Adolescents and young adults who survive cancer are at higher risk of mental and physical weakness and of developing age-related diseases, such as depression and anxiety, a study reports.
Other factors that contributed to that increased risk of deteriorating health, include smoking, obesity, and delaying healthcare due to lack of health insurance.
The study with those findings, “Frailty and Comorbidities Among Survivors of Adolescent and Young Adult Cancer: A Cross-Sectional Examination of a Hospital-Based Survivorship Cohort,” was published in the Journal of Adolescent and Young Adult Oncology.
Survivors of cancer, including lymphoma, usually develop age-related diseases much earlier than those without a history of cancer. But if the same happens in patients who fought cancer during adolescence or as young adults, is uncertain.
Researchers from the UNC Lineberger Comprehensive Cancer Center and UNC Gillings School of Global Public Health, University of North Carolina Chapel Hill, investigated the prevalence of frailty — a condition of mental and physical weakness commonly related to aging — and non-cancer diseases in cancer survivors who had been diagnosed from age 15 to 39.
Participants were recruited from a cancer survivorship group — the University of North Carolina (UNC) Cancer Survivorship cohort — and inquired about a list of 23 non-cancer diseases, including depression, anxiety, asthma, high cholesterol, hypertension, among others.
To limit the influence of potential therapies on frailty, researchers examined this condition only in participants who had been diagnosed with cancer at least one year before the survey. Frailty was assessed with the FRAIL Questionnaire, a five-question scale that reliably predicts declining health function and mortality.
Also, participants provided information regarding age at diagnosis, limitations on regular activities, and medications prescribed for non-cancer diseases.
Researchers identified 271 adolescent and young adults with a cancer diagnosis, most of whom were young adults (30-39 years) at the time of the survey. The most common cancers were breast (31%), cervical (11%), testicular (9%), and skin cancer (9%).
Frailty and non-cancer diseases had a high incidence in this population, researchers found. A majority of survivors (60%) had at least one additional disease, with depression, anxiety, asthma, high cholesterol, and high blood pressure being the most common. More women had these concurrent diseases than men — 65% versus 47%.
Frailty was found in 10% of patients and pre-frailty in 21%. The most common frailty-linked conditions included difficulties in climbing stairs, walking, and weight loss.
Survivors who were divorced, widowed, or separated, or those who smoked ,were more likely to be frail or “pre-frail” compared to married or non-smokers. Also, obese patients were more likely to have these conditions (70%), as were patients who delayed care due to lack of health insurance (2.7-fold) or who had depression or anxiety (2.3-fold).
Overall, these findings support a high level of frailty and co-occurring diseases among adolescent and young adult cancer survivors, suggestive of accelerated aging.