Department of Public Health Sciences, Henry Ford Health System, Detroit, MI; Department of Otolaryngology Head and Neck Surgery, Henry Ford Health System, Detroit, MI.
Saint Louis University School of Medicine, St. Louis, MO.
Ann Epidemiol. 2022 Aug;72:48-56. doi: 10.1016/j.annepidem.2022.03.014. Epub 2022 Apr 9.
We examined emotional distress in cancer survivors diagnosed as adolescents or young adults (AYAs) versus cancer survivors diagnosed as middle/older adults and versus the general population without a history of cancer.
Using the 2014-2017 National Health Interview Surveys, 2500 AYA survivors (initial cancer diagnosed between aged 15-39 years) were matched with 2500 middle/older adult survivors (initial cancer diagnosed at aged ≥40 years) as well as with 1609 from the general population without a history of cancer. Multinomial logistic regression models estimated the risk of emotional distress (measured using the validated Kessler distress (K6) scale) in the study population (AYA vs. middle/older adult cancer survivors and vs. general population without cancer), adjusting for known covariates.
Emotional distress was more prevalent among AYAs (average age 52.8 ± 19.1 years) than middle/older adult (average age 67.4 ± 14.0 years) cancer survivors (moderate: 25.5% vs. 19.4%; and severe: 6.4% vs. 4.4% [P < .0001]); however, there was no difference in emotional distress between AYA cancer survivors (moderate: 26.8% and severe: 7.5%) versus general population without cancer (moderate: 23.7% and severe: 6.2%). In the multivariable multinomial analyses, AYA cancer survivors had higher risk of reporting emotional distress (adjusted relative risk = 1.45; 95% confidence interval = 1.13-1.86) than middle/older adult cancer survivors.
Psychosocial support may be especially needed for cancer survivors diagnosed as adolescents or young adults to mitigate adverse psychosocial outcomes.
我们研究了青少年或青年期（AYA）诊断的癌症幸存者、中年/老年期诊断的癌症幸存者以及无癌症病史的一般人群的情绪困扰。
使用 2014-2017 年全国健康访谈调查，将 2500 名 AYA 幸存者（初始癌症诊断年龄为 15-39 岁）与 2500 名中年/老年幸存者（初始癌症诊断年龄≥40 岁）以及 1609 名无癌症病史的一般人群相匹配。多变量逻辑回归模型估计了研究人群（AYA 与中年/老年癌症幸存者和无癌症一般人群）中情绪困扰的风险（使用经过验证的 Kessler 困扰（K6）量表测量），并调整了已知的协变量。
情绪困扰在 AYA（平均年龄 52.8±19.1 岁）中比中年/老年癌症幸存者（平均年龄 67.4±14.0 岁）更为普遍（中度：25.5%比 19.4%；严重：6.4%比 4.4%[P<0.0001]）；然而，AYA 癌症幸存者与无癌症一般人群之间的情绪困扰没有差异（中度：26.8%和严重：7.5%）。在多变量多分类分析中，AYA 癌症幸存者报告情绪困扰的风险更高（调整后的相对风险=1.45；95%置信区间=1.13-1.86）比中年/老年癌症幸存者。
对于被诊断为青少年或青年期的癌症幸存者，可能特别需要提供社会心理支持，以减轻不良的社会心理后果。
