Quality of Life Among Adolescents and Young Adults with Melanoma: A Systematic Review

Abstract

While quality of life (QoL) has been well-studied in older adults with melanoma, it has received less attention in adolescents and young adults (AYAs). Understanding QoL trajectories in AYAs with melanoma can help identify care gaps and develop interventions to support patients through cancer treatment and survivorship. A systematic review of MEDLINE, Embase, Cochrane, and Web of Science identified 4283 unique articles. Clinical trials, cohort studies, cross-sectional studies, and qualitative studies were included if the study cohort addressed any aspect of QoL in AYA patients (ages 15-39) with cutaneous, ocular, or mucosal melanoma. Out of 128 full-text articles, 9 met inclusion criteria, representing 1516 AYAs with melanoma. Psychological health was the most reported QoL domain, followed by social health and relationships. Compared with AYAs with other cancers, patients with melanoma, were more likely to experience distress related to body image, fear of cancer recurrence, and higher levels of depression, anxiety, and sexual problems. Eighty-two studies did not stratify QoL outcomes by age, and eight studies included AYA patients with multiple types of cancer, but did not stratify QoL outcomes by cancer type, thus, the AYA patients could not be identified within the larger QoL data pool and excluding at least 374 patients. Gaps remain in our understanding of these challenges, emphasizing the need for additional research investigating distress in this population. Developing a standard QoL battery and stratifying QoL outcomes by age and cancer type are two potential opportunities to improve future QoL outcomes research for this population.

Keywords: AYA; adolescents; melanoma; quality of life; skin cancer; systematic review; young adults.