Impaired social functioning in adolescent and young adult sarcoma survivors: Prevalence and risk factors

• Published in: Cancer Vol. 129; no. 9; pp. 1419 - 1431
• Main Authors: Drabbe, Cas, Coenraadts, Elena S., Houdt, Winan J., Sande, Michiel A. J., Bonenkamp, Johannes J., Haan, Jacco J., Nin, Johanna W. M., Verhoef, Cornelis, Graaf, Winette T. A., Husson, Olga
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2023
• Subjects: Adolescent; Adolescents; adolescents and young adults; Adults; Age; Age groups; Cancer; Comorbidity; Cross-Sectional Studies; Diagnosis; Domains; Health services; health‐related quality of life; Humans; Medical treatment; Neoplasms - therapy; Oncology; Population studies; Prevalence; Quality of life; Quality of Life - psychology; Questionnaires; Risk Factors; Sarcoma; Sarcoma - epidemiology; social functioning; Social Interaction; Social interactions; Soft Tissue Neoplasms; Survival; Survivors; survivorship; Teenagers; Young Adult; Young adults; social functioning; survivorship; health-related quality of life; sarcoma; adolescents and young adults
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.34689

Background Sarcomas account for almost 11% of all cancers in adolescents and young adults (AYAs; 18–39 years). AYAs are increasingly recognized as a distinct oncological age group with its own psychosocial challenges and biological characteristics. Social functioning has been shown to be one of the most severely affected domains of health‐related quality of life in AYA cancer survivors. This study aims to identify AYA sarcoma survivors with impaired social functioning (ISF) and determine clinical and psychosocial factors associated with ISF. Methods AYAs from the population‐based cross‐sectional sarcoma survivorship study (SURVSARC) were included (n = 176). ISF was determined according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 social functioning scale, and age‐ and sex‐matched norm data were used as reference. Results The median time since diagnosis was 6.2 years (range, 1.8–11.2). More than one‐quarter (28%) of AYA sarcoma survivors experienced ISF. Older age, higher tumor stage, comorbidities, lower experienced social support, uncertainty in relationships, feeling less attractive, sexual inactivity, unemployment, and financial difficulties were associated with ISF. In a multivariable analysis, unemployment (OR, 3.719; 95% CI, 1.261–10.967) and having to make lifestyle changes because of financial problems caused by one's physical condition or medical treatment (OR, 3.394; 95% CI, 1.118–10.300) were associated with ISF; better experienced social support was associated with non‐ISF (OR, 0.739; 95% CI, 0.570–0.957). Conclusion More than one‐quarter of AYA sarcoma survivors experience ISF long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐oriented but also focuses on the psychological and social domains. Plain Language Summary Sarcomas account for almost 11% of all cancers in adolescents and young adults (AYAs; 18–39 years). The AYA group is increasingly recognized as a distinct oncological age group with its own psychosocial challenges and biological characteristics. Social functioning has been shown to be severely affected in AYA cancer survivors. A population‐based questionnaire study to identify AYA sarcoma survivors with impaired social functioning (ISF) and determine factors associated with ISF was conducted. More than one‐quarter of AYA sarcoma survivors experience ISF long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐orientated but also focuses on the psychological and social domains. More than one‐quarter of adolescent sarcoma survivors experience impaired social functioning long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐oriented but also focuses on the psychological and social domains.