Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
Theresa H M Keegan, Li Tao, Mindy C DeRouen, Xiao-Cheng Wu, Pinki Prasad, Charles F Lynch, Margarett Shnorhavorian, Brad J Zebrack, Roland Chu, Linda C Harlan, Ashley W Smith, Helen M Parsons, AYA HOPE Study Collaborative Group, Rosemary Cress, Gretchen Agha, Mark Cruz, Stephen M Schwartz, Martha Shellenberger, Tiffany Janes, Ikuko Kato, Ann Bankowski, Marjorie Stock, Xiao-cheng Wu, Vivien Chen, Bradley Tompkins, Theresa Keegan, Laura Allen, Zinnia Loya, Lisa Shelton-Herendeen, Charles F Lynch, Michele M West, Lori A Odle, Ann Hamilton, Jennifer Zelaya, Mary Lo, Urduja Trinidad, Linda C Harlan, Ashley Wilder Smith, Jana Eisenstein, Gretchen Keel, Arnold Potosky, Keith Bellizzi, Karen Albritton, Michael Link, Brad Zebrack, Theresa H M Keegan, Li Tao, Mindy C DeRouen, Xiao-Cheng Wu, Pinki Prasad, Charles F Lynch, Margarett Shnorhavorian, Brad J Zebrack, Roland Chu, Linda C Harlan, Ashley W Smith, Helen M Parsons, AYA HOPE Study Collaborative Group, Rosemary Cress, Gretchen Agha, Mark Cruz, Stephen M Schwartz, Martha Shellenberger, Tiffany Janes, Ikuko Kato, Ann Bankowski, Marjorie Stock, Xiao-cheng Wu, Vivien Chen, Bradley Tompkins, Theresa Keegan, Laura Allen, Zinnia Loya, Lisa Shelton-Herendeen, Charles F Lynch, Michele M West, Lori A Odle, Ann Hamilton, Jennifer Zelaya, Mary Lo, Urduja Trinidad, Linda C Harlan, Ashley Wilder Smith, Jana Eisenstein, Gretchen Keel, Arnold Potosky, Keith Bellizzi, Karen Albritton, Michael Link, Brad Zebrack
Abstract
Purpose: Adolescent and young adult (AYA) cancer survivors experience barriers to utilizing healthcare, but the determinants of cancer-related medical care of AYAs has not been fully explored.
Methods: We studied factors associated with medical care utilization among 465 AYA cancer survivors in the AYA Health Outcomes and Patient Experience Study, a cohort of 15 to 39 year olds recently diagnosed with germ cell cancer, lymphoma, sarcoma, or acute lymphocytic leukemia. Descriptive statistics and multivariate logistic regression methods were used.
Results: Most AYA cancer survivors (95%), who were 15-35 months post diagnosis, received medical care in the past 12 months and 17% were undergoing cancer treatment. In multivariate analyses, compared with AYAs with no cancer-related medical visits in the previous year, AYAs receiving cancer-related care were more likely to currently have health insurance (odds ratio (OR) = 4.9; 95% confidence interval (CI) = 1.7-13.8) or have had health insurance in the past year (OR = 4.0; 95% CI = 0.99-16.3). Cancer recurrence, lacking employment, and negative changes in self-reported general health were associated with ongoing cancer treatment versus other cancer-related medical care. Eleven percent of all AYAs and 25% of AYAs who did not receive medical care in the past 12 months lost health insurance between the initial and follow-up surveys.
Conclusion: AYA cancer survivors with health insurance were much more likely to receive cancer-related medical care than those without insurance.
Implications for cancer survivors: Despite the need for post-treatment medical care, lacking health insurance is a barrier to receiving any medical care among AYAs.
Source: PubMed