Patient-Reported Quality of Life at Diagnosis in Adolescent and Young Adults With Cancer
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UTHealth Houston McGovern Medical School, Houston, TX
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UTHealth Houston McGovern Medical School, Houston, TX
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Background: The overall landscape of health-related quality of life (HRQoL) has not been thoroughly investigated in adolescents and young adults (AYAs) with cancer. Data are also lacking on how well HRQoL at the time of cancer diagnosis can prognosticate long-term survival in AYA survivors. Patients and Methods: We included 3,497 survivors of AYA cancer (age 15–39 years at diagnosis) who completed the Short-Form 12 Health Survey (SF-12) HRQoL questionnaire at diagnosis. Physical component summary (PCS) and mental component summary (MCS) scores were generated, with scores <50 representing poor HRQoL. Differences in HRQoL by patient characteristics and tumor type were investigated using violin plots and t tests/analysis of variance. The effect of HRQoL on overall survival was assessed using Kaplan-Meier plots and Cox proportional hazards models. Results: Overall mean PCS and MCS scores in this racially/ethnically diverse cohort (64% White, 19% Hispanic, 10% Black, and 7% other race/ethnicity) were 43.6 and 46.7, respectively. Women with breast cancer reported the most favorable PCS (50.8), and those with cervical cancer reported the lowest MCS (42.8). Age at diagnosis was associated positively with PCS (P<.001) and inversely with MCS (P<.001). Females had higher PCS yet lower MCS than males (both P<.001). Marginalized racial and ethnic populations reported lower PCS than White patients (P<.001). Physical and mental HRQoL were prognostic and associated with increased risk of poor survival (hazard ratio, 1.95; 95% CI, 1.72–2.21 for physical HRQoL, and 1.26; 95% CI, 1.13–1.40 for mental HRQoL). Conclusions: Physical and mental HRQoL at diagnosis vary across patient characteristics in AYA cancer survivors. Poor HRQoL at diagnosis may be a prognosticator of diminished overall survival among AYA cancer survivors.
Submitted October 5, 2023; final revision received January 17, 2024; accepted for publication January 22, 2024. Published online July 12, 2024.
Previous presentation: An abstract based on the findings from this study was presented at the 2022 Annual AACR Meeting; April 8–12, 2022; New Orleans, Louisianna. Cancer Res 2022;82(12 Suppl):Abstract 1997.
Author contributions: Study concept & design: George, Roth, Hildebrandt. Data collection: Tang, Rodriguez, Jafry. Data analysis & interpretation: George, Andersen, Tang, Swartz, Ahmed, Barcenas, Livingston, Roth, Hildebrandt. Writing—original draft: George, Andersen, Roth, Hildebrandt. Writing—review & editing: All authors.
Data availability statement: Data used for this research study can be made available to investigators by request from the senior author.
Disclosures: Dr. Ahmed has disclosed participating in research for Nektar Therapeutics, Merck & Co., Inc., Xencor, Chimagen Biosciences, and Genmab; serving as a consultant for ADC Therapeutics and Kite/Gilead; and serving as a scientific advisor for Myeloid Therapeutics. The remaining authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: Support for this study was provided by MD Anderson’s Cancer Center Support Grant P30CA016672 from the National Cancer Institute, National Cancer Institute R01CA242565 (G.C. George), Harry S. Moss Heart Trust Fund (M.A.T. Hildebrandt), MD Anderson University Cancer Foundation and the Duncan Family Institute for Cancer Prevention and Risk Assessment via the Cancer Survivorship Research Seed Money Grant (M.A.T. Hildebrandt), and the State of Texas Tobacco Settlement Funds for the Patient History Database.
Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Supplementary material: Supplementary material associated with this article is available online at https://doi.org/10.6004/jnccn.2024.7012. The supplementary material has been supplied by the author(s) and appears in its originally submitted form. It has not been edited or vetted by JNCCN. All contents and opinions are solely those of the author. Any comments or questions related to the supplementary materials should be directed to the corresponding author.
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