Tufts Medical Center/Tufts University School of Medicine, Boston, MA
Susan K. Parsons, Rachel Murphy-Banks, Angie Mae Rodday, Kimberly A. Miller, Nadine Linendoll, Howland E. Crosswell, Michael Roth, David R. Freyer
Background: Young adults (YA) have been identified by the American Society of Clinical Oncology as a special population having unmet needs during the transition into survivorship care (SC). These include concerns with financial/insurance status and care coordination, which are compounded further by racial, ethnic, gender, and socioeconomic disparities. The primary aim of this analysis was to describe the proportion of YA survivors, who had been diagnosed in childhood (<18 years) or young adulthood (≥ 18 years), engaging in SC after treatment for leukemia or lymphoma. Methods: The present analysis was part of a fully remote, multi-site, randomized effectiveness-implementation trial on financial distress, which closed to recruitment in April 2023. At trial entry, participants were aged 18- 39 years, ≥3 years post-diagnosis, and in remission. 45% were diagnosed in childhood; 55% as YA. At baseline, participants reported their current SC status. Operationally, SC was defined as care that addresses prevention, surveillance, intervention for the consequences of treatment, and care coordination; a treatment summary (TS) was defined as a document summarizing all cancer treatment received. Using chi-square tests participants were compared by receiving SC and having a TS versus not. Results: The cohort included 130 YA from 18 states who were a mean age of 30 years (SD=5), 60% female, 33% Hispanic, 22% non-Hispanic/non-White (NHNW), and 53% were ≥10 years from diagnosis.Being in SC and having a TS were each endorsed by 46% of participants. Those receiving SC were significantly more likely to be non-Hispanic White (NHW) or have at least a college education compared to those not receiving SC; there were no differences in age at diagnosis or insurance (see Table). There were no statistically significant differences by age group at diagnosis or other characteristics by whether they received a TS. Conclusions: Fewer than half of YA were in SC or had a TS. Providers should encourage long-term follow up care, especially with survivors at further risk based on health care disparities. Clinical trial information: NCT05620979.
In SC | Not in SC | p-value | Has TS | No TS | p-value | |
---|---|---|---|---|---|---|
Total | 57 (46%) | 68 (54%) | 57 (46%) | 68 (54%) | ||
Diagnosed at <18 years | 25 (44) | 31 (46) | 0.85 | 27 (47) | 29 (43) | 0.60 |
Race/Ethnicity | 0.01 | 0.84 | ||||
Hispanic | 12 (21) | 28 (42) | 17 (30) | 23 (35) | ||
NHNW | 11 (19) | 16 (24) | 13 (23) | 14 (21) | ||
NHW | 34 (60) | 22 (33) | 27 (47) | 29 (44) | ||
≥ College Education | 42 (74) | 37 (55) | 0.03 | 39 (68) | 40 (60) | 0.31 |
Private insurance only | 38 (67) | 43 (64) | 0.77 | 40 (70) | 41 (61) | 0.30 |
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