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Excess risk of chronic health conditions in Hispanic survivors of adolescent and young adult cancers

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Abstract

Purpose

There is a growing population of survivors of adolescent and young adult (AYA) cancers (age 15–39 years at diagnosis). Studies in AYA cancer survivors have identified racial and ethnic disparities in long-term outcomes. To understand the extent to which a cancer diagnosis exacerbates pre-existent health disparities within a minoritized population, comparisons should be made to those of the same race or ethnicity without a cancer history.

Methods

Self-reported data from the National Health Interview Survey (2009–2018) were used to identify Hispanic AYA cancer survivors and Hispanic age- and sex-matched controls. SES factors (marital status, income, education, insurance) and prevalence of chronic health conditions were compared between groups using chi-square tests. The log-odds of chronic conditions were modeled by survey-weighted logistic regression with relation to age at survey, sex, marital status, education, family income, and cancer group (control versus cancer), together with interactions between each variable and cancer group (survivors vs. controls).

Results

Five hundred thirty-nine survivors and 5390 controls were included. Compared with controls, survivors were less likely to be married and have family income > 45 K/year, and more likely to be insured and have completed some college. Survivors had higher odds than controls of chronic health conditions (odds ratio (OR): 7.39, p < 0.001 for at least 1 and OR: 4.78, p < 0.001 for 3 or more) including cardiovascular disease, diabetes, and hypertension. Female sex, higher educational attainment, and public insurance were each associated with increased odds of chronic conditions in Hispanic AYA survivors.

Conclusions

An AYA cancer diagnosis is associated with poor SES outcomes and increased odds of comorbidities within the Hispanic population.

Implications for Cancer Survivors

Cancer history can exacerbate underlying health disparities. Screening for chronic conditions is especially important in minoritized populations.

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Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Cancer Institute at the National Institutes of Health [grant number P30 CA016672 (MR) and R38-HL143612 (AB)] and research support from the Archer Foundation and LyondellBasell (MR) and the Argyros Oncology Nursing Research Fellowship (EC). The funding source had no role in the design of this study, its execution, analyses, interpretation of the data, or decision to submit results.

Author information

Author notes

  1. Amy M. Berkman and Eunju Choi contributed equally as co-first authors.

Authors and Affiliations

  1. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA

    Amy M. Berkman

  2. Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Eunju Choi

  3. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA

    John M. Salsman

  4. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Susan K. Peterson

  5. University of Maryland School of Social Work, Baltimore, MD, USA

    Christabel K. Cheung

  6. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Clark R. Andersen

  7. Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Institute, Houston, TX, USA

    Qian Lu

  8. Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    J. A. Livingston

  9. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michelle A. T. Hildebrandt

  10. Institute for Clinical Research and Health Policy Studies and the Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA

    Susan K. Parsons

  11. Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michael E. Roth

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  1. Amy M. Berkman
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Contributions

Amy M. Berkman, Eunju Choi, and Michael E. Roth contributed to study conception and design. Data collection and analysis were performed by Eunju Choi. The first draft of the manuscript was written by Amy M. Berkman, Eunju Choi, and Michael E. Roth. And all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael E. Roth.

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Berkman, A.M., Choi, E., Salsman, J.M. et al. Excess risk of chronic health conditions in Hispanic survivors of adolescent and young adult cancers. J Cancer Surviv 18, 907–916 (2024). https://doi.org/10.1007/s11764-023-01342-z

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  • DOI: https://doi.org/10.1007/s11764-023-01342-z

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