Psychological distress and associated additional medical expenditures in adolescent and young adult cancer survivors

Abstract

Background Adolescent and young adult (AYA) cancer survivors experience psychological distress often because of cancer and its treatment. However, no prior studies have evaluated the additional medical expenditures and health care utilization associated with psychological distress in AYA cancer survivors. Methods AYA cancer survivors and a comparison matched group of adults with no history of cancer were identified from 2011‐2016 Medical Expenditure Panel Survey data. Medical expenditures and health care utilization were evaluated with multivariable regression models. Results AYA cancer survivors were more likely to have psychological distress (11.5% of 1757) than adults with no history of cancer (5.8% of 5227). The prevalence of psychological distress was found to be high many years after the diagnosis, with 11.2% reporting distress ≥20 years after their cancer diagnosis. AYA cancer survivors with psychological distress were more likely to smoke and have chronic conditions and were less likely to exercise regularly in comparison with AYAs with no history of psychological distress. AYA cancer survivors with psychological distress had additional annual medical expenses ($4415; 95% CI, $993‐$9690), office visits (2.80; 95% CI, 0.23‐6.15), and use of prescription medications/medication renewals (11.58; 95% CI, 5.70‐19.47) in comparison with AYA cancer survivors without psychological distress. Additional annual medical expenses of psychological distress were $2600 higher in AYA cancer survivors than adults without a history of cancer ($1802; 95% CI, $440‐$3791). Conclusions These results highlight the substantial economic burden associated with psychological distress in AYA cancer survivors. This research could inform survivorship care plans and interventions addressing the psychological needs of AYA cancer survivors.

Cancer-related psychosocial challenges

“…Being considered a major life stressor, cancer may cause substantial psychological distress as well as mental health disorders. 6 The most common mental health disorders include major depressive disorder, generalised anxiety disorder, adjustment disorder, panic disorder and posttraumatic stress disorder. 32 A poor psychological state is always related to a less satisfying quality of life, decreased psychosocial functioning 33 and a worse prognosis.…”

“…36 Another recently published survey showed that adolescents and young cancer survivors(people diagnosed with cancer when they were young) are more likely to experience psychological distress (11.5% of 1757) than adults with no history of cancer (5.8% of 5227), including 11.2% reporting distress more than 20 years after cancer diagnosis. 6 Treatment-related problems Among the stressors that cause emotional distress, treatment-related problems are exclusive to the medical field, especially in oncology. Based on qualitative and quantitative results, because of fear, individuals may either decide to undergo cancer screening or postpone their hospital visits to seek medical advice.…”

“…4 5 Psychosocial factors affect physical and mental well-being 4 and also practical concerns, such as medical expenditures. 6 The progression or recovery from a disease causes psychological distress and affects the emotions, perceptions and beliefs, as well as the daily lives of patients. 7 Additionally, coping with cancer is not just an individual battle.…”

“…Referring to the well-known biopsychosocial model, a reciprocal effect exists between psychosocial factors and biological outcomes 4 5. Psychosocial factors affect physical and mental well-being4 and also practical concerns, such as medical expenditures 6. The progression or recovery from a disease causes psychological distress and affects the emotions, perceptions and beliefs, as well as the daily lives of patients 7.…”

Psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia, 2022

“…Long-term distress can have additional signi cant nancial toxicity (31). In comparison to patients without a history of distress, cancer survivors with distress reported higher annual medical expenses (32). As the burden of psychosocial distress among patients is on the rise, it affects a signi cantly higher number of families or primary caregivers (33,34).…”