Kirchhoff Anne C, Spraker-Perlman Holly L, McFadden Molly, Warner Echo L, Oeffinger Kevin C, Wright Jennifer, Kinney Anita Y
Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute , Salt Lake City, Utah. ; Center for Children's Cancer Research, Huntsman Cancer Institute , Salt Lake City, Utah. ; Department of Pediatrics, University of Utah , Salt Lake City, Utah.
Center for Children's Cancer Research, Huntsman Cancer Institute , Salt Lake City, Utah. ; Department of Pediatrics, University of Utah , Salt Lake City, Utah.
J Adolesc Young Adult Oncol. 2014 Jun 1;3(2):66-74. doi: 10.1089/jayao.2013.0035.
Survivors of cancer diagnosed during adolescence and young adulthood (AYA; aged 15-39) may experience quality of life (QOL) limitations; however, little is known about QOL for AYA survivors who are now middle-aged or among racial/ethnic minority survivors. We evaluated QOL outcomes for AYA cancer survivors relative to a non-cancer comparison group by gender, race/ethnicity, and current age. Using the 2009 Behavioral Risk Factor Surveillance System (BRFSS) data, we identified 8375 individuals diagnosed with cancer while aged 15-39 years old and 334,759 controls. Participants were currently ≥20 years of age. QOL was measured using four items from the Center for Disease Control's Healthy Days Measure (general health, number of days of poor physical and mental health, and activity limitation days). Multivariable regressions compared these measures for survivors and controls by gender, race/ethnicity, and age, and among survivors to determine cancer-related factors associated with poor QOL. Survivors were more likely to report fair/poor general health than controls (relative risk=1.92; 95% confidence interval: 1.77-2.10; <0.001). QOL limitations existed by gender and race/ethnicity for survivors. Approximately 30% of survivors currently in their 40s, 50s, and early 60s were in poor health, compared to less than 20% of same-aged controls (both <0.001). Of survivors with two or more cancers, 41.0% reported poor health, compared to 26.2% with one cancer (<0.001). AYA cancer survivors have worse QOL compared to the general population and these limitations persist across gender, race/ethnicity, and age. Targeted interventions are essential for improving AYA cancer survivors' health status.
在青春期和青年期（15 - 39岁）被诊断出患有癌症的幸存者可能会经历生活质量（QOL）受限的情况；然而，对于现在已步入中年的青春期和青年期癌症幸存者或种族/族裔少数群体幸存者的生活质量，我们却知之甚少。我们按性别、种族/族裔和当前年龄，评估了青春期和青年期癌症幸存者相对于非癌症对照组的生活质量结果。利用2009年行为危险因素监测系统（BRFSS）的数据，我们识别出8375名在15 - 39岁时被诊断患有癌症的个体以及334,759名对照者。参与者当前年龄≥20岁。生活质量通过疾病控制中心健康日测量的四个项目进行衡量（总体健康状况、身心健康不佳的天数以及活动受限天数）。多变量回归按性别、种族/族裔和年龄比较了幸存者和对照者的这些指标，并在幸存者中确定与生活质量差相关的癌症相关因素。与对照者相比，幸存者更有可能报告总体健康状况为一般/较差（相对风险 = 1.92；95%置信区间：1.77 - 2.10；<0.001）。幸存者在性别和种族/族裔方面存在生活质量受限的情况。目前40多岁、50多岁和60岁出头的幸存者中约30%健康状况较差，而同年龄段对照者中这一比例不到20%（两者均<0.001）。在患有两种或更多种癌症的幸存者中，41.0%报告健康状况较差，而患有一种癌症的幸存者中这一比例为26.2%（<0.001）。与一般人群相比，青春期和青年期癌症幸存者的生活质量更差，且这些受限情况在性别、种族/族裔和年龄方面持续存在。有针对性的干预对于改善青春期和青年期癌症幸存者的健康状况至关重要。
