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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Impact of the AYA HOPE Comorbidity Index on Assessing Health Care Service Needs and Health Status among Adolescents and Young Adults with Cancer

Xiao-Cheng Wu, Pinki K. Prasad, Ian Landry, Linda C. Harlan, Helen M. Parsons, Charles F. Lynch, Ashley W. Smith, Ann S. Hamilton and Theresa H.M. Keegan
Xiao-Cheng Wu
1Department of Epidemiology, LSUHSC, New Orleans, Louisiana.
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  • For correspondence: xwu@lsuhsce.du
Pinki K. Prasad
2Department of Pediatric Hematology/Oncology, LSUSHC/Children's Hospital of New Orleans, New Orleans, Louisiana.
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Ian Landry
1Department of Epidemiology, LSUHSC, New Orleans, Louisiana.
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Linda C. Harlan
3Applied Research Program, National Cancer Institute, Bethesda, Maryland.
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Helen M. Parsons
4University of Texas Health Science Center, San Antonio, Texas.
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Charles F. Lynch
5Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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Ashley W. Smith
6Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
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Ann S. Hamilton
7Preventive Medicine, University of Southern California Norris Cancer Center, Los Angeles, California.
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Theresa H.M. Keegan
8Department of Internal Medicine, Division of Hematology and Oncology, University of California, Davis, California.
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DOI: 10.1158/1055-9965.EPI-15-0401 Published December 2015
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Abstract

Background: Existing comorbidity indices were not developed for adolescent and young adults (AYA) 15 to 39 years of age. The aim of this study was to assess impact of comorbidities on health care service needs and health status among AYA cancer survivors using the newly developed AYA HOPE comorbidity index in comparison with the existing indices.

Methods: Data on comorbid conditions were obtained from medical records and service needs and health status were from a survey of AYA cancer survivors. Prevalence of comorbidities was based on the AYA HOPE index. Charlson and NCI indices were compared. Multivariable logistic regression was used.

Results: Of the 485 patients, 14.6% had ≥2 comorbidities based on the AYA HOPE Index. Prevalence of mental illness and obesity/overweight, which were not included in existing indices, were 8.2% and 5.8%, respectively. Prevalence of cardiovascular, endocrine, gastrointestinal, and neurologic conditions were higher with the AYA HOPE Index than the other two indices. Forty percent of AYA patients reported service needs, particularly for mental health services (25.2%) and support groups (17.7%). Having ≥2 comorbidities on the AYA index was associated with higher mental health service needs [OR, 2.05; 95% confidence interval (CI), 1.10–3.82] adjusting for demographic and clinical factors. Comorbidities were associated with fair/poor self-reported health status.

Conclusion: The AYA HOPE Index is a more comprehensive comorbidity index for AYA cancer patients than existing indices, and the number of comorbidities is associated with service needs and health status.

Impact: The AYA HOPE index could identify patients' additional service needs early in therapy. Cancer Epidemiol Biomarkers Prev; 24(12); 1844–9. ©2015 AACR.

This article is featured in Highlights of This Issue, p. 1809

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Received April 17, 2015.
  • Revision received September 16, 2015.
  • Accepted September 22, 2015.
  • ©2015 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 24 (12)
December 2015
Volume 24, Issue 12
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Impact of the AYA HOPE Comorbidity Index on Assessing Health Care Service Needs and Health Status among Adolescents and Young Adults with Cancer
Xiao-Cheng Wu, Pinki K. Prasad, Ian Landry, Linda C. Harlan, Helen M. Parsons, Charles F. Lynch, Ashley W. Smith, Ann S. Hamilton and Theresa H.M. Keegan on behalf of AYA HOPE Study Collaborative Group
Cancer Epidemiol Biomarkers Prev December 1 2015 (24) (12) 1844-1849; DOI: 10.1158/1055-9965.EPI-15-0401

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Impact of the AYA HOPE Comorbidity Index on Assessing Health Care Service Needs and Health Status among Adolescents and Young Adults with Cancer
Xiao-Cheng Wu, Pinki K. Prasad, Ian Landry, Linda C. Harlan, Helen M. Parsons, Charles F. Lynch, Ashley W. Smith, Ann S. Hamilton and Theresa H.M. Keegan on behalf of AYA HOPE Study Collaborative Group
Cancer Epidemiol Biomarkers Prev December 1 2015 (24) (12) 1844-1849; DOI: 10.1158/1055-9965.EPI-15-0401
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