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AYA Cancer Survivors at Greater Risk of Inpatient Hospitalization


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A population-based study investigating the risk of inpatient hospitalizations among adolescent and young adult (AYA) cancer survivors compared with their siblings and those in the general population found that the AYA survivors had nearly double the risk of being hospitalized than the matched cohort. The study’s findings indicate the importance of long-term, risk-based follow-up care for AYA survivors to prevent and treat severe morbidities after cancer treatment. The study by Anderson et al was published in Cancer Epidemiology, Biomarkers & Prevention.

According to the National Cancer Institute, each year, about 70,000 AYAs, defined as those between the ages of 15 and 39, are diagnosed with cancer in the United States. Although advances in cancer treatments have improved the 5-year relative survival for all invasive cancers diagnosed in AYAs to 82.5%, many long-term survivors may be at an increased risk for several adverse health outcomes as a result of late effects from their cancer therapy.

Photo credit: Getty

Study Methodology

The researchers used data from the Utah Population Database, which links statewide administrative records to cancer diagnosis information from the Utah Cancer Registry, to analyze the risk of first hospitalization and the rate of total hospitalizations among 6,330 AYA survivors diagnosed between 1994 and 2015 who were at least 2 years from their cancer diagnosis. The researchers also analyzed data from 12,924 siblings of the AYA patients and an 18,171 age- and sex-matched comparison cohort.

The researchers estimated multivariable-adjusted hazard ratios (HRs) for first hospitalization and rate ratios (RRs) for total hospitalizations for survivors relative to the matched comparison cohort and siblings.

KEY POINTS

  • AYA cancer survivors had nearly double the risk of being hospitalized compared with their siblings and unrelated age- and sex-matched cohorts.
  • Compared with controls, the risk of a first hospitalization increased 4.76-fold for survivors of leukemia; 3.45-fold for survivors of central nervous system cancers; 2.83-fold for survivors of colorectal cancer; 2.76-fold for survivors of non-Hodgkin lymphoma; and 2.37-fold for survivors of breast cancer.

Study Findings

The researchers found that, overall, the risk of a first hospitalization was higher among AYA cancer survivors than the matched population-based cohort (HR = 1.93; 95% confidence interval [CI] = 1.81–2.06). Risk was most elevated for survivors of leukemia (HR = 4.76), central nervous system cancers (HR = 3.45), colorectal cancers (HR = 2.83), non-Hodgkin lymphoma (HR = 2.76), and breast cancer (HR = 2.37). The rate of total hospitalizations was also increased among survivors relative to the comparison cohort (RR = 2.05; 95% CI = 1.95–2.14). Patterns were generally similar in analyses comparing survivors to their siblings.

“[These] results indicate the importance of long-term, risk-based follow-up care to prevent and treat severe morbidities after cancer treatment,” concluded the study authors.

Clinical Significance

“A better understanding of the burden of hospitalizations among AYA cancer survivors may help to anticipate future health-care utilization in more recently diagnosed patients,” said lead study author Chelsea Anderson, PhD, MPH, a postdoctoral fellow at the American Cancer Society, in a statement. “These findings may also inform the development of guidelines for follow-up care for adolescent and young adult cancer survivors.”

Dr. Anderson is the corresponding author of this study.

Disclosure: This study was funded by St. Baldrick’s Foundation. For full disclosures of the study authors, visit cepb.aacrjournals.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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