Health-related quality of life in adolescent and young adult patients with cancer: A longitudinal study

Olga Husson, Brad J. Zebrack, Rebecca Block, Leanne Embry, Christine Aguilar, Brandon Hayes-Lattin, Steve Cole

Research output: Contribution to journalArticle

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Abstract

Purpose: To examine changes in health-related quality of life (HRQoL) and its predictors during the first 2 years after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Patients and Methods: A multicenter, longitudinal, prospective study was conducted among a diverse sample of AYA patients with cancer ages 15 to 39 years. One hundred seventy-six patients (75% response) completed a self-report measure of HRQoL (Short Form-36 [SF-36]) within the first 4 months after diagnosis and again 12 and 24 months later. Linear mixed models with random intercepts and slopes estimated changes in QoL. Results: Recently diagnosed AYA patients with cancer had significantly worse physical component scale (PCS) scores (38.7 v 52.8; P < .001) and mental component scale (MCS) scores (42.9 v 48.9; P < .001) when compared with population norms. Significant improvements in PCS and MCS scores from baseline to 24-month follow-up were observed; however, these increases were largest during the first 12 months. At the 24-month follow-up, AYA patients still had significantly lower PCS scores (48.0 v 52.8; P < .001) and MCS scores (45.8 v 48.9; P = .002) when compared with population norms. Multivariable analyses revealed that improvements in PCS and MCS scores were primarily a function of being off-treatment and being involved in school or work. PCS but not MCS scores were worse for AYA patients diagnosed with cancers with poorer prognoses. Conclusion: Although HRQoL improved over time, it was still compromised 24 months after primary diagnosis. Given relatively little observed improvement in HRQoL during the 12- to 24-month period after diagnosis, AYA patients may benefit from supportive care interventions administered during the second year after diagnosis.

Original languageEnglish (US)
Pages (from-to)652-659
Number of pages8
JournalJournal of Clinical Oncology
Volume35
Issue number6
DOIs
StatePublished - Feb 20 2017

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Longitudinal Studies
Young Adult
Quality of Life
Neoplasms
Self Report
Population
Linear Models
Prospective Studies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Health-related quality of life in adolescent and young adult patients with cancer : A longitudinal study. / Husson, Olga; Zebrack, Brad J.; Block, Rebecca; Embry, Leanne; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve.

In: Journal of Clinical Oncology, Vol. 35, No. 6, 20.02.2017, p. 652-659.

Research output: Contribution to journalArticle

Husson, Olga ; Zebrack, Brad J. ; Block, Rebecca ; Embry, Leanne ; Aguilar, Christine ; Hayes-Lattin, Brandon ; Cole, Steve. / Health-related quality of life in adolescent and young adult patients with cancer : A longitudinal study. In: Journal of Clinical Oncology. 2017 ; Vol. 35, No. 6. pp. 652-659.
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abstract = "Purpose: To examine changes in health-related quality of life (HRQoL) and its predictors during the first 2 years after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Patients and Methods: A multicenter, longitudinal, prospective study was conducted among a diverse sample of AYA patients with cancer ages 15 to 39 years. One hundred seventy-six patients (75{\%} response) completed a self-report measure of HRQoL (Short Form-36 [SF-36]) within the first 4 months after diagnosis and again 12 and 24 months later. Linear mixed models with random intercepts and slopes estimated changes in QoL. Results: Recently diagnosed AYA patients with cancer had significantly worse physical component scale (PCS) scores (38.7 v 52.8; P < .001) and mental component scale (MCS) scores (42.9 v 48.9; P < .001) when compared with population norms. Significant improvements in PCS and MCS scores from baseline to 24-month follow-up were observed; however, these increases were largest during the first 12 months. At the 24-month follow-up, AYA patients still had significantly lower PCS scores (48.0 v 52.8; P < .001) and MCS scores (45.8 v 48.9; P = .002) when compared with population norms. Multivariable analyses revealed that improvements in PCS and MCS scores were primarily a function of being off-treatment and being involved in school or work. PCS but not MCS scores were worse for AYA patients diagnosed with cancers with poorer prognoses. Conclusion: Although HRQoL improved over time, it was still compromised 24 months after primary diagnosis. Given relatively little observed improvement in HRQoL during the 12- to 24-month period after diagnosis, AYA patients may benefit from supportive care interventions administered during the second year after diagnosis.",
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