Betts Andrea C, Eary Rebecca, Thakur Bhaskar, Hughes Amy, Booker Quiera S, Shay L Aubree, Lee Simon Craddock, Bowers Daniel C, Balasubramanian Bijal A
Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA.
Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Cancer Med. 2025 May;14(9):e70924. doi: 10.1002/cam4.70924.
Survivors of childhood, adolescent, and young adult cancers (CAYA) experience lifelong health risks and accelerated aging. We examined routine health care (no routine checkup in the past year) among a nationally representative sample of CAYA survivors at different life stages.
We pooled data from the Behavioral Risk Factor Surveillance System (BRFSS; 2012, 2014, 2016-2019). CAYA survivors (ages 0-39 at cancer diagnosis) were young adults (18-39 years), middle-aged (40-64 years), or older adults (≥ 65 years) at the time of the survey. We estimated the prevalence of: (1) not receiving routine health care and (2) not having a personal doctor, overall and by age at survey. We used multivariable Poisson regression to identify factors associated with these outcomes.
We identified 4284 CAYA survivors: 884 young adults, 2201 middle-aged, and 1199 older adults. More young adults were uninsured and unable to afford care, compared to other age groups. A higher proportion of young adults did not receive routine health care (35.9%, 95% CI 30.3-41.9) or have a personal doctor (25.6%, 95% CI 20.5-31.4), compared to middle-aged or older CAYA survivors (p < 0.01). In multivariable models, being a young adult was strongly associated with (1) not receiving routine health care (aPR 1.82, 95% CI 1.24-2.67) and (2) not having a personal doctor (aPR 3.14, 95% CI 1.84-5.35).
Younger CAYA survivors experience a triple threat of chronic conditions, modifiable risks, and disconnection from routine health care.
Early interventions to facilitate care transitions are needed.
儿童、青少年和青年癌症（CAYA）幸存者面临着终身健康风险和加速衰老的问题。我们在全国代表性的不同生命阶段的CAYA幸存者样本中调查了常规医疗保健情况（过去一年未进行常规体检）。
我们汇总了行为风险因素监测系统（BRFSS；2012年、2014年、2016 - 2019年）的数据。CAYA幸存者（癌症诊断时年龄为0 - 39岁）在调查时分别为青年（18 - 39岁）、中年（40 - 64岁）或老年（≥65岁）。我们估计了以下情况的患病率：（1）未接受常规医疗保健；（2）没有私人医生，总体情况以及按调查时的年龄进行估计。我们使用多变量泊松回归来确定与这些结果相关的因素。
我们识别出4284名CAYA幸存者：884名青年、2201名中年和1199名老年。与其他年龄组相比，更多青年未参保且无力承担医疗费用。与中年或老年CAYA幸存者相比，更高比例的青年未接受常规医疗保健（35.9%，95%置信区间30.
