Anne C. Kirchhoff

Social well-being among adolescents and young adults with cancer: A systematic review.

A cancer diagnosis during adolescence or young adulthood may negatively influence social well‐being. The existing literature concerning the social well‐being of adolescents and young adults (AYAs) with cancer was reviewed to identify gaps in current research and highlight priority areas for future research.

Social well-being among adolescents and young adults with cancer

A cancer diagnosis during adolescence or young adulthood may negatively influence social well‐being. The existing literature concerning the social well‐being of adolescents and young adults (AYAs) with cancer was reviewed to identify gaps in current research and highlight priority areas for future research.

Geography and the Burden of Care in Pediatric Cancers

Childhood cancers typically require rigorous treatment at specialized centers in urban areas, which can create substantial challenges for families residing in remote communities. We evaluated the impact of residence and travel time on the burden of care for families of childhood cancer patients.

Serrated polyposis: colonic phenotype, extracolonic features, and familial risk in a large cohort.

BACKGROUND: Serrated polyposis is a poorly understood and likely underdiagnosed condition. Little is known regarding the colorectal cancer risk, extracolonic phenotype, and cause of serrated polyposis. OBJECTIVE: The aim of this study is to describe the clinical and family history features of a large cohort of individuals with serrated polyposis. DESIGN: This is a retrospective cohort study from 2 prospectively collected registries. PATIENTS: Patients meeting the updated 2010 World Health Organization criteria for serrated polyposis were included. MAIN OUTCOME MEASURES: We report descriptive statistics for clinical and family history factors. RESULTS: A total of 52 individuals met criteria for serrated polyposis. Of these, one had Lynch syndrome and was not included in the statistical analyses. Median age at serrated polyposis diagnosis was 51 years (range, 18–77). Twenty-four (47%) patients were male, and 25 (49%) had a history of smoking. Two hundred sixty-eight lower endoscopic procedures were performed; 42 (82%) patients had colorectal adenomas, 8 (16%) had a personal history of colorectal cancer (only 1 was diagnosed during follow-up), 12 (24%) had extracolonic tumors (4 had more than 1 primary tumor), and 19 (37%) reported a family history of colorectal cancer. Esophagogastroduodenoscopy in 30 individuals revealed only 1 (3%) with unexplained gastroduodenal polyps. No association was found between colorectal cancer diagnosis and sex, age at serrated polyposis diagnosis, extracolonic tumor, history of adenoma, or smoking status. LIMITATIONS: This was a retrospective study with no comparison groups. CONCLUSIONS: Gastroduodenal polyps are uncommon and likely not associated with serrated polyposis. Although extracolonic tumors were common in our cohort, it is still unclear whether these are associated with serrated polyposis. Our data, along with previous studies, support an association between serrated polyposis and smoking. Further work is still needed to clarify the effect of smoking on polyp development/progression in serrated polyposis.

Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study

PurposeThe Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI.MethodsWe conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8.ResultsUninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care.ConclusionsChildhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

Mental distress and health care use among survivors of adolescent and young adult cancer: A cross-sectional analysis of the National Health Interview Survey

The current study was conducted to examine the prevalence and correlates of mental distress among survivors of adolescent and young adult (AYA) cancer and a comparison group.

Statewide Longitudinal Hospital Use and Charges for Pediatric and Adolescent Patients With Cancer

PURPOSE We investigated longitudinal hospitalization outcomes (total charges, hospital days and admissions) among pediatric and adolescent patients with cancer compared with individuals from the general population without cancer using a novel and efficient three-step regression procedure. METHODS The statewide Utah Population Database, with linkages to the Utah Cancer Registry, was used to identify 1,651 patients who were diagnosed with cancer from 1996 to 2009 at ages 0 to 21 years. A comparison group of 4,953 same-sex and -age individuals was generated from birth certificates. Claims-based hospitalization data from 1996 to 2012 were retrieved from the Utah Department of Health. Using the regression method, we estimated survival (differences due to survival) and intensity (differences due to resource accumulation) effects of the cancer diagnosis on hospitalization outcomes within 10 years after diagnosis. RESULTS At 10 years after diagnosis, on average, patients with cancer incurred

Barriers to follow-up care among survivors of adolescent and young adult cancer

51,723 (95% CI,

A population-based study of childhood cancer survivors' body mass index.

48,100 to

Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

58,284) more in charges, spent 30 additional days (95% CI, 27.7 to 36.1 days) in the hospital, and had 5.7 (95% CI, 5.4 to 6.4) more admissions than the comparison group. Our analyses showed that the highest hospitalization burden occurred during the first 4 years of diagnosis. Patients with leukemia incurred the greatest hospitalization burden throughout the 10 years from diagnosis. Intensity effects explained the majority of differences in hospital outcomes. CONCLUSION Our results suggest that children and adolescents who were diagnosed with cancer in 2014 in the United States will incur over