title: Prevalence and Intensity of Pain and Other Physical and Psychological Symptoms in Adolescents and Young Adults Diagnosed with Cancer on Referral to a Palliative Care Service.
abstract: OBJECTIVE
  While adolescent and young adult (AYA) oncology is recognized as a distinct specialty, there remains a paucity of literature documenting symptomatology in this cohort. This study aimed to identify the prevalence, severity, and mechanism of pain and other symptoms in AYA patients referred to a palliative care service in a specialist Australian cancer center.
  
  
  METHODS
  A retrospective design analyzed the case file data of 33 eligible AYA patients aged 15-25 years old at diagnosis and two randomly selected control groups of patients >25 years old: unmatched and matched for diagnosis and sex. All cases were referred to the palliative care service between July 2009 and June 2012. Descriptive statistics, analysis of Edmonton Symptom Assessment Scale (ESAS) and Edmonton Classification System of Cancer Pain (ECS-CP) data, and non-parametric tests were performed.
  
  
  RESULTS
  The most common malignancies among the AYA patients were sarcoma and hematological cancers. All AYA patients reported pain syndrome on the ECS-CP compared with 85% of the matched controls (p=0.018). An age group effect was found for mechanisms of pain (p=0.035). A trend toward more neuropathic pain among AYA cases was also found (59% vs. 39%). The most common ESAS symptoms in AYAs were pain (91%), diminished well-being (76%), fatigue (75%), and decreased appetite (67%).
  
  
  CONCLUSIONS
  AYA cancer patients appear to experience a unique symptom profile with high symptom prevalence and complexity. Further research is warranted to identify determinants and inform integration of supportive and palliative care services for this unique patient cohort.
authors.affiliation: 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia .
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Hughes
authors.affiliation: 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia .
authors.forename: Lucy R
authors.initials: LR
authors.lastname: Holland
authors.affiliation: 2 Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia .
authors.forename: Diana
authors.initials: D
authors.lastname: Zanino
authors.affiliation: 2 Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia .
authors.forename: Emma
authors.initials: E
authors.lastname: Link
authors.affiliation: 3 Cabrini Health-Palliative Care , Prahan, Australia .
authors.forename: Natasha
authors.initials: N
authors.lastname: Michael
authors.affiliation: 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia .
authors.forename: Kate E
authors.initials: KE
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D010166:Palliative Care; D015995:Prevalence; D011788:Quality of Life; D012017:Referral and Consultation; D012720:Severity of Illness Index; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: cancer care continuum; pain management; palliative care; quality of life; supportive care