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Prevalence, severity, and predictors of symptom burden among adolescents and young adults with cancer.


ABSTRACT:

Background

Symptom burden in adolescents and young adults (AYA) with cancer is poorly characterized but impacts quality of life.

Methods

All Ontario, Canada AYA aged 15-29 years at diagnosis between 2010 and 2018 were linked to population-based healthcare databases, including to Edmonton Symptom Assessment System-revised (ESAS) scores, an 11-point scale routinely obtained at the time of cancer-related outpatient visits and collected provincially. Multistate models estimated mean duration of symptom severity states [none (0) vs. mild (1 vs. 2 vs. 3) vs. moderate (4-6) vs. severe (7-10)], trajectories, and subsequent mortality risk. Variables associated with severe symptoms were also determined.

Results

In total, 4296 AYA with ≥1 ESAS score within a year of diagnosis were included (median age 25 years). Prevalent moderate/severe symptoms included fatigue (59% of AYA) and anxiety (44%). Across symptom type, AYA reporting moderate symptoms were likelier to subsequently experience improvement versus worsening. Risk of death within 6 months increased with increasing symptom burden and was highest in AYA with severe dyspnea (9.0%), pain (8.0%), or drowsiness (7.5%). AYA in the poorest urban neighborhoods were more likely to experience severe symptoms than in the wealthiest areas, with twice the odds of reporting severe depression [adjusted odds ratio (OR) 1.95, 95th confidence interval (95% CI) 1.37-2.78], pain (OR: 1.94, 95% CI: 1.39-2.70), and dyspnea (OR: 1.96, 95% CI: 1.27-3.02).

Conclusions

AYA with cancer experience substantial symptom burden. Risk of death increased with symptom severity. Interventions targeting cancer fatigue and anxiety, and targeting AYA in lower-income neighborhoods, are likely to improve quality of life in this population.

SUBMITTER: Gupta S 

PROVIDER: S-EPMC10242332 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Prevalence, severity, and predictors of symptom burden among adolescents and young adults with cancer.

Gupta Sumit S   Li Qing Q   Nathan Paul C PC   D'Agostino Norma N   Baxter Nancy N NN   Fox Colleen C   Chalifour Karine K   Coburn Natalie N   Sutradhar Rinku R  

Cancer medicine 20230327 10


<h4>Background</h4>Symptom burden in adolescents and young adults (AYA) with cancer is poorly characterized but impacts quality of life.<h4>Methods</h4>All Ontario, Canada AYA aged 15-29 years at diagnosis between 2010 and 2018 were linked to population-based healthcare databases, including to Edmonton Symptom Assessment System-revised (ESAS) scores, an 11-point scale routinely obtained at the time of cancer-related outpatient visits and collected provincially. Multistate models estimated mean d  ...[more]

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