J Clin Oncol: The mental health problems of young cancer survivors cannot be ignored!

Risks and predictive factors for long-term mental health outcomes in adolescents and young adults (AYA) cancer survivors have not been well summarized.
mental health is often overlooked during long-term follow-up of such populations.
Riddhita and others used a population-based database to screen all AYA 15-21 year olds diagnosed with one of the six common cancers in Ontario, Canada, between 1992 and 2012, and compared them with a matching control group.
is linked to provincial health-care data and can analyse outpatient visits (family doctors and psychiatrists) and the timing of serious mental events (emergency room visits, hospitalizations and suicides).
, poor prognostic predictors associated with demographics, disease and treatment were studied, including the therapeutic environment (adult vs pediatrics).
the cumulative number of visits for mental health problems was compared to 2,208 cancer survivors and 10,457 matching patients, five-year cancer survivors experienced a higher rate of outpatient mental health visits than the control group (671 vs 506 visits/1000 person-years; adjusted ratio was 1.3; 95% CI 1.1-1.5; p-0.06).
risk of developing severe mental illness in cancer survivors also increased (adjusted risk ratio of 1.2; 95% CI 1.1-1.4, p=0.008).
although the absolute risk remains low (1.7 per cent cumulative incidence over 15 years; 95 per cent CI 1.0-2.7), cancer survivors have doubled the risk of serious events associated with mental disorders (HR 2.0, 95 per cent CI 1.3-2.4; p=0.007).
in the multivariable analysis, cancer survivors treated in adult centers had significantly higher outpatient visits (RR 1.8; 95% CI 1.0-3.1; p=0.04) than individuals treated in pediatrics.
, adolescents and young adult cancer survivors have a significantly increased risk of adverse mental health prognosis, especially those treated in adult centers.
the absolute incidence remains low, there is a significant increase in the risk of serious events associated with mental disorders among cancer survivors.
is necessary for long-term mental health monitoring of such populations, and research into effective interventions during or after cancer treatment is also necessary.