A retrospective study of AYA patients with cancer enrolled in the University of North Carolina (UNC) at Chapel Hill’s AYA Cancer Program, which aims to address these challenges, were more likely to receive guideline-recommended care, including clinical trial enrollment, fertility counseling, and palliative care than those not enrolled in the program. The study findings will be presented during the 2024 ASCO Quality Care Symposium (Abstract 4).
Previous studies have shown that adolescent and young adult (AYA) cancer survivors are at risk for adverse long-term outcomes, including chronic conditions, secondary cancers, loss of fertility, psychosocial concerns, and financial toxicity.
Study Methodology
The researchers used data from linked electronic health records and the state’s cancer registry to study AYA patients receiving care at UNC at Chapel Hill, from 2014 to 2022, comparing sociodemographic and clinical criteria between those patients with and without contact in UNC’s AYA Cancer Program. The researchers’ analysis included outcomes of care utilization, complications, and supportive care measures. Using standardized mortality ratio (SMR)-propensity weighting with multivariable log binomial modeling, they evaluated associations between outcomes and AYA program contact.
KEY POINTS
- AYA cancer survivors enrolled in UNC’s AYA Cancer Program were more likely to receive guideline-recommended care, including clinical trial enrollment, fertility counseling, and palliative care, than those not enrolled in the program.
- Over time, the AYA Cancer Program’s reach expanded from 6% to more than 25% of the total AYA survivor population.
The researchers included such factors as age at diagnosis, race, gender, insurance status, cancer site, metastatic disease, and receipt of systemic therapy in the weighting scheme.
Key Results
Of the 4,016 AYAs receiving care at UNC, 670 had contact with the AYA Cancer Program. The researchers found that program-engaged patients were younger at diagnosis, more likely to identify as Black, and had higher rates of metastatic disease or hematologic malignancies. In weighted model analyses, the program participants were more likely to receive guideline-recommended care, including enrollment in a clinical trial, fertility counseling, palliative care, and documented advanced care planning. Over time, the UNC program’s reach expanded from 6% to more than 25% of the total AYA population.
“Our findings indicate that AYAs contacted by our program through a consult-based, targeted outreach model represent a distinct population with higher clinical needs. Despite this complexity, they were more likely to receive guideline-recommended care, including clinical trial enrollment, fertility counseling, and palliative care,” concluded the study authors.
Disclosure: The study authors reported no conflicts of interest.
