Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, Texas, USA.
Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, San Antonio, Texas, USA.
J Adolesc Young Adult Oncol. 2023 Jun;12(3):324-330. doi: 10.1089/jayao.2022.0045. Epub 2022 Sep 29.
Adolescent and young adult cancer survivors (AYAs) experience early-onset chronic conditions and disrupted psychosocial development. We report prevalence of disruptions in care delivery and social support during the early wave of the pandemic in a national sample of AYAs in the United States. We used data from the population-based National Health Interview Survey (NHIS; July-December 2020), which allows for nationally representative estimates, and included questions related to COVID-19. We identified 61 AYAs diagnosed with cancer between ages 15 and 39 years and not currently receiving cancer treatment and 244 age- and sex-matched controls. We compared the proportion of AYAs and controls reporting delayed care due to the pandemic, not getting needed care due to the pandemic, and changes in social and emotional support. AYAs were predominantly non-Hispanic White (61.3%) and female (58.8%), with a median age at diagnosis of 28 years (interquartile range [IQR] 21-31 years). Fewer AYAs were employed (52.1% vs. 71.5%), and more lived in poverty (32.0% vs. 12.4%) and felt depressed daily (9.9% vs. 3.0%, all < 0.05). The proportion of AYAs reporting delayed care (39.8% vs. 15.3%) and not getting needed care (31.7% vs. 10.4%) due to the pandemic was more than double that of controls (both < 0.01). One in five AYAs experienced less social and emotional support compared to the prior year, although not significantly different from controls (21.6% vs. 12.4%, = 0.10). The pandemic disrupted AYAs' care and exacerbated their psychosocial challenges. Providers and health systems should prioritize reconnecting AYAs to affordable and comprehensive care.
青少年和年轻成人癌症幸存者（AYAs）经历早发性慢性疾病和心理社会发育中断。我们报告了在美国全国 AYA 样本中，在大流行的早期阶段，医疗服务提供和社会支持中断的流行率。我们使用了基于人群的全国健康访谈调查（NHIS；2020 年 7 月至 12 月）的数据，该调查允许进行全国代表性估计，并包含与 COVID-19 相关的问题。我们确定了 61 名年龄在 15 至 39 岁之间、目前未接受癌症治疗且被诊断患有癌症的 AYA，以及 244 名年龄和性别匹配的对照。我们比较了 AYA 和对照组因大流行而延迟治疗、因大流行而未获得所需治疗以及社会和情感支持变化的比例。AYA 主要为非西班牙裔白人（61.3%）和女性（58.8%），诊断时的中位年龄为 28 岁（四分位距 [IQR] 21-31 岁）。AYA 中就业的人数较少（52.1% vs. 71.5%），更多人生活在贫困中（32.0% vs. 12.4%），每天感到沮丧的比例更高（9.9% vs. 3.0%，均<0.05）。AYA 报告因大流行而延迟治疗（39.8% vs. 15.3%）和未获得所需治疗（31.7% vs. 10.4%）的比例是对照组的两倍多（均<0.01）。五分之一的 AYA 与前一年相比，社会和情感支持减少，尽管与对照组相比没有显著差异（21.6% vs. 12.4%，=0.10）。大流行扰乱了 AYA 的治疗，并加剧了他们的心理社会挑战。提供者和卫生系统应优先将 AYA 重新连接到负担得起的综合护理。
