Health-related quality of life and supportive care needs in young adult cancer survivors—a longitudinal population-based study

• Published in: Supportive care in cancer 2024, Vol.32 (11), p.742, Article 742
• Main Authors: Wide, Alexandra, Ahlgren, Johan, Smedby, Karin E., Hellman, Kristina, Henriksson, Roger, Ståhl, Olof, Lampic, Claudia, Wettergren, Lena
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cancer; Cancer Survivors - psychology; Cancer Survivors - statistics & numerical data; Female; Health Services Needs and Demand; HRQoL; Humans; Logistic Models; Longitudinal Studies; Lymphoma; Male; Medicine; Medicine & Public Health; Neoplasms - psychology; Neoplasms - therapy; Nursing; Nursing Research; Oncology; Pain Medicine; Psycho-oncology; Quality of Life; Rehabilitation Medicine; Social Support; Supportive care needs; Surveys and Questionnaires; Survivor; Survivors; Sweden; Testicular cancer; Young Adult; Young adults
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-024-08896-3

Purpose To examine health-related quality of life (HRQoL) and supportive care needs among young adult (YA) cancer survivors up to 3 years post-diagnosis. Methods A national cohort of individuals diagnosed at 18–39 years with breast, cervical, ovarian, or testicular cancer, lymphoma or brain tumor was approached with surveys at 1.5 ( n  = 1010, response rate 67%) and 3 ( n  = 722) years post-diagnosis. HRQoL was measured using the EORTC QLQ-C30. Scores were dichotomized using cut-off scores to predict supportive care needs in the Supportive Care Needs Survey-Long Form 59 (SCNS-LF59). Swedish cancer quality registers provided clinical data. Factors predicting need of support at 1.5 and 3 years post-diagnosis were identified using logistic regression. Results HRQoL improvements over time were trivial to small. At both time points, a majority of respondents rated HRQoL levels indicating supportive care needs. At 1.5 years post-diagnosis, the risk of having support needs was lower among survivors with testicular cancer (compared to lymphoma) or university-level education, and higher among those on treatment (predominantly endocrine therapy). At 3 years post-diagnosis, when controlling for previous HRQoL scores, most correlations persisted, and poor self-rated household economy and chronic health conditions were additionally associated with supportive care needs. Conclusion A majority of YAs diagnosed with cancer rate HRQoL at levels indicating support needs up to 3 years post-diagnosis. Testicular cancer survivors are at lower risk of having support needs. Concurrent health conditions and poor finances are linked to lower HRQoL. More efforts are needed to provide adequate, age-appropriate support to YA cancer survivors.