Rapid Fire Session 2014 World Cancer Congress

Investigating the Impact of Distress on Wellbeing among Adolescent and Young Adult (AYA) Cancer Patients at Princess Margaret Cancer Centre: A Needs Assessment Analysis (#431)

Melissa Li 1 , Hayley Panet 2 , Alyssa Macedo 2 , Manjula Maganti 2 3 , Norma D'Agostino 2 , Laura Mitchell 2 , Abha Gupta 2 4 , Terri Stuart-McEwan 1 2
  1. University of Toronto, Toronto, ON, Canada
  2. Princess Margaret Cancer Centre, Toronto, ON, Canada
  3. Bio-Statistics, Princess Margaret Cancer Centre Institute, Toronto
  4. Medical Oncology, Hospital for Sick Children, Toronto, ON, Canada

Background: It has become increasingly recognized that adolescents and young adults (AYA) with cancer have unique medical and psychosocial needs that differ from those of the pediatric and older adult oncology populations1 2 3    AYA is defined by the National Cancer Institute (NCI) as including those between 18-39 years of age which encompasses important developmental stages, marked by distinct and complex psychosocial, emotional, and physical stresses which can be assessed by distress screening4.

Aim:  Our study will investigate the types of distress that have the highest influence on the wellbeing of the AYA population, and whether there are differences found between disease sites, age groups or gender.

Methods: This study was a retrospective, cross-sectional quantitative data analysis design. The study examines the patient self-reported Distress Assessment and Response Tool (DART) results captured between March 1st 2010 and March 12th 2013 using a Chi-square test (categorical data), T-test (continuous data), Correlations between ESAS vs. SDI-16, PHQ-9, GAD-7: Pearson correlation coefficient, and a Multivariable logistic regression analysis

Results: Amongst the three SDI (social) subscales, SDI-Everyday Living showed a stronger correlation with ESAS wellbeing  (r= 0.53, p<0.001) than SDI-Money Matters (r= 0.31, p<0.001) and SDI-Self and Others (r= 0.44, p<0.001)

PHQ-9 (depression scale) demonstrated a stronger association with ESAS wellbeing (r=0.61, p<0.001), than GAD-7 (anxiety scale) and ESAS wellbeing (r=0.51, p<0.001)

Conclusions: The results of our study suggest (or demonstrate) that social difficulties (SDI-16) and the presence of depressive symptoms (PHQ-9) are the types of distresses that have the strongest association with wellbeing for the AYA cancer population. More specifically, the SDI-Everyday Living subscale had the strongest correlation with ESAS wellbeing. These findings suggest that the social difficulties of daily life, particularly those involving personal independence, domestic chores and personal care, are especially applicable to AYAs, and a significant contributor to distress and wellbeing. 

  1. Cancer Care Ontario: Cancer in Young Adults in Canada. May 2006
  2. Bleyer WA. Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol 2002;38(1):1-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citatio n&list_uids=11835231
  3. Fernandez C, Fraser GA, Freeman C, Grunfeld E, Gupta A, Mery LS, De Pauw S, Schacter B: Principles and Recommendations for the Provision of Healthcare in Canada to Adolescent and Young Adult-Aged Cancer Patients and Survivors. J Adolesc Young Adult Oncol 2011, 1(1):53-59.
  4. Bultz BD, Groff SL, Fitch M, Blais MC, Howes J, Levy K, Mayer C: Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology 2011, 20(5):463-469.