Department of Research & Evaluation News

Growing numbers of patients are diagnosed with cancer between the ages of 15 and 39. These younger cancer patients can have complex health needs after their cancer treatment and should receive health care that includes screening for new cancers, addresses potential issues related to their treatment, and emphasizes general preventive care.

Researchers at Kaiser Permanente Southern California set out to determine if these young patients were getting that care, and if not, what barriers they may be facing.

“In this study, we looked at patterns of outpatient primary and oncology care visits for a group of over 7,900 younger patients after their cancer treatment had ended,” said the study’s lead researcher, Erin E. Hahn, PhD, MPH, with the Kaiser Permanente Southern California Department of Research & Evaluation. “We found that during the 4 years after treatment, the majority had visits with either an oncology specialist or primary care provider. However, there were 17% who did not see an oncology specialist and 6% who did not see an oncology specialist or a primary care provider.”

Those with fewer or no visits were more likely to be younger, male, Black, or have high-deductible or Medicaid insurance plans.

Study based on large, diverse patient population

The study was published in June 2025, in the Journal of Oncology Practice. This study of patients diagnosed and treated within Kaiser Permanente Southern California is among the largest, most diverse U.S.-based patient population of young cancer survivors. It included robust data on patient demographics, cancer diagnosis and treatment, and comprehensive, longitudinal outpatient utilization for primary and specialty care.

Current clinical guidelines from the National Comprehensive Cancer Network  recommend 1 to 4 clinician visits annually for 5 years, with the number of visits dependent on the cancer stage and disease.

The authors suggest that the study findings show that some young cancer survivors may need tailored outreach for follow-up care, especially those who are youngest among this population, males, of Black race/ethnicity, and with high-deductible or Medicaid insurance.

Tailored outreach may help reach more patients

“We want to ensure that patients have access to both oncology and primary care services after they have been treated for cancer, and some groups of patients may benefit from tailored outreach after their treatment has ended,” Dr. Hahn said.

Other authors on this study included Thearis Osuji, MPH; Ernest Shen PhD; and Eric C. Haupt ScM, of the Department of Research & Evaluation; Neetu Chawla PhD, of Veterans Affairs Los Angeles County; Andrew B. Smitherman,21 MD, and Hazel B. Nichols, PhD, of University of North Carolina, Chapel Hill; Mallory Casperson, MS, of the Cancer Cactus Society, Oakland; Anne C. Kirchhoff, PhD, of University of Utah, Salt Lake City; Bradley J. Zebrack PhD, of University of Michigan, Ann Arbor; Cecile Laurent, MS, of Kaiser Permanente Northern California Division of Research; Theresa H. M. Keegan, PhD and Renata Abrahão, MD, PhD, of University of California, Davis; Kathryn J. Ruddy, MD, MPH, of Mayo Clinic, Rochester, MN; Jessica Chubak PhD, and senior author, Karen J. Wernli, PhD, of Kaiser Permanente Washington Institute of Health Research, Seattle.