Advances in the treatment of adolescents and young adults with cancer have resulted in higher survival rates and longer life expectancies. But up to 20 years after people diagnosed with cancer at age 20 to 44 are declared cancer-free, they still have more hospitalizations than the general public, new research has found.

“Even when young adults survive cancer, the cancer still has an impact on their lives and their long-term health,” said Nancy Baxter, MD, PhD, a colorectal surgeon at St. Michael’s Hospital and a senior adjunct scientist at the Institute for Clinical Evaluative Sciences in Toronto, ON, Canada. “And this age group still has a lot of life to live.”

In a paper published in the Journal of Clinical Oncology (2015; doi:10.1200/JCO.2014.60.1914), Baxter found that young adult cancer survivors overall were hospitalized 1.5 times as often as people in a control group.

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For all malignancies, except for melanoma and testicular cancers, the rate of hospitalization was significantly higher than the control population.

The rate of hospitalization was twice as high as the control population or greater for survivors of gastrointestinal cancer, leukemia, urological malignancies (such as bladder or kidney cancer), colorectal cancer, brain cancer, and lymphoma.

The results were similar to what previous studies have found in children diagnosed with cancer. As many as two-thirds of childhood cancer survivors develop a long-term complication from the surgery, chemotherapy, or radiation used in cancer treatment.

Baxter