School of Nursing, Indiana University, 1111 Middle Drive, Indianapolis, IN 46202, USA.
Support Care Cancer. 2013 Jun;21(6):1597-604. doi: 10.1007/s00520-012-1701-7. Epub 2013 Jan 10.
Each year, nearly 21,000 adolescents and young adults (AYA) ages 15 to 29 years are diagnosed with cancer. Breast and gynecological cancers account for 25% of the cancers seen in AYA females. The purpose of this study was to compare the current physical and mental health status of female AYA cancer survivors with non-cancer female controls.
Using data from the population-based 2009 National Health Interview Survey, 100 cases of female AYA survivors of breast and gynecological cancers were identified [female AYA cancer survivor (FCS) group]. FCS cases were matched with 300 female respondents without a history of cancer on age, education, marital status, and minority status [non-cancer control (NCC) group]. The FCS and NCC groups were compared on a range of physical and mental health status indices using analysis of covariance and binary logistic regression.
FCS group reported significantly poorer physical and mental health status than the matched controls. Relative to the NCC group, FCS survivors had significantly poorer scores on 7 of 8 mental health outcomes and were more likely to meet criteria for serious psychological distress (odds ratio = 4.23, p ≤ 0.001). FCS group also reported greater lifetime and current prevalence of various medical conditions, more health-related disabilities, and greater functional limitations than the NCC group.
Diagnosis of breast and gynecological cancer during adolescence and young adulthood is associated with clinically important deficits in physical and mental health status. Given the young age of this cancer survivor cohort, increased attention should be devoted to minimizing these deficits.
每年有近 21000 名 15 至 29 岁的青少年和年轻人(AYA)被诊断患有癌症。乳腺癌和妇科癌症占 AYA 女性癌症的 25%。本研究的目的是比较女性 AYA 癌症幸存者与非癌症女性对照者目前的身心健康状况。
利用基于人群的 2009 年全国健康访谈调查数据,确定了 100 例女性 AYA 乳腺癌和妇科癌症幸存者(FCS)。FCS 病例与 300 名无癌症病史的女性在年龄、教育程度、婚姻状况和少数民族地位方面相匹配[非癌症对照组(NCC)]。使用协方差分析和二项逻辑回归比较 FCS 组和 NCC 组在一系列身心健康状况指标上的差异。
FCS 组报告的身心健康状况明显差于匹配对照组。与 NCC 组相比,FCS 幸存者在 8 项心理健康结果中的 7 项得分明显较低,且更有可能符合严重心理困扰的标准(比值比=4.23,p≤0.001)。FCS 组还报告了更多的终生和当前各种医疗状况、更多的健康相关残疾和更大的功能限制,与 NCC 组相比。
青少年和年轻成人诊断为乳腺癌和妇科癌症与身心健康状况存在明显的临床缺陷有关。鉴于该癌症幸存者队列的年轻年龄,应更加关注最大限度地减少这些缺陷。