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Randomized Controlled Trial
. 2022 Oct;16(5):1149-1164.
doi: 10.1007/s11764-021-01105-8. Epub 2021 Sep 29.

Cancer survivorship care for young adults: a risk-stratified, multicenter randomized controlled trial to improve symptoms

Karen L Syrjala  1   2 , Casey A Walsh  3   4 , Jean C Yi  3 , Wendy M Leisenring  3   5 , Emily Jo Rajotte  3 , Jenna Voutsinas  3 , Patricia A Ganz  6 , Linda A Jacobs  7 , Steven C Palmer  7 , Ann Partridge  8 , K Scott Baker  3   5
Affiliations
Randomized Controlled Trial

Cancer survivorship care for young adults: a risk-stratified, multicenter randomized controlled trial to improve symptoms

Karen L Syrjala et al. J Cancer Surviv. 2022 Oct.

Abstract

Purpose: Young adult (YA) cancer survivors have high rates of adverse health and psychosocial outcomes. This risk-stratified, multicenter, randomized controlled trial (RCT) compared a self-management survivorship intervention to usual care in YA survivors with symptoms of cancer-related distress, insomnia, fatigue, pain, and/or depression.

Methods: Eligibility included age 18-39 at diagnosis with an invasive malignancy in the previous 1-5 years. Baseline assessment determined "high need" participants, with 2-5 elevated targeted symptoms. We randomized high need participants to intervention or usual care and offered intervention participants a survivorship clinic visit, which included mutually decided action plans for symptoms. Follow-up calls at 1 and 3 months after the clinic visit reviewed action plan progress. Outcomes compared rates of improved symptoms for intervention vs usual care at 6 months and 12 months.

Results: N = 344 completed baseline assessment, with n = 147 (43%) categorized as high need and randomized. Of n = 73 randomized to the intervention, n = 42 (58%) did not attend their survivorship clinic visit. In intent-to-treat analyses, aggregate symptom scores did not differ between arms, though distress improved for 46% in the intervention arm at 6 months compared to 18% in usual care (p = 0.03) among those with elevated distress at baseline.

Conclusions: Distress improved for YAs who received self-management survivorship care. However, the study demonstrates a need for alternative strategies for providing YA survivorship care.

Trial registration: NCT02192333 IMPLICATIONS FOR CANCER SURVIVORS: While YA survivors demonstrate some improved distress when provided survivorship care, to make care accessible and effective, they require options such as remote delivery of care.

Keywords: AYA; Cancer survivor; Randomized controlled trial; Risk-stratified; Survivorship care plan; Young adult.

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Conflict of interest statement

Conflict of interest The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study participation
See this image and copyright information in PMC

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