-sectional, matched case-control design; data were from the Texas Behavioral Risk Factor Surveillance System for 2015-2019. AYAs aged between 18 and 39 years and with cancer were matched to controls using propensity score matching to control for predisposing (age, sex, race/ethnicity, and education) and enabling (employment, marital status, income, and health insurance) factors. Weighted chi-square tests were used to compare differences in need for care, health practices, and health services utilization between AYAs with cancer and controls without cancer. Multiple logistic regression models were used to compare HRQOL outcomes. The final study sample consisted of 276 AYAs diagnosed with cancer and 828 controls, after propensity score matching. The AYAs with cancer were more likely to have chronic comorbidities, smoke, and avoid health services utilization because of cost in comparison with the matched controls. Multiple logistic regression showed significant differences in HRQOL between AYAs with cancer and controls: AYAs with cancer were more likely to have worse general health (OR = 2.488; 95% CI, 1.305-4.741) and worse perceived cognitive function (OR = 2.070; 95% CI, 1.076-3.919). AYAs with cancer experience more chronic comorbidities, smoking, financial barriers to health service, and worse HRQOL than do AYAs without cancer. Thus age-appropriate tailored surveillance and survivorship support/resources are needed for AYAs with cancer.
Keywords: Adolescents and young adults with cancer, health-related quality of life, propensity score matching