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Meernik C, Dorfman CS, Zullig LL, Lazard AJ, Fish L, Farnan L, Nichols HB, Oeffinger KC, Akinyemiju T. Health Care Access Barriers and Self-Reported Health Among Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2024; 13:112-122. [PMID: 37307018 DOI: 10.1089/jayao.2023.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Purpose: Adolescents and young adult (AYA) cancer survivors (15-39 years at diagnosis) are at risk for treatment-related late effects but face barriers in accessing survivorship care. We examined the prevalence of five health care access (HCA) barriers: affordability, accessibility, availability, accommodation, and acceptability. Methods: We identified AYA survivors from the University of North Carolina (UNC) Cancer Survivorship Cohort who completed a baseline questionnaire in 2010-2016. Participants had a history of cancer, were ≥18 years of age, and receiving care at a UNC oncology clinic. The sample was restricted to AYA survivors who were interviewed ≥1 year postdiagnosis. We used modified Poisson regression to estimate prevalence ratios (PRs) for the association between HCA barriers and self-reported fair or poor health, adjusted for sociodemographic and cancer characteristics. Results: The sample included 146 AYA survivors who were a median age of 39 at the time of the survey. The majority (71%)-and 92% of non-Hispanic Black survivors-reported at least one HCA barrier, including acceptability (40%), accommodation (38%), or affordability (31%). More than one-quarter of survivors (28%) reported fair or poor health. Affordability barriers (PR: 1.89, 95% confidence interval [CI]: 1.13-3.18) and acceptability barriers (PR: 1.60, 95% CI: 0.96-2.66) were associated with a higher prevalence of fair/poor health, as were the cumulative effects of multiple HCA dimensions reported as barriers. Conclusions: Barriers across multiple HCA dimensions were prevalent and associated with worse health in AYA survivors. Findings highlight the need to better understand and target specific barriers to care for diverse AYA survivors to improve their long-term health.
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Affiliation(s)
- Clare Meernik
- Department of Population Health Sciences and Duke University School of Medicine, Durham, North Carolina, USA
| | - Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Leah L Zullig
- Department of Population Health Sciences and Duke University School of Medicine, Durham, North Carolina, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Allison J Lazard
- Hussman School of Journalism and Media, and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura Fish
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hazel B Nichols
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin C Oeffinger
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tomi Akinyemiju
- Department of Population Health Sciences and Duke University School of Medicine, Durham, North Carolina, USA
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Ou JY, Bennion N, Parker K, Fair D, Hanson HA, Kepka D, Warner EL, Ramsay JM, Kaddas HK, Kirchhoff AC. Risk Factors and Trends for HPV-Associated Subsequent Malignant Neoplasms among Adolescent and Young Adult Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2023; 32:625-633. [PMID: 37071501 PMCID: PMC10159883 DOI: 10.1158/1055-9965.epi-22-0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Subsequent malignant neoplasms (SMN; new cancers that arise after an original diagnosis) contribute to premature mortality among adolescent and young adult (AYA) cancer survivors. Because of the high population prevalence of human papillomavirus (HPV) infection, we identify demographic and clinical risk factors for HPV-associated SMNs (HPV-SMN) among AYA cancer survivors in the SEER-9 registries diagnosed from 1976 to 2015. METHODS Outcomes included any HPV-SMN, oropharyngeal-SMN, and cervical-SMN. Follow-up started 2 months after their original diagnosis. Standardized incidence ratios (SIR) compared risk between AYA survivors and general population. Age-period-cohort (APC) models examined trends over time. Fine and Gray's models identified therapy effects controlling for cancer and demographic confounders. RESULTS Of 374,408 survivors, 1,369 had an HPV-SMN, occurring on average 5 years after first cancer. Compared with the general population, AYA survivors had 70% increased risk for any HPV-SMN [95% confidence interval (CI), 1.61-1.79] and 117% for oropharyngeal-SMN (95% CI, 2.00-2.35); cervical-SMN risk was generally lower in survivors (SIR, 0.85; 95% CI, 0.76-0.95), but Hispanic AYA survivors had a 8.4 significant increase in cervical-SMN (SIR, 1.46; 95% CI, 1.01-2.06). AYAs first diagnosed with Kaposi sarcoma, leukemia, Hodgkin, and non-Hodgkin lymphoma had increased HPV-SMN risks compared with the general population. Oropharyngeal-SMN incidence declined over time in APC models. Chemotherapy and radiation were associated with any HPV-SMN among survivors with first HPV-related cancers, but not associated among survivors whose first cancers were not HPV-related. CONCLUSIONS HPV-SMN in AYA survivors are driven by oropharyngeal cancers despite temporal declines in oropharyngeal-SMN. Hispanic survivors are at risk for cervical-SMN relative to the general population. IMPACT Encouraging HPV vaccination and cervical and oral cancer screenings may reduce HPV-SMN burden among AYA survivors.
