Wang Rebecca, Syed Iqra A, Nathan Paul C, Barr Ronald D, Rosenberg-Yunger Zahava R S, Klassen Anne F
J Adolesc Young Adult Oncol. 2015 Dec;4(4):192-9. doi: 10.1089/jayao.2015.0029.
Adolescent and young adult (AYA) survivors of cancers in childhood experience cancer worry, defined as concerns about cancer-related issues such as relapse and late effects of treatment. Cancer worry is an important determinant of successful transition to long-term follow-up care. The primary aim of this study was to identify patient-, cancer-, and treatment-related factors associated with cancer worry in AYA survivors. A secondary aim was to explore and understand inappropriate cancer worry (e.g., worry of developing a late effect when not at risk) in this population.
Two hundred and fifty AYA survivors, aged 15–26 years, completed a 6-item Cancer Worry Scale. Selection of factors potentially associated with cancer worry was guided by literature and expert opinion for inclusion in univariable and multivariable regression analyses.
Female survivors reported significantly more cancer worry than males did (b=-9.4; 95% CI -14.4 to -4.5; p < 0.001). Survivors treated with the most intensive therapies reported more cancer worry compared with those who received the least intensive therapies (b=-18.5; 95% CI -31.2 to -5.9; p = 0.004). Thirty-one percent of participants had inappropriate worry regarding infertility and/or secondary malignancy.
In AYA survivors, female sex and higher treatment intensity were associated with increased cancer worry. Inappropriate worry was prevalent among survivors and may contribute to unnecessary distress. These findings can help identify survivors who are more likely to worry and support the development of appropriate services to reduce the effect of cancer worry on survivor well-being.
儿童期癌症的青少年和青年（AYA）幸存者会经历癌症担忧，即对与癌症相关问题的担忧，如复发和治疗的晚期效应。癌症担忧是成功过渡到长期后续护理的一个重要决定因素。本研究的主要目的是确定与AYA幸存者的癌症担忧相关的患者、癌症和治疗相关因素。次要目的是探索和了解该人群中不适当的癌症担忧（例如，在没有风险时担心出现晚期效应）。
250名年龄在15至26岁之间的AYA幸存者完成了一份6项的癌症担忧量表。潜在与癌症担忧相关因素的选择以文献和专家意见为指导，纳入单变量和多变量回归分析。
女性幸存者报告的癌症担忧明显多于男性（b=-9.4；95%CI -14.4至-4.5；p<0.001）。接受最强化治疗的幸存者比接受最不强化治疗的幸存者报告了更多的癌症担忧（b=-18.5；95%CI -31.2至-5.9；p=0.004）。31%的参与者对不孕和/或继发性恶性肿瘤存在不适当的担忧。
在AYA幸存者中，女性和更高的治疗强度与癌症担忧增加有关。不适当的担忧在幸存者中很普遍，可能会导致不必要的痛苦。这些发现有助于识别更可能担忧的幸存者，并支持开发适当的服务，以减少癌症担忧对幸存者幸福感的影响。
