Graduate Group of Epidemiology, University of California, Davis, One Shields Avenue, Davis, CA, 95616, USA.
Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.
J Cancer Surviv. 2022 Jun;16(3):487-496. doi: 10.1007/s11764-021-01044-4. Epub 2021 Apr 26.
Adolescent and young adult (AYA) cancer survivors are more likely to have multiple chronic conditions compared to AYAs without history of cancer. The financial hardship of chronic conditions associated with cancer can substantially impact cancer survivors. We aim to assess health risk behaviors and health care access factors associated with increased medical expenses in AYA cancer survivors.
We utilized 2011-2016 Medical Expenditure Panel Survey (MEPS) data to identify the prevalence of chronic conditions, health risk behaviors, and health care access in 2326 AYA cancer survivors. The association between health risk behaviors, health care access factors, and chronic conditions with medical expenditures was assessed using multivariable regression with gamma distribution and log link. Analyses were adjusted for age, sex, race/ethnicity, education, and marital status. Expenses were adjusted for inflation to 2016 dollars.
Most AYA cancer survivors had ≥1 chronic condition (74%) and were diagnosed with cancer ≥10 years prior to the survey (76%). AYA cancer survivors with chronic conditions spent an additional $2777 (95% CI, $480 to $5958) annually compared to survivors with no chronic conditions. Additional annual expenses also were associated with physical inactivity ($3558; 95% CI, $2200 to $4606) and being unable to get care when needed ($1291; 95% CI, $198 to 3335).
Chronic conditions are associated with a substantial increase in medical expenses well after cancer diagnosis in AYA cancer survivors.
Getting care when needed and adopting healthy behaviors, particularly exercise, may reduce medical expenses associated with chronic conditions in AYAs.
与无癌症病史的青少年和年轻成年人（AYA）相比，AYA 癌症幸存者更有可能患有多种慢性疾病。与癌症相关的慢性疾病的经济困难会对癌症幸存者产生重大影响。我们旨在评估与癌症幸存者医疗费用增加相关的健康风险行为和获得医疗保健的因素。
我们利用 2011-2016 年医疗支出面板调查（MEPS）数据，确定了 2326 名 AYA 癌症幸存者中慢性疾病、健康风险行为和获得医疗保健的流行情况。使用具有伽马分布和对数链接的多变量回归评估健康风险行为、获得医疗保健的因素与慢性疾病与医疗支出之间的关联。分析调整了年龄、性别、种族/民族、教育程度和婚姻状况。费用根据通货膨胀调整为 2016 年美元。
大多数 AYA 癌症幸存者患有≥1 种慢性疾病（74%），并且在调查前≥10 年被诊断患有癌症（76%）。与无慢性疾病的幸存者相比，患有慢性疾病的 AYA 癌症幸存者每年额外花费 2777 美元（95%CI，480 美元至 5958 美元）。身体不活动（3558 美元；95%CI，2200 美元至 4606 美元）和需要时无法获得护理（1291 美元；95%CI，198 美元至 3335 美元）也与额外的年度费用有关。
在 AYA 癌症幸存者中，诊断癌症后多年，慢性疾病与医疗费用的大幅增加有关。
当需要时获得护理并采取健康行为，特别是锻炼，可能会降低 AYA 慢性疾病相关的医疗费用。