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Affiliation(s)
- Judy Y Ou
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Cancer Biostatistics Shared Resource, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, North Carolina
| | - Natalie Bennion
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Kellee Parker
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Douglas Fair
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Heidi A Hanson
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Oak Ridge National Laboratory, United States Department of Energy, Oak Ridge, Tennessee
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Joemy M Ramsay
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Heydon K Kaddas
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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Bahanan L, Scott T, Kaye E, Sohn W. Examining the association between cancer history in early life and dental care utilization. Community Dent Oral Epidemiol 2022; 50:500-505. [PMID: 34590342 DOI: 10.1111/cdoe.12700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/11/2021] [Accepted: 09/17/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This study aims to examine associations between cancer history in early life (diagnosed at 20 years of age or younger) and utilization of dental care. METHODS We analysed data of 10,185 participants, aged ≥20 years, from the National Health and Nutrition Examination Survey cycles 2015-2018. The main predictor was self-reported past history of any type of cancer diagnosed at 20 years of age or younger (yes/no). The outcome variables were having a dental visit within the past year, treatment or preventative visit, urgent need for care, and unmet dental need. Covariates included gender, age, race, marital status, education, and income. Bivariate and multiple logistic regression were conducted, accounting for the complex sampling design. RESULTS There was no difference between early life cancer survivors in regards to dental visit within the past year (OR: 0.7; 95% CI: 0.3-1.6), visit for dental treatment (OR: 0.6; 95% CI: 0.3-1.6), urgent need for care (OR: 0.8; 95% CI: 0.3-2.0), or unmet dental need (OR: 0.6; 95% CI: 0.2-1.6) compared to cancer-free participants. CONCLUSIONS Cancer history in early life doesn't impact dental care visits, type of last dental visit, dental care recommendation, or unmet dental need. Future cohort studies are needed to confirm this association.
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Affiliation(s)
- Lina Bahanan
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Thayer Scott
- Department of Health Policy & Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - Elizabeth Kaye
- Department of Health Policy & Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - Woosung Sohn
- Population Oral Health, The University of Sydney School of Dentistry, Sydney, New South Wales, Australia
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Dyer G, Brice L, Schifter M, Gilroy N, Kabir M, Hertzberg M, Greenwood M, Larsen SR, Moore J, Gottlieb D, Huang G, Hogg M, Brown L, Tan J, Ward C, Kerridge I. Oral health and dental morbidity in long-term allogeneic blood and marrow transplant survivors in Australia. Aust Dent J 2018; 63:312-319. [PMID: 29878377 DOI: 10.1111/adj.12627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral and dental disease is a major cause of long-term morbidity following allogeneic blood and marrow transplantation (Allo-BMT). This study aimed to describe the extent and range of oral and dental complications in BMT recipients and to identify gaps in service provision provided to this high-risk group. METHODS Participants were Allo-BMT recipients, aged >18 years, and received transplants between 2000 and 2012 in NSW. They completed seven surveys, the purpose-designed Sydney Post-BMT Study survey and six other validated instruments. RESULTS Of 441 respondents, many reported dry mouth (45.1%), dental caries (36.7%), mouth ulcers (35.3%), oral GVHD (35.1%), gingivitis (16.2%), tooth abscess (6.1%) and oral cancer (1.5%). Regular dental visits were reported by 66.2% of survivors. Middle-high income, older age and geographic location showed a positive association with regular dental visits. Of those who did not visit the dentist regularly, 37% stated they did not feel it necessary, 36% reported cost and 20% stated it was not advised by the treating team. CONCLUSION Despite oral complications commonly occurring after Allo-BMT, many survivors receive inadequate dental care. These results emphasize the need for improved oral health education, the importance of regular dental checks and improvement in the delivery of dental health services for BMT survivors.
