부산대학교 도서관

Background: Adolescent and young adult cancer survivors (AYAs, aged 18-39 years at first diagnosis) have a higher second cancer risk. Accelerated aging is hypothesized as underlying mechanism and has been described clinically by 6 indicators; fatigue, low quality of sleep, low mood, lack of motivation, subjective memory complaints, and poor exercise tolerance. Using patient-reported outcomes, we aimed to identify clusters of accelerated aging among AYA cancer survivors and to investigate their association with second cancer development. Patients and Methods: Patient, tumor, and treatment data were obtained from the Netherlands Cancer Registry. Patient- reported clinical indicators and second cancer data were obtained from the SURVivors (5-20 years) of cancer in AYAs (SURVAYA) questionnaire study between 1999 and 2015. Latent class and multivariable logistic regression analyses were performed. Results: In total, n = 3734 AYA survivors with known second cancer status (n = 278 [74%] second cancers) were included. Four latent clusters were identified and named based on their clinical indicator features; (1) high accelerated aging (31.3%,2) intermediate accelerated aging without poor exercise tolerance (15.1%,3) intermediate accelerated aging without lack of motivation (274%), and (4) low accelerated aging (26.2%). AYAs in the high accelerated aging cluster were more likely to have second cancer (odds ratio: 1.6; 95% CI, 1.1-2.3) compared to the low accelerated aging cluster. Conclusion: AYAs with a higher burden of accelerated aging were more likely to develop a second cancer. Validation of the clinical indicators and how to best capture them is needed to improve (early) detection of AYAs at high risk of developing second cancer. Key words: adolescents and young adults; cancer survivors; patient-reported outcomes; second cancer; accelerated aging; oncology.
Implications for Practice If proven valid, the use of reliable patient-reported clinical indicators that can accurately capture the cellular changes underlying accelerated aging could provide a simple and noninvasive way [...]