PDF(Pubmed)
Abstract：
About 4.5% of new cancer cases affect adolescent and young adult aged between 15 and 39 years in the United States (US). However, the effect of neuropsychiatric conditions on long-term adolescent and young adult cancer (AYAC) survivors has not been formally investigated. Thus, the impact and management of late neuropsychiatric complications in AYAC survivors compared to non-cancer-matched controls (NCMC) in the US were evaluated using the All of Us (AoU) Research Program.
Participants in the AoU Controlled Tier Dataset (v6) diagnosed with cancer between ages 15 and 39 were identified from electronic health records and surveys. AYAC survivors were matched with NCMC using the optimal pair-matching algorithm at a 1:4 ratio. Data on past diagnoses, current follow-up care, and treatment patterns of neuropsychiatric complications were collected.
Analysis was performed on 788 AYAC survivors and 3152 NCMC. AYAC survivors, with an average of 8.8 years since their first cancer diagnosis, were more likely than NCMC to receive a diagnosis of neuropathy, memory loss and epilepsy (p < 0.001). Survivors also had a higher rate of follow-up care and treatment utilization for these neurological conditions compared to NCMC (p < 0.05). Treatment utilization was highest among survivors receiving care for epilepsy (88%), and lower for neuropathy (70%), memory loss (61%), and chronic fatigue (59%).
This large study reveals that AYAC survivors, on average 9 years after their cancer diagnosis, require more frequent follow-up care for neurological complications compared to non-cancer individuals. However, the management of neuropathy, memory loss, and chronic fatigue is hindered by a lack of mechanism-based effective therapies.
Participants in the AoU Controlled Tier Dataset (v6) diagnosed with cancer between ages 15 and 39 were identified from electronic health records and surveys. AYAC survivors were matched with NCMC using the optimal pair-matching algorithm at a 1:4 ratio. Data on past diagnoses, current follow-up care, and treatment patterns of neuropsychiatric complications were collected.
Analysis was performed on 788 AYAC survivors and 3152 NCMC. AYAC survivors, with an average of 8.8 years since their first cancer diagnosis, were more likely than NCMC to receive a diagnosis of neuropathy, memory loss and epilepsy (p < 0.001). Survivors also had a higher rate of follow-up care and treatment utilization for these neurological conditions compared to NCMC (p < 0.05). Treatment utilization was highest among survivors receiving care for epilepsy (88%), and lower for neuropathy (70%), memory loss (61%), and chronic fatigue (59%).
This large study reveals that AYAC survivors, on average 9 years after their cancer diagnosis, require more frequent follow-up care for neurological complications compared to non-cancer individuals. However, the management of neuropathy, memory loss, and chronic fatigue is hindered by a lack of mechanism-based effective therapies.
摘要：
背景：在美国（US），约4.5%的新癌症病例影响年龄在15至39岁之间的青少年和年轻成年人。然而,神经精神疾病对长期青少年和年轻成人癌症(AYAC)幸存者的影响尚未得到正式研究.因此，我们使用AllofUs(AoU)研究计划评估了与美国非癌症匹配对照组(NCMC)相比,AYAC幸存者晚期神经精神并发症的影响和管理.
方法：从电子健康记录和调查中确定了AoU受控层级数据集（v6）中被诊断为15至39岁癌症的参与者。使用最佳配对匹配算法以1：4的比例将AYAC幸存者与NCMC进行匹配。过去诊断的数据，目前的后续护理，收集神经精神并发症的治疗模式。
结果：对788名AYAC幸存者和3152名NCMC进行了分析。AYAC幸存者，自从他们第一次诊断癌症以来，平均有8.8年的时间，比NCMC更有可能接受神经病变的诊断，记忆丧失和癫痫（p<0.001）。与NCMC相比，幸存者对这些神经系统疾病的随访护理和治疗利用率也更高（p<0.05）。在接受癫痫治疗的幸存者中，治疗利用率最高(88%)。和较低的神经病变（70％），记忆丧失（61%），和慢性疲劳（59％）。
结论：这项大型研究表明，AYAC幸存者，在他们确诊癌症后平均9年,与非癌症患者相比,神经系统并发症需要更频繁的后续护理.然而,神经病的管理，记忆丧失,缺乏基于机制的有效疗法阻碍了慢性疲劳。
方法：从电子健康记录和调查中确定了AoU受控层级数据集（v6）中被诊断为15至39岁癌症的参与者。使用最佳配对匹配算法以1：4的比例将AYAC幸存者与NCMC进行匹配。过去诊断的数据，目前的后续护理，收集神经精神并发症的治疗模式。
结果：对788名AYAC幸存者和3152名NCMC进行了分析。AYAC幸存者，自从他们第一次诊断癌症以来，平均有8.8年的时间，比NCMC更有可能接受神经病变的诊断，记忆丧失和癫痫（p<0.001）。与NCMC相比，幸存者对这些神经系统疾病的随访护理和治疗利用率也更高（p<0.05）。在接受癫痫治疗的幸存者中，治疗利用率最高(88%)。和较低的神经病变（70％），记忆丧失（61%），和慢性疲劳（59％）。
结论：这项大型研究表明，AYAC幸存者，在他们确诊癌症后平均9年,与非癌症患者相比,神经系统并发症需要更频繁的后续护理.然而,神经病的管理，记忆丧失,缺乏基于机制的有效疗法阻碍了慢性疲劳。