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Affiliation(s)
- G Dyer
- Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, New South Wales, Australia
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - L Brice
- Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - M Schifter
- Westmead Centre for Oral Health, Westmead Hospital, Sydney, New South Wales, Australia
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
- Department of Haematology, Westmead Hospital, Sydney, New South Wales, Australia
| | - N Gilroy
- Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, New South Wales, Australia
| | - M Kabir
- Westmead Breast Cancer Institute, Sydney, New South Wales, Australia
| | - M Hertzberg
- Department of Haematology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - M Greenwood
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
- Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - S R Larsen
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - J Moore
- Department of Haematology, St Vincents Hospital, Sydney, New South Wales, Australia
| | - D Gottlieb
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - G Huang
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - M Hogg
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - L Brown
- Department of Haematology, Calvary Mater, Newcastle, New South Wales, Australia
| | - J Tan
- Department of Haematology, St Vincents Hospital, Sydney, New South Wales, Australia
| | - C Ward
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
- Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - I Kerridge
- Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
- Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
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Hartnett E, Krainovich-Miller B. Preventive Dental Care: An Educational Program to Integrate Oral Care Into Pediatric Oncology. Clin J Oncol Nurs 2017; 21:611-616. [PMID: 28945720 DOI: 10.1188/17.cjon.611-616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Erin Hartnett
- College of Nursing at New York University in New York
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Modifiable health-related factors (smoking, physical activity and body mass index) and health care use and costs among adult cancer survivors. J Cancer Res Clin Oncol 2017; 143:2469-2480. [DOI: 10.1007/s00432-017-2494-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/04/2017] [Indexed: 01/31/2023]
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Kaul S, Avila JC, Mehta HB, Rodriguez AM, Kuo YF, Kirchhoff AC. Cost-related medication nonadherence among adolescent and young adult cancer survivors. Cancer 2017; 123:2726-2734. [DOI: 10.1002/cncr.30648] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Sapna Kaul
- University of Texas Medical Branch; Galveston Texas
| | | | | | | | | | - Anne C. Kirchhoff
- Department of Pediatrics and Huntsman Cancer Institute; University of Utah; Salt Lake City Utah
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Kaul S, Avila JC, Mutambudzi M, Russell H, Kirchhoff AC, Schwartz CL. Mental distress and health care use among survivors of adolescent and young adult cancer: A cross-sectional analysis of the National Health Interview Survey. Cancer 2016; 123:869-878. [DOI: 10.1002/cncr.30417] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Sapna Kaul
- Preventive Medicine and Community Health; University of Texas Medical Branch; Galveston Texas
| | - Jaqueline C. Avila
- Preventive Medicine and Community Health; University of Texas Medical Branch; Galveston Texas
| | - Miriam Mutambudzi
- Preventive Medicine and Community Health; University of Texas Medical Branch; Galveston Texas
| | - Heidi Russell
- Section of Hematology-Oncology, Department of Pediatrics; Baylor College of Medicine; Houston Texas
| | - Anne C. Kirchhoff
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute; University of Utah; Salt Lake City Utah
| | - Cindy L. Schwartz
- Division of Pediatrics, Department of Pediatrics Patient Care; The University of Texas MD Anderson Cancer Center; Houston Texas
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9
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Preventive services use among female survivors of adolescent and young adult cancer. J Cancer Surviv 2016; 11:167-174. [DOI: 10.1007/s11764-016-0575-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/23/2016] [Indexed: 11/27/2022]
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Smits-Seemann RR, Kaul S, Zamora ER, Wu YP, Kirchhoff AC. Barriers to follow-up care among survivors of adolescent and young adult cancer. J Cancer Surviv 2016; 11:126-132. [PMID: 27582007 DOI: 10.1007/s11764-016-0570-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/13/2016] [Indexed: 01/06/2023]
Abstract
