– Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, United States
Background: The needs of Adolescent and Young Adult (AYA) cancer survivors diagnosed between 15-39 are inadequately met by current care systems.
Objectives: This project was to stratify unmet need risks associated with clinical or non-clinical factors to supportive services.
Methods: Setting: Using administrative claims and national health behavior survey (BRFSS) datasets, cancer survivors (n=7,288) of three age-specific groups including adolescent (15-18), emerging (19-25), and young adults (26-39) were compared. Exposures or interventions: Unmet needs were measured for those who did not receive any cancer care summaries compared to their counterparts. Main outcome measures: Five unmet needs contexts including physical, mental, accessible, developmental, and behavioral health were compared between unmet versus met groups. Statistical analysis: Descriptive and hierarchical clustering were performed to identify unmet risks and their patterns.
Results: The unmet AYA survivors show a 2.8 times higher unemployment rate (7.60% vs. 2.70%) compared to adult survivors. In fact, they described not being able to work due to cancer (13.40% vs. 5.80%). Our findings highlight social health determinants as potential factors which include low income (less than $15,000), ethnic minority (non-White), and rural residency (not in MSA). Low-income related risks were observed as the greatest gap and rurality related risks were observed in the adolescent group in comparison to the other AYA groups.
Conclusions: Our preliminary findings identified high risks of psychosocial unmet needs and reproductive concerns in clinical unmet needs. Ultimately, this project expects to determine how perceived risks with relevance to high unmet demands may vary over the course of survivorship. Predicting unmet patterns of referred supportive services could determine optimal strategy to reinforce local cancer care needs.
