title: Distress among young adult cancer survivors: a cohort study.
abstract: OBJECTIVE
  Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39).
  
  
  METHODS
  Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES).
  
  
  RESULTS
  The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05).
  
  
  CONCLUSIONS
  Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.
authors.affiliation: Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th floor, Chicago, IL 60611, USA. betina.yanez@northwestern.edu
authors.forename: Betina
authors.initials: B
authors.lastname: Yanez
authors.forename: Sofia F
authors.initials: SF
authors.lastname: Garcia
authors.forename: David
authors.initials: D
authors.lastname: Victorson
authors.forename: John M
authors.initials: JM
authors.lastname: Salsman
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D004522:Educational Status; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011584:Psychology; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult