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

DOI: 10.1158/1055-9965.EPI-15-0401 Published December 2015

Article Figures & Data

Table 1.

Characteristics of AYA HOPE participants

	Frequency	%
Sociodemographic variables
Age at diagnosis, y
15–19	62	12.8
20–29	211	43.5
30–39	212	43.7
Sex
Male	303	62.5
Female	182	37.5
Race/ethnicity
White	394	81.2
Black	39	8.0
Asian	36	7.4
Unknown^a	16	3.3
Health insurance status
Yes	442	91.1
No	36	7.4
Unknown	7	1.5
Service needed
Nurse comes to home
Yes	30	6.2
No	434	89.5
Unknown	21	4.3
Support groups
Yes	86	17.7
No	374	77.1
Unknown	25	5.2
Mental health services
Yes	122	25.2
No	341	70.3
Unknown	22	4.5
Physical/occupational therapy
Yes	68	14.0
No	391	80.6
Unknown	26	5.4
Pain management specialist
Yes	59	12.2
No	404	83.3
Unknown	22	4.5
Any service needed
Yes	192	39.6
No	293	60.4
Clinical variables
Health status
Good/very good/excellent	404	83.3
Fair/poor	81	16.7
Cancer type
Germ cell tumor	189	39.0
Hodgkin lymphoma	134	27.6
Leukemia	21	4.3
Non-Hodgkin lymphoma	117	24.1
Sarcoma	24	5.0
Cancer stage
All cancers combined
Stage I	161	33.2
Stage II	139	28.7
Stage III	66	13.6
Stage IV	50	10.3
Unknown	69	14.2
Treatment received
Surgery
Yes	59	12.2
No	426	87.8
Radiation
Yes	52	10.7
No	433	89.3
Chemotherapy
Yes	238	49.1
No	247	50.9

Table 2.

Frequency (n) and percentage of comorbidities in AYA HOPE participants, by comorbidity index

	Comorbidity index
	AYA HOPE	Charlson	NCI
	n (%)	n (%)	n (%)
Comorbidity categories
Cardiovascular	30 (6.2)	12 (2.5)	^b
Diabetes	18 (3.7)	18 (3.7)	18 (3.7)
Endocrine	10 (2.1)	^b	^a
Gastrointestinal	20 (4.1)	6 (1.2)	5 (1.0)
HIV/AIDS	18 (3.7)	18 (3.7)	18 (3.7)
Hypertension	29 (6.0)	29 (6.0)	^a
Liver	13 (2.7)	13 (2.7)	13 (2.7)
Mental health	40 (8.2)	^a	^a
Neurologic	42 (8.7)	^b	^b
Obesity/overweight	28 (5.8)	^a	^a
Renal	5 (1.0)	^b	^b
Asthma/respiratory	30 (6.1)	30 (6.1)	30 (6.1)
Rhematologic/autoimmune	5 (1.0)	5 (1.0)	5 (1.0)
Hematologic	^b	^a	^a
Distribution of number of comorbidities
0	320 (66.4)	381 (78.6)	406 (83.7)
1	94 (19.4)	80 (16.5)	66 (13.6)
≥2	71 (14.6)	24 (4.9)	13 (2.7)

NOTE: All indices are shown unweighted for accurate frequency comparisons.

Table 3.

Multivariable adjusted ORs and 95% CIs for each of the services needed and health status, by comorbidity index

Comorbidity count	AYA HOPE^b	Charlson^b	NCI^b
Service needed/health status^a	OR (95% CI)	OR (95% CI)	OR (95% CI)
Nurse come to home
0	1.00	1.00	1.00
1	1.37 (0.53–3.53)	1.10 (0.39–3.08)	1.65 (0.62–4.35)
≥2	1.20 (0.40–3.57)	2.44 (0.63–9.37)	^c
Support group
0	1.00	1.00	1.00
1	1.06 (0.55–2.03)	1.53 (0.82–2.88)	1.15 (0.57–2.29)
≥2	1.56 (0.80–3.05)	0.86 (0.28–2.61)	0.64 (0.12–3.34)
Mental health services
0	1.00	1.00	1.00
1	1.62 (0.93–2.84)	2.01 (1.14–3.53)	2.26 (1.24–4.11)
≥2	2.05 (1.10–3.82)	1.53 (0.58–4.00)	0.68 (0.16–2.86)
Physical/occupational therapy
0	1.00	1.00	1.00
1	1.08 (0.54–2.17)	1.43 (0.72–2.84)	1.55 (0.75–3.18)
≥2	1.12 (0.50–2.44)	1.21 (0.39–3.79)	0.70 (0.13–3.75)
Pain management specialist
0	1.00	1.00	1.00
1	2.56 (1.30–5.04)	2.18 (1.09–4.37)	2.07 (1.00–4.27)
≥2	1.75 (0.78–3.92)	1.84 (0.60–5.67)	0.48 (0.05–4.08)
Health status
0	1.00	1.00	1.00
1	1.70 (0.87–3.33)	2.35 (1.23–4.52)	3.17 (1.61–6.26)
≥2	3.16 (1.58–6.33)	5.59 (2.05–15.2)	8.88 (2.44–32.3)

NOTE: Significant ORs and 95% CI are in bold.

↵^aService needed: yes versus no; health status: fair/poor versus good/very good/excellent.
↵^bModels are adjusted for both clinical factors (i.e., cancer type, health status, treatment) and demographic factors (i.e., age, sex, and race/ethnicity).
↵^cNot able to get statistics because of small number of cases.