Physical, emotional, and social health differences between posttreatment young adults with cancer and matched healthy controls

Authors

  • John M. Salsman PhD,

    Corresponding author
    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
    • Corresponding author: John M. Salsman, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North St. Clair, Suite 1900, Chicago, IL 60611; Fax: (312) 503-9800; j-salsman@northwestern.edu

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  • Sofia F. Garcia PhD,

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
    3. Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Betina Yanez PhD,

    1. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
    2. Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Stacy D. Sanford PhD,

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
    3. Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Mallory A. Snyder MPH,

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • David Victorson PhD

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
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Abstract

BACKGROUND

Young adults (YAs; ages 18-39 years) with cancer face interrupted developmental milestones and increased stressors that can adversely influence psychosocial adjustment. Transitioning from active treatment to posttreatment survivorship can be particularly challenging. The purpose of this study is to describe the health-related quality of life (HRQL) and psychological adaptation of YAs after treatment, relative to young adults without cancer.

METHODS

Three cohorts of YAs of mixed cancer diagnoses (N = 120, 0-12 months after treatment; N = 102, 13-24 months after treatment; and N = 113, 25-60 months after treatment; combined M = 31.8 years old, combined sex = 68% women) and an age-, education-, sex-, and partner status–matched group of healthy control participants (HCs; N = 335) were recruited via an online research panel. All participants completed measures assessing demographic and clinical characteristics, HRQL (physical, emotional, social, and spiritual), and psychological adaptation (anxiety, depression, positive affect, posttraumatic growth). Measure content was slightly modified for applicability to HCs without a cancer history.

RESULTS

Multivariate analysis of covariance found a significant main effect for group (YAs versus HCs) and a significant group-by-cohort interaction. YAs reported poorer physical (P = .005, d = .22) and emotional well-being (P = .011, d = .20) but better social well-being (P < .001, d = .49). YAs reported comparatively stable scores (P = .74) for posttraumatic growth compared to HCs, who reported greater posttraumatic growth across cohorts (P = .01, d = 16).

CONCLUSIONS

Findings underscore the negative and positive sequelae for YAs and highlight the need for comprehensive assessment among YA survivors of cancer. A matched, HC group allows the HRQL and psychological adaptation of YAs to be placed in context, enabling a more precise determination of the impact of cancer on YAs. Cancer 2014;120:2247–2254. © 2014 American Cancer Society.

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