Psychological distress and cognition among long-term survivors of adolescent and young adult cancer in the USA

Menée aux Etats-Unis par enquête réalisée entre 2010 et 2018 auprès de 2 646 patients ayant survécu à un cancer diagnostiqué à l'adolescence ou au début de l'âge adulte, cette étude analyse la présence de dysfonctionnements cognitifs et d'une détresse psychologique

Résumé en anglais

Background : Patients diagnosed with cancer as adolescent and young adult (AYA) are at risk for a range of long-term psychosocial sequelae, which have been poorly studied. We sought to characterize the prevalence of cognitive dysfunction and psychological distress among long-term AYA cancer survivors.

Methods : Using data from the National Health Interview Survey between 2010 and 2018, multivariable logistic regression analyses defined the association between AYA cancer diagnosis and cognitive dysfunction and psychological distress, as defined by the 6-item Kessler Psychological Distress Scale. Among AYA cancer survivors, the association between psychological distress and cognitive dysfunction was assessed via multivariable logistic regression.

Results : Among 230,675 participants, 2646 (1.1%) were AYA cancer survivors diagnosed > 10 years prior to survey administration. Prior AYA cancer diagnosis was associated with greater odds of cognitive dysfunction (AOR 1.61, 95% CI 1.41–1.82; 27.8% vs. 16.4%) and psychological distress (AOR 1.60, 95% CI 1.41–1.83; 26.6 vs. 15.3%) as compared to individuals without a cancer history. Among survey participants reporting a cancer diagnosis, greater psychological distress was associated with greater odds of cognitive dysfunction (AOR 12.31, 95% CI 7.51–20.18 for severe psychological distress) and cognitive dysfunction was associated with having psychological distress (AOR 4.97, 95% CI 3.66–6.73).

Conclusion : Long-term survivors of AYA cancer have higher rates of cognitive dysfunction and psychological distress as compared to the general population. Additional services addressing psychosocial and neurocognitive issues should be integrated into standard AYA cancer survivorship care.

Implications for Cancer Survivors : Cancer survivors should be aware of self-reported high rates of long-term cognitive dysfunction and psychologic distress and actively seek out formal evaluation and services such as mental health counseling