Medical Oncology, BC Cancer, Vancouver Centre, Vancouver, Canada.
Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada.
J Adolesc Young Adult Oncol. 2020 Aug;9(4):540-545. doi: 10.1089/jayao.2019.0157. Epub 2020 Apr 7.
Adolescents and young adults (AYA) (18-40) are a population of patients with cancer, who have distinctive developmental and psychosocial pressures. Using validated distress screening tools, we investigated psychosocial needs of AYA compared to older adults with cancer at diagnosis. AYA and older adult patients from British Columbia, Canada, between 2011 and 2016, who completed the Canadian Problem Checklist (CPC) and the PsychoSocial Screen for Cancer-Revised (PSSCAN-R) within 6 months of their cancer diagnosis were included in the study. Emotional, informational, physical, practical, social, and spiritual domain concerns are identified using the CPC. Psychosocial needs and distress are evaluated using the PSSCAN-R. Baseline demographics were obtained from the cancer registry. Based on gender, primary tumor site, and presence of metastasis, a 3:1 case match was performed with older adults (>40 years old). Statistical analyses included Chi square and Fisher's exact tests. Two thousand and forty five AYA were case matched with 6050 older adults. Majority of patients were female (61.9%), and at diagnosis, 12.1% had metastatic disease. Top three tumor types were breast (20.4%), lymphoma (11.5%), and gastrointestinal (10.8%). The top five concerns for AYA (% AYA, % adults) were fear/worry (56.6, 42.9), understanding of illness (47.6, 41.4), sleep (35.2, 28.9), sadness (34.1, 20.0), and finances (33.8, 15.0). AYA reported higher symptoms of anxiety at baseline (% AYA, % older adults), both moderate (26.0, 19.9) and severe (26.6, 17.1) < 0.01. Significant differences in psychosocial needs for AYA were seen at diagnosis across multiple domains, specifically, higher emotional, informational, physical, and financial distress. Development of supportive programming geared toward these domains early at diagnosis could benefit this distinct population.
青少年和年轻成年人（AYA）（18-40 岁）是癌症患者群体，他们面临着独特的发展和心理社会压力。本研究使用经过验证的困扰筛查工具，调查了 AYA 与癌症确诊时的老年患者相比的心理社会需求。2011 年至 2016 年期间，加拿大不列颠哥伦比亚省的 AYA 和老年成年患者在癌症诊断后 6 个月内完成了加拿大问题清单（CPC）和癌症修订后的心理社会筛查（PSSCAN-R），纳入了本研究。使用 CPC 确定情感、信息、身体、实际、社会和精神领域的关注点。使用 PSSCAN-R 评估心理社会需求和困扰。基线人口统计学数据从癌症登记处获得。根据性别、原发肿瘤部位和转移的存在，对老年患者（>40 岁）进行了 3:1 的病例匹配。统计分析包括卡方检验和 Fisher 确切检验。2045 名 AYA 与 6050 名老年患者进行了病例匹配。大多数患者为女性（61.9%），诊断时 12.1%有转移性疾病。排名前三的肿瘤类型是乳腺癌（20.4%）、淋巴瘤（11.5%）和胃肠道癌（10.8%）。AYA 的前五大关注点（%AYA，%成年人）是恐惧/担忧（56.6，42.9）、对疾病的了解（47.6，41.4）、睡眠（35.2，28.9）、悲伤（34.1，20.0）和财务（33.8，15.0）。AYA 在基线时报告了更高的焦虑症状（%AYA，%老年人），无论是中度（26.0，19.9）还是重度（26.6，17.1），均 < 0.01。在多个领域，AYA 在确诊时的心理社会需求存在显著差异，特别是情绪、信息、身体和财务方面的困扰更高。在确诊时早期针对这些领域制定支持性计划可能会使这一独特群体受益。
