title: Dental Care for Survivors of Adolescent and Young Adult Cancer: Special Considerations.
abstract: Oral health is important for quality of life, but may be undermanaged for survivors of cancer. We examine dental care use and barriers among long-term survivors of adolescent and young adult (AYA) cancer in comparison to individuals without a history of cancer.
  
  
  
  The 2008-2012 Medical Expenditure Panel Survey (MEPS) identified 1216 individuals diagnosed with cancer at AYA ages (15-39 years), who were at least 5 years from diagnosis. A comparison group was matched using age, sex, and other factors. We evaluated self-reported dental visits in the previous 12 months, and inability and delay in receiving necessary dental care among survivors and the comparison group. Furthermore, individual factors associated with dental care use were identified using multivariable logistic regressions.
  
  
  
  Of survivors, 60.86% reported no dental visits in the previous year compared to 51.96% of the comparison individuals (p < 0.001). Survivors were more likely to report inability (10.71% vs. 6.29%, p = 0.001) and delay (8.12% vs. 4.45%, p = 0.001) in getting necessary dental care than the comparison group. Notably, survivors without dental insurance were more likely to report inability and delay. Female survivors were more likely to use dental care than males (odds ratio = 1.76, 95% confidence interval 1.15-2.71, p = 0.01). Hispanic survivors, those diagnosed at younger ages, and uninsured survivors were less likely to have at least one dental visit.
  
  
  
  Survivors of AYA cancer need timely surveillance to manage late effects, including dental complications. Yet, these survivors, particularly those who are uninsured, delay dental care more often than individuals from the general population. Survivor-specific interventions are needed to reduce dental care barriers.
authors.affiliation: 1 Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas.
authors.forename: Sapna
authors.initials: S
authors.lastname: Kaul
authors.affiliation: 2 Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah.
authors.forename: Douglas
authors.initials: D
authors.lastname: Fair
authors.affiliation: 3 Huntsman Cancer Institute and Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wright
authors.affiliation: 3 Huntsman Cancer Institute and Pediatric Hematology/Oncology, University of Utah , Salt Lake City, Utah.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000073116:Cancer Survivors / Q000523:psychology*; D003729:Dental Care / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult
keywords: MEPS; dental care; dental use barriers; survivors of AYA cancer