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

doi:10.1007/s11764-013-0332-4

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Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?

Journal article

Peer reviewed

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, …

Journal of cancer survivorship, Vol.8(2), pp.282-292

06/2014

DOI: 10.1007/s11764-013-0332-4

PMCID: PMC4074375

PMID: 24408440

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Abstract

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. 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. 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. AYA cancer survivors with health insurance were much more likely to receive cancer-related medical care than those without insurance. Despite the need for post-treatment medical care, lacking health insurance is a barrier to receiving any medical care among AYAs.

Humans

Survivors

Neoplasms - mortality

Logistic Models

Male

Young Adult

Neoplasms - therapy

Health Services Accessibility

Adolescent

Adult

Female

Health Status

Insurance, Health

Details

Title: Subtitle: Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
Creators: Theresa H M Keegan - Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA, theresa.keegan@cpic.org
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
Resource Type: Journal article
Publication Details: Journal of cancer survivorship, Vol.8(2), pp.282-292
DOI: 10.1007/s11764-013-0332-4
PMID: 24408440
PMCID: PMC4074375
NLM abbreviation: J Cancer Surviv
ISSN: 1932-2267
eISSN: 1932-2267
Publisher: United States
Grant note: N01PC35142 / NCI NIH HHS N01PC54404 / NCI NIH HHS N01PC54402 / NCI NIH HHS KL2 TR001118 / NCATS NIH HHS N01-PC-35142 / NCI NIH HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS K07 CA175063 / NCI NIH HHS UL1 TR001120 / NCATS NIH HHS N01PC35145 / NCI NIH HHS N01-PC-35136 / NCI NIH HHS N01PC35143 / NCI NIH HHS N01-PC-35145 / NCI NIH HHS N01-PC-35139 / NCI NIH HHS N01-PC-54404 / NCI NIH HHS K07CA175063 / NCI NIH HHS N01PC35136 / NCI NIH HHS N01-PC-54402 / NCI NIH HHS N01-PC-35143 / NCI NIH HHS
Language: English
Date published: 06/2014
Academic Unit: Epidemiology
Record Identifier: 9983995033602771

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