Factors Affecting Psychosocial Distress in Adolescents and Young Adults with Cancer: BRIGHTLIGHT Cross-Sectional and Longitudinal Cohort Study Results.

BACKGROUND/OBJECTIVES: AYAs face unique psychosocial challenges compared to younger children and older adults. Little published data exists about symptoms of psychological distress in AYAs, particularly in large cohorts over time. This study aimed to (1) explore relationships between distress and variables known to impact mental health, (2) examine distress over time, and (3) consult with a patient and public involvement group (Young Advisory Panel, YAP) to contextualize the results.

METHODS

Secondary data analyses were conducted from a multicentre longitudinal cohort study, which recruited 830 participants aged 13-24 years newly diagnosed with different cancers. The mean age was 20.1 (SD 3.3) and 45% were female. Bespoke surveys, including a validated measure of psychosocial distress, were administered five times over 3 years following diagnosis. Participatory workshops were conducted with the YAP to gather their impressions of the study results and inform conclusions.

RESULTS

At the first time point, higher social support was associated with higher distress scores (β = 0.202, < 0.001) and AYAs with higher depressive symptoms were more likely to see a mental health professional ( < 0.01). Over time, anxiety symptoms remained stable ( = 0.090); however, depressive symptoms improved ( < 0.001). The YAP highlighted the mixed effects of social support and the under-recognition and undertreatment of distress.

CONCLUSIONS

This information identifies key targets, such as social support, that can inform the design of personalized screening and intervention tools. It also highlights specific timepoints at which these efforts can be directed to mitigate distress and improve quality of life. Future research should include longer-term follow-up, qualitative explorations of distress along the disease trajectory, and ongoing co-production efforts.