Patient-reported outcomes of accelerated aging: a novel approach to investigate second cancer risk in adolescent and young adult (18-39 years) cancer survivors

Meer, D.J. van der; Zevenbergen, S.; Vlooswijk, C.; Bijlsma, R.M.; Kaal, S.E.J.; Kerst, J.M.; ... ; Husson, O. (2023)

Article / Letter to editor

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 [7.4%] 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 (27.4%), 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.

• adolescents and young adults
• cancer survivors
• patient-reported outcomes
• second cancer
• accelerated aging
• oncology

• All authors: Meer, D.J. van der; Zevenbergen, S.; Vlooswijk, C.; Bijlsma, R.M.; Kaal, S.E.J.; Kerst, J.M.; Tromp, J.M.; Bos, M.E.M.M.; Hulle, T. van der; Lalisang, R.; Nuver, J.; Kouwenhoven, M.C.M.; Graaf, W.T.A. van der; Husson, O.
• Date: 2023-11-23
• Journal: The Oncologist
• Volume: 29
• Issue: 4
• Pages: e526 - e534
• DOI: doi:10.1093/oncolo/oyad307
• Link: https://academic.oup.com/oncolo/article/29/4/e526/7444337