Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia.
Research, Evaluation and Social Policy Canteen Australia, Sydney, New South Wales, Australia.
Psychooncology. 2022 Sep;31(9):1448-1458. doi: 10.1002/pon.5987. Epub 2022 Jul 2.
Most adolescents and young adults (AYA) can expect to survive a cancer diagnosis and treatment, but all will be left with the potential of long-term negative effects that can impact their ability to reach their full potential in life. Understanding aspects of psychological, functional, and social health and well-being outcomes, is pivotal for optimising long-term well-being.
We completed a systematic review of longitudinal studies reporting outcomes after anti-cancer treatment for Adolescents and Young Adults diagnosed between the age of 12-29 years according to established systematic review processes. The protocol was registered with PROSPERO (ID: CRD 42020203116).
Thirteen reports from 10 studies met eligibility criteria representing 17,645 individuals (50.3% female, mean age at diagnosis 22 years, and 26 years at last, follow up). Eleven reports were from eight quantitative studies that relied on self-report surveys and two were qualitative studies. Psychological outcomes were reported to improve over time, as were functional health outcomes, although reported health behaviours were inconsistent between studies. Neurocognitive deficits were reported to affect the ability to return to work and impacts on fertility and sexuality were sustained over time.
While some outcomes for AYA are reported to improve over time, particularly for physical functioning, and anxiety and depression, the long-term impact of cancer on many important domains remains largely unknown. Specifically, the evidence to understand what changes occur over time, and when, remains underdeveloped.
大多数青少年和年轻成年人（AYA）可以期望从癌症诊断和治疗中存活下来，但所有人都有可能产生长期的负面影响，这可能会影响他们在生活中充分发挥潜力的能力。了解心理、功能和社会健康及福祉结果的各个方面，对于优化长期福祉至关重要。
我们根据既定的系统审查程序，对报告青少年和年轻成年人（诊断年龄为 12-29 岁）接受抗癌治疗后结果的纵向研究进行了系统审查。该方案已在 PROSPERO（注册号：CRD 42020203116）上注册。
有 10 项研究的 13 份报告符合入选标准，共涉及 17645 人（50.3%为女性，诊断时的平均年龄为 22 岁，最后一次随访时的年龄为 26 岁）。11 份报告来自 8 项定量研究，这些研究依赖于自我报告调查，有 2 份为定性研究。研究报告称，心理结果随着时间的推移而改善，功能健康结果也是如此，尽管研究之间的健康行为报告不一致。报告称，神经认知缺陷会影响重返工作的能力，对生育和性的影响会随着时间的推移而持续存在。
虽然一些 AYA 的结果随着时间的推移而有所改善，特别是身体功能、焦虑和抑郁方面，但癌症对许多重要领域的长期影响在很大程度上仍未知。具体来说，对于随着时间的推移会发生什么变化以及何时发生变化的理解，证据仍然不充分。
