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Introduction: Fertility after cancer is a top concern for adolescents and young adults with cancer (AYAs) (15–39 years old at diagnosis). The authors characterized live births after cancer by race and ethnicity ("race/ethnicity") in a population‐based sample of female AYAs. Methods: This study used Texas Cancer Registry data linked to birth certificates (1995–2016) to estimate cumulative incidence of live birth, based on first live birth after cancer, and compared differences by race/ethnicity. Proportional subdistribution hazards models were used to estimate associations between race/ethnicity and live birth, adjusted for diagnosis age, cancer type, stage, year, and prior live birth, overall and for each cancer type. Results: Among 65,804 AYAs, 10‐year cumulative incidence of live birth was lower among non‐Hispanic Black AYAs than other racial/ethnic groups: 10.2% (95% confidence interval [CI], 9.4–10.9) compared to 15.9% (95% CI, 14.1–17.9) among Asian or Pacific Islander, 14.7% (95% CI, 14.2–15.3) among Hispanic, and 15.2% (95% CI, 14.8–15.6) among non‐Hispanic White AYAs (p <.01). In the adjusted overall model, Black AYAs were less likely to have a live birth after cancer than all other groups. In adjusted models for each cancer type, live birth was significantly less likely for Black AYAs with gynecologic cancers or lymphomas (compared to White AYAs) or thyroid cancers (compared to Hispanic AYAs). Conclusion: Black AYAs are less likely than AYAs of other races/ethnicities to have a live birth after cancer, in contrast to patterns of live birth in the general population. Research and action to promote childbearing equity after cancer are imperative. The authors used Texas Cancer Registry data linked to live birth certificates (1995–2016) to characterize live births after cancer by race and ethnicity ("race/ethnicity") among females diagnosed with cancer as adolescents and young adults (AYAs) (15–39 years old at diagnosis). Overall and within certain cancer types, Black AYAs were less likely than AYAs of other races or ethnicities to have a live birth after cancer, in contrast to general population birth patterns. [ABSTRACT FROM AUTHOR]

Background: Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. Methods: National Health Interview Survey data (2010–2018) were analyzed that identified non‐Hispanic Black (hereafter, Black) survivors of AYA cancer and age‐ and sex‐matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. Results: The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR], 1.64; p <.001), use mental health care (OR, 1.53; p =.027), report an inability to afford mental health care (OR, 3.82; p <.001), and use medication for anxiety and/or depression (OR, 2.16; p =.001). Forty‐one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18–39 years (vs. 40–64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. Conclusions: A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population. Black survivors of adolescent and young adult cancer have higher levels of psychological distress than Black individuals without a history of cancer and are more likely to report an inability to afford mental health care. There is a gap in receipt of mental health care among Black survivors, with approximately 40% of survivors reporting moderate/severe distress and only 15% reporting a mental health care visit. [ABSTRACT FROM AUTHOR]

Survivors of adolescent and young adult (AYA; age 15-39 years at diagnosis) cancer are a growing population with the potential to live for many decades after treatment completion. Survivors of AYA cancer are at risk for adverse long-term outcomes including chronic conditions, secondary cancers, impaired fertility, poor psychosocial health and health behaviors, and financial toxicity. Furthermore, survivors of AYA cancer from racially minoritized and low socioeconomic status populations experience disparities in these outcomes, including lower long-term survival. Despite these known risks, most survivors of AYA cancer do not receive routine survivorship follow-up care, and research on delivering high-quality, evidence-based survivorship care to these patients is lacking. The need for survivorship care was initially advanced in 2006 by the Institute of Medicine. In 2019, the Quality of Cancer Survivorship Care Framework (QCSCF) was developed to provide an evidence-based framework to define key components of optimal survivorship care. In this commentary focused on survivors of AYA cancer, we apply the QCSCF framework to describe models of care that can be adapted for their unique needs, multilevel factors limiting equitable access to care, and opportunities to address these factors to improve short- and long-term outcomes in this vulnerable population., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Evidence suggests neighborhood-level factors contribute to cancer outcomes, though most research focuses on pediatric and adult populations. Using population-based data from the Texas Cancer Registry, we examined neighborhood-level social vulnerability, a composite measure of 14 census tract-level social risk factors, and survival among 112,142 adolescents and young adults with cancer (AYAs, age 15-39 years). We estimated one-, five-, and ten-year overall survival by quintile of social vulnerability and used Cox proportional hazards models (two-sided significance testing) to estimate the association between social vulnerability and all-cause mortality. Survival decreased as social vulnerability increased; for example, five-year survival was 86.5% (95% CI 85.1, 87.0) in the least vulnerable quintile compared to 74.0% (95% CI 73.4, 74.5) in the most vulnerable quintile. Social vulnerability was associated with all-cause mortality in adjusted models (highest vs lowest quintile: aHR 1.55, 95% CI 1.48, 1.63). Achieving equity in AYAs' survival requires interventions to address neighborhood disparities., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)