PURPOSE Though the need for risk-based follow-up care for survivors of adolescent and young adult (AYA) cancer has been documented, survivors often report forgoing recommended care due to cost. We sought to understand whether additional barriers to follow-up care exist for AYA survivors. METHODS We recruited survivors who were diagnosed with cancer between the ages of 15 and 39 using the Utah Cancer Registry (UCR). Overall, 28 survivors participated in 6 focus groups held between March and May 2015 in Salt Lake City and St. George, UT. Focus group discussions focused on the reasons survivors may or may not attend recommended medical visits after completing therapy. RESULTS Survivors reported myriad barriers to follow-up medical visits, including lack of clear provider recommendation, fear of recurrent cancer diagnosis, wishing to move on with life, competing life responsibilities due to work and children, and not perceiving the need for a visit due to lack of symptoms. CONCLUSIONS Though cost likely plays a major part in follow-up care adherence for survivors of AYA cancer, in our focus groups, participants indicated there were many other psychosocial and logistic barriers to care. Such factors play an important role in the day-to-day lives of survivors and are critical in medical decision-making. IMPLICATIONS FOR CANCER SURVIVORS Several factors impede follow-up care adherence for survivors of AYA cancer that are amenable to interventions, including clearer provider recommendations, flexible appointment times, and childcare availability in clinics.
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Affiliation(s)
- Rochelle R Smits-Seemann
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA. .,Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Rm 4124, Salt Lake City, UT, 84112, USA.
| | - Sapna Kaul
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Yelena P Wu
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Rm 4124, Salt Lake City, UT, 84112, USA.,Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA.,Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Rm 4124, Salt Lake City, UT, 84112, USA
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Kaul S, Veeranki SP, Rodriguez AM, Kuo YF. Cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult cancer. Cancer 2016; 122:2895-905. [PMID: 27286172 DOI: 10.1002/cncr.30086] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/05/2016] [Accepted: 04/21/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND We examined the associations between cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult (AYA) cancer and a comparison group. METHODS From the 2012 to 2014 National Health Interview Surveys, we identified 1019 survivors of AYA cancer, defined as individuals who had been diagnosed with cancer between 15 and 39 years of age and were at least 5 years after their initial cancer diagnosis. A noncancer comparison group was matched on age, sex, and other factors. Self-reported smoking status (never smoker, former smoker, or current smoker), comorbidities (eg, asthma and diabetes), and general health status (excellent, very good, or good versus poor or fair) were compared among these groups. Survivors' smoking status before diagnosis and interaction with health care professionals regarding smoking cessation were reported. Multivariable logistic regressions modeled the associations between smoking status and comorbidity and general health. RESULTS 33% of survivors were current smokers compared with 22% in the comparison group (P < .001). Prevalence of comorbidities and fair/poor health was significantly higher among survivors. Current smokers among survivors were more likely to report greater comorbidities (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.06-2.47; P = .03) and less likely to report at least good health (OR, 0.34; 95% CI, 0.22-0.54; P < .001) than never-smokers. Among survivors who smoked currently, 92% started smoking before diagnosis, and 37% reported having no smoking-related discussions with health care professionals in the previous year. CONCLUSIONS Smoking among survivors of AYA cancer is associated with greater comorbidities and poorer general health. Younger survivors may need to be targeted for effective smoking cessation interventions. Addressing cigarette smoking during medical visits may encourage survivors to quit smoking. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2895-2905. © 2016 American Cancer Society.
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Affiliation(s)
- Sapna Kaul
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Sreenivas P Veeranki
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Ana M Rodriguez
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
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Kaul S, Fluchel M, Spraker-Perlman H, Parmeter CF, Kirchhoff AC. Health care experiences of long-term survivors of adolescent and young adult cancer. Support Care Cancer 2016; 24:3967-77. [DOI: 10.1007/s00520-016-3235-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/17/2016] [Indexed: 11/27/2022]
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