Characterizing unmet supportive care needs in diverse adolescent and young adult cancer survivors.

Abstract

11104 Background: Research addressing the supportive care needs of diverse adolescent and young adult (AYA) cancer survivors remains underdeveloped relative to younger and older cancer survivor populations. Given their distinct developmental, psychosocial, and healthcare challenges, it is critical to characterize the unmet supportive care needs (USCN) specific to AYAs. This study aimed to compare self-reported USCN between AYA and older (>39 years old) cancer survivors to identify age-specific gaps in care and opportunities to improve outcomes. Methods: Between October 2019 and October 2024, 20,520 cancer survivors (n=1,287 AYA and n=19,233 non-AYA) at Sylvester Comprehensive Cancer Center completed the My Wellness Check (MWC) questionnaire. MWC is fully integrated and scored in real-time in the electronic health record, and evaluates 16 domains of supportive care needs (e.g., stress management, financial concerns, informational resources, transportation) alongside patient-reported outcomes (PROs; PROMIS measures of pain interference, fatigue, physical function, anxiety, and depression) and health-related quality of life (HRQOL; FACT-G7). Sociodemographic and clinical characteristics and the prevalence of USCNs were compared between AYA and other cancer survivors using chi-square and t-tests. Results: The AYA group had a higher proportion of females (64% vs. 51%), non-White (20% vs. 14%), Hispanic (56% vs. 44%), uninsured (4% vs. 3%), and unpartnered individuals (59% vs. 34%) compared to non-AYAs (all p s < 0.01). Across both groups, the most frequently reported USCNs were general cancer education (11%), coping with a cancer diagnosis (11%), and financial concerns (9%). AYAs were more likely to report at least one USCN compared to non-AYA survivors (33% vs. 28%). AYAs were also more likely to endorse needs related to coping with a cancer diagnosis (14% vs. 11%), financial concerns (12% vs. 9%), work-related issues (6% vs. 3%), oncofertility (10% vs. 1%), and childcare (3% vs. 0.5%) (all p s < 0.001). No significant differences were observed for other USCN, including transportation, housing, family problems, sexual health, spiritual concerns, access to medicines, and advance directives. Conclusions: While both AYA and non-AYA cancer survivors face substantial unmet supportive care needs, AYAs exhibit additional challenges, particularly in areas such as financial concerns, work-related issues, fertility preservation, and childcare. These findings align with prior research while uniquely emphasizing the unmet needs of a more ethnically diverse population. This study underscores the urgent need for targeted assessments and interventions to address the unique supportive care needs of AYA cancer survivors, ensuring equitable and age-appropriate survivorship care.