Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Cancer Surviv. 2024 Dec;18(6):1931-1940. doi: 10.1007/s11764-023-01433-x. Epub 2023 Aug 14.
The US population of adolescent and young adult (age 15-39 years at diagnosis) cancer survivors is growing. Previous studies have identified racial and ethnic disparities in survival and health outcomes in racially minoritized survivors, including Black survivors, compared with White survivors. However, comparisons should be made between those of the same race or ethnicity with and without a history of AYA cancer to fully understand the association of a cancer diagnosis with socioeconomic status (SES) and health outcomes within a minoritized population.
Non-Hispanic Black AYA cancer survivors and non-Hispanic Black age- and sex-matched controls were identified from self-reported data from the National Health Interview Survey (2009-2018). SES factors and chronic health conditions prevalence were compared between survivors and controls using chi-square tests. Survey-weighted logistic regression models were used to determine odds of chronic conditions by SES factors within and between survivors and controls. Interactions between each variable and cancer group were assessed.
A total of 445 survivors and 4450 controls were included. Survivors were less likely than controls to be married, have family income >45K/year, have completed a bachelor's degree or higher, and have private insurance. Survivors had higher odds than controls of having at least one (odds ratio (OR): 7.02, p<0.001) and ≥3 (OR: 4.44, p<0.001) chronic conditions. Survivors had higher odds of each chronic condition assessed including cardiovascular disease, diabetes, and hypertension. Survivors had higher odds of having chronic health conditions compared with controls across all SES variables.
A cancer diagnosis during adolescence and young adulthood is associated with poor SES outcomes and increased odds of comorbidities within the Black population, thus further exacerbating existing disparities.
Black AYA cancer survivors have a very high risk of developing chronic health conditions after cancer treatment and interventions are needed to improve long-term health outcomes for this population.
美国青少年和年轻成年人（诊断时年龄为 15-39 岁）癌症幸存者人数不断增加。先前的研究已经确定了少数族裔幸存者中生存和健康结果的种族和民族差异，包括与白人幸存者相比的黑人幸存者。然而，为了充分了解癌症诊断与少数族裔人群中社会经济地位（SES）和健康结果之间的关联，应该在具有和不具有青少年癌症病史的同一种族或族裔之间进行比较。
从国家健康访谈调查（2009-2018 年）的自我报告数据中确定了非西班牙裔黑人青少年和年轻成年人癌症幸存者和非西班牙裔黑人年龄和性别匹配的对照组。使用卡方检验比较幸存者和对照组之间 SES 因素和慢性健康状况的患病率。使用调查加权逻辑回归模型确定幸存者和对照组内部和之间 SES 因素与慢性疾病的几率。评估了每个变量与癌症组之间的相互作用。
共纳入 445 名幸存者和 4450 名对照组。与对照组相比，幸存者更有可能未婚、家庭收入>45K/年、完成学士学位或更高学历、拥有私人保险。与对照组相比，幸存者更有可能至少有一种（优势比（OR）：7.02，p<0.001）和≥3 种（OR：4.44，p<0.001）慢性疾病。与对照组相比，幸存者患有心血管疾病、糖尿病和高血压等每种慢性疾病的几率更高。在所有 SES 变量中，与对照组相比，幸存者患有慢性健康状况的几率更高。
青少年和年轻成年人期间的癌症诊断与不良 SES 结果相关，并且在黑人人群中增加了合并症的几率，从而进一步加剧了现有的差异。
黑人青少年和年轻成年人癌症幸存者在癌症治疗后患有慢性健康状况的风险非常高，需要采取干预措施来改善这一人群的长期健康结果。
