The study objective was to identify sociodemographic and coronavirus disease 2019 (COVID-19) factors that are associated with COVID-19 vaccine hesitancy among adolescent and young adult (AYA) cancer survivors. Eligible participants were 18 years or older and were diagnosed with cancer as an AYA (ages 15-39 years) and received services through an AYA cancer program. A total of 342 participants completed a cross-sectional survey. Our primary outcome—COVID-19 vaccine hesitancy—was surveyed as a 5-point Likert scale and operationalized as a binary outcome (agree vs hesitant). A large proportion of participants reported COVID-19 vaccine hesitancy (37.1%). In the multivariable regression, female survivors (odds ratio = 1.81, 95% confidence interval = 1.10 to 2.98) and survivors with a high school education or less (odds ratio = 3.15, 95% confidence interval = 1.41 to 7.04) reported higher odds of vaccine hesitancy compared with their male or college graduate or higher counterparts. COVID-19 vaccine hesitancy persists among AYA survivors despite their recommended priority vaccination status and higher chances of severe COVID-19 outcomes.

◥Background: Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM 2.5 ) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM 2.5 .Methods: We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM 2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM 2.5 and mortality. Among AYAs, we examined effect modification of PM 2.5 and mortality by stage while controlling for cancer type.Results: Increases in PM 2.5 per 5 mg/m 3 were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR 5-year ¼ 1.32 (1.02-1.71)]. Among AYAs, PM 2.5 per 5 mg/m 3 was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR 5-year ¼ 1.06 (1.01-1.13)]. PM 2.5 ≥12 mg/m 3 was associated with cancer mortality among breast [HR 5-year ¼ 1.50 (1.29-1.74); HR 10-year ¼ 1.30 (1.13-1.50)] and colorectal cancers [HR 5-year ¼ 1.74 (1.29-2.35); HR 10-year ¼ 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk.Conclusions: PM 2.5 was associated with mortality in pediatric and AYA patients with specific cancers.Impact: Limiting PM 2.5 exposure may be important for young cancer patients with certain cancers.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."

Our findings demonstrate the importance of formalizing provider transitions and roles after cancer therapy to improve patient comfort with new providers. By understanding the complexities of the transition from active cancer treatment to follow-up care for AYA survivors, these findings can inform programs undertaking post-care educational activities to ensure a seamless transition into survivorship care. Survivorship care plans can facilitate these transitions and improve patient confidence in follow-up care.