Health-related quality of life in adolescent and young adult cancer survivors

Purpose: Today, survival rates for adolescent and young adult (AYA) cancer patients exceed 80%. However, cancer and treatment leave many patients suffering from chronic conditions. These late effects may impair their health-related quality of life (HRQoL). We aimed to (1) compare HRQoL of AYA cancer survivors with the Swiss general population and (2) investigate socio-demographic and cancer-related characteristics associated with poor HRQoL.

Methods: AYA cancer survivors (age 16-25 at diagnosis; ≥5 years survival) who had been identified through the Cancer Registry Zurich and Zug, Switzerland, filled out a questionnaire. We assessed HRQoL using the Short-Form 12 (SF-12), producing two scores: Physical Component Summary score (PCS, physical health) and Mental Component Summary score (MCS, mental health). We used multivariable logistic regression analyses to investigate associated characteristics.

Results: We compared 155 survivors with 350 controls. Survivors had significantly lower physical health than controls (mean = 52.5 vs. mean = 54.7, p < 0.001). Male survivors reported better mental health than controls (55.2 vs.53.3, p = 0.078) and females slightly worse (49.8 vs. 51.8, p = 0.285). Poor physical health was strongly associated with having a migration background (OR = 4.63, p = 0.008) and unemployment (OR = 7.66, p = 0.005). Poor mental health was associated with female sex (OR = 2.69, p = 0.057), suffering from late effects (OR = 5.91, p < 0.001) and a migration background (OR = 5.82, p = 0.004).

Conclusions: Results emphasize the need for individualized support services to improve survivors' HRQoL in vulnerable subgroups. We recommend adapted care for women and migrants, in addition to educational and employment support systems.