Advancing equity and collaboration in a dedicated young onset cancer clinic: A prospective study.

Abstract

1546 Background: Coordinated young onset cancer (YOC) clinics improve patient experience and access to supportive services. However, geographic and ethnic disparities hinder equitable representation and outcomes. This study describes the design and impact of a YOC clinic serving a socioeconomically diverse population. Methods: A YOC clinic was established at a peripheral cancer center for patients aged 18-49, staffed with an oncologist, nurse, and social worker. Tailored referrals were facilitated to designated psychosocial and integrative services. Monthly team meetings and biweekly patient support activities were implemented. Data on demographics, cancer characteristics, coping styles (BASIC-Ph model), anxiety and depression (HADS-A/D), referral patterns and satisfaction were prospectively collected and analyzed across ethnic and clinical subgroups. Results: From 6/2022 - 4/2023, 104 patients enrolled (mean age 38; 76% female; 62.4% Jewish, 34.7% Arab). Most were married (63.5%), had children (81.4%), unemployed (72.3%), with up to high school education (50.7%). Most (76%) were on active treatment and 38% had metastatic disease. Breast cancer was most common (46.2%), followed by gastrointestinal and thoracic malignancies. Family cancer history (61.5%) actionable somatic (25%) and germline (6.7%) alterations were noted. Referrals were most frequent for integrative medicine (50%), genetics (41.3%), psychology, occupational therapy, with adherence rates of 88%. Ethnic and cancer-type variations in referral patterns were observed, but high uptake was consistent. HADS-A correlated with lack of exercise and HADS-D with unemployment and non-metastatic disease (p < 0.05). Females tended more to belief-based coping, males favored imagination, academics employed cognitive strategies, alcohol use to affect and cannabis to imagination (p < 0.05), while those with advanced cancer preferred physical coping (p = 0.82). HADS-A correlated with psychology referrals (M = 9.78 vs. 6.86, p = 0.013), belief-based coping to spirituality, social coping to physiotherapy and nutrition (p < 0.05). Social coping and sexuality services were less utilized in ethnic minorities and those on active treatment. Nearly all (94.2%) had no prior support group yet satisfaction was high (mean 5/5) with patients citing community, supportive services and side effect management as key benefits. Conclusions: A structured, multidisciplinary YOC clinic leverages existing services to enhance collaboration, equity, and access to tailored resources, meeting the unique needs of diverse young cancer patients. Beyond addressing disparities, this model fosters a sense of community among patients, promoting engagement with supportive services that may enhance treatment outcomes. Sharing this approach globally may inspire broader adoption of YOC clinics to benefit underserved populations and advance cancer care equity.