Abstract 6377: UNC AYA Cancer Program: Reach and influence on cancer care delivery
Authors: Stein Jacob N. , Ritzwoller Dawn M. , Wardell Alexis C. , Haines Emily R. , Thom Bridgette , Lux Lauren , Smitherman Andrew B. 
Published: March 2024

Category:

Cancer Disparities and Inequities Research

Purpose of the study

Adolescent and young adults (AYAs, aged 13-39) with cancer face barriers to care and stagnant outcomes. National groups have called for the development of AYA-specific programs, yet how these programs influence outcomes remains largely unexplored. With a dedicated AYA Cancer Program at the University of North Carolina (UNC) since 2015, we conducted a retrospective study to describe the AYA population and compare outcomes between those receiving program support and those who did not.

Methods

Linking electronic health records and NC Cancer Registry data, we defined a cohort of AYA patients who received cancer treatment at UNC from 2014-2022. We compared sociodemographic, clinical, utilization, and supportive care measures for those who received AYA Program contact and those who did not. Chi-square and two-group t-tests were used for comparison.

Results

Of 4044 AYAs receiving care at UNC, 670 engaged with our AYA Program (Table 1). Program-contacted patients were younger at diagnosis, more likely to be Black, have metastatic disease or hematologic malignancies, and more likely to receive systemic therapy. Program patients had increased clinical trial enrollment, more palliative care and fertility counseling.

Conclusions

Our findings suggest AYAs contacted by our program represent a distinct population with higher clinical and social needs. Despite higher rates of acute care events and no-shows, they were more likely to receive guideline-recommended care - clinical trial enrollment, fertility counseling, and palliative care. Future analyses will compare outcomes using adjusted modeling, and track trends over time. Results will inform next steps for the UNC AYA Cancer Program and other centers aiming to improve care delivery for AYAs.

Table 1. Notable results for AYAs with and without program contact AYA Program Contact (n=670) No AYA Program Contact (n=3374) P value Age at diagnosis Mean years 27 31 &lt;0.01 Sex Female 55% 61% 0.02 Male 45% 39% Race White 56% 61% &lt;0.01 Black 26% 20% Other 18% 16% Ethnicity Hispanic 13% 12% 0.29 Non-Hispanic 86% 84% Marital Status Married/Partnered 34% 42% &lt;0.01 Not Married 65% 51% Cancer Type Solid 54% 87% &lt;0.01 Hematologic 46% 13% Stage Metastatic 52% 18% &lt;0.01 Treatment Chemotherapy 85% 37% &lt;0.01 Radiotherapy 6% 12% Immunotherapy 18% 9% Clinical Trial Enrollment 45% 26% &lt;0.01 No-Shows Mean 7 4 &lt;0.01 Supportive Care Palliative care visits 19% 3% &lt;0.01 Advance Care Planning 14% 5% Fertility visit 18% 2% Hospice enrollment 3% 0.7% Complications ED visit 68% 48% &lt;0.01 Unplanned hospitalization 63% 29%

Citation Format: Jacob N. Stein, Dawn M. Ritzwoller, Alexis C. Wardell, Emily R. Haines, Bridgette Thom, Lauren Lux, Andrew B. Smitherman. UNC AYA Cancer Program: Reach and influence on cancer care delivery [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6377.