Department of Research & Evaluation News

Adolescent and young adult cancer survivors face significantly higher risks of developing chronic medical conditions compared to their peers without cancer, a new study showed.

The findings were published in Cancer, the journal of the American Cancer Society.

“As cancer survival rates improve for adolescent and young adult cancer survivors, their numbers are increasing,” said the study’s senior author, Erin E. Hahn, PHD, MPH, a health services researcher with the Kaiser Permanente Southern California Department of Research & Evaluation. “This study provides information for clinicians, policymakers, and patients regarding the importance of comprehensive, long-term care strategies for this AYA population.”

The study analyzed data from 14,917 patients from Kaiser Permanente Northern California and Kaiser Permanente Southern California aged 15–39 who survived at least 2 years after being diagnosed with one of 11 common cancers between 2006 and 2020. These survivors were compared to a cohort of 149,164 individuals without cancer, matched by age, sex, calendar year and Kaiser Permanente site.

Study finds two-fold increase in risk for AYA cancer survivors

Researchers found that by 5 years post-diagnosis, the cumulative incidence of chronic conditions was highest for thyroid (17.4%), respiratory (6.6%), cardiovascular (5.0%), and liver (4.8%) diseases. At the 10-year mark, nearly 39% of cancer survivors had developed at least one chronic condition, compared to 26% in the non-cancer cohort.

“AYA cancer survivors had a two-fold increased risk of being diagnosed with any chronic medical condition,” said the study’s lead author, UC Davis Comprehensive Cancer Center epidemiologist Theresa Keegan, principal investigator of the Valuing Opinions and Insight from Cancer Experience (VOICE) study. “This risk was even higher for survivors of hematologic cancers and those diagnosed with distant stage disease.”

The study also revealed that survivors were 2.3 times more likely to develop 2 or more chronic conditions. Elevated risks were consistent across all sociodemographic groups, including race, ethnicity, and insurance status, within this insured population.

Study among first to quantify risk for AYA cancer survivors

Previous research had identified increased risks for cardiovascular disease and other late effects among AYA cancer survivors, but this new study is among the first to quantify the burden of chronic conditions across cancer types and demographic subgroups using a matched comparison cohort.

The findings highlight the need for ongoing monitoring and focused lifestyle changes to reduce risks for AYA cancer survivors, authors said. Survivorship care should include thorough strategies for early detection and management of chronic conditions.

In addition to Dr. Hahn, other Kaiser Permanente authors include Jessica Chubak, PhD, of the Kaiser Permanente Washington Health Research Institute; Charles Quesenberry. PhD, of the Kaiser Permanente Northen California Division of Research; Eric C. Haupt, ScM, and Chun Chao PhD, MS, of the Kaiser Permanente Southern California Department of Research & Evaluation. Both Dr. Hahn and Dr. Chao also are affiliated with the Kaiser Permanente Bernard J. Tyson School of Medicine.