Oncology primary care clinics for comprehensive care of high-risk adolescent and young adult (AYA) cancer survivors.

Abstract

1641 Background: Adolescent and young adult (AYA) cancer survivors experience early development of chronic medical conditions compared to healthy peers. Due to their young age at diagnosis and living decades beyond treatment, they are also at higher risk for second primary malignancies (SPM) and late effects than older adult-onset cancer survivors. Primary care providers are responsible for most long-term care of survivors and many are unfamiliar with the effects of cancer treatment in younger populations. Oncology primary care providers are uniquely positioned to address increased needs of AYA patients because of their additional survivorship expertise. Methods: In 2020, the University of Cincinnati Cancer Center established an oncology primary care clinic. An accompanying clinical registry was developed to track patient outcomes longitudinally Electronic medical records of all patients seen between 1/2021 and 1/2025 (n = 901) were extracted and entered in REDCap. Records of AYA cancer survivors, defined as cancer diagnosis between the ages of 18-39, were queried and analyzed (9%, n = 85). Results: The patient population’s mean age was 36 yrs (range 20-74; std dev = 11.3). Hematologic cancers (37%) were most common followed by breast (13%) and brain (9%). Additionally, 14% were diagnosed with a SPM. Comorbid conditions were prevalent with 60% of patients having cardiovascular disease such as hypertension. Neurologic (46%), endocrine (44%), and psychologic (71%) co-morbidities were also common. Over half of patients were overweight/obese (68%) and many patients were former (19%) or current (7%) smokers. Eligible patients received their recommended cancer screening including breast (82%), colon (60%), and cervical (40%). Due to treatment exposures, 53% of patients were eligible for cardiomyopathy screening and 73% received recommended echocardiograms. A reduced ejection fraction was found in 26% of patients screened. Conclusions: Comprehensive primary care services and longitudinal monitoring are imperative in this high-risk population. Oncology primary care provides necessary survivorship-informed care and longitudinal monitoring for early onset comorbidities and SPMs. Tailored education and outreach efforts for providers and patients should address preventative health services needed in this high-risk population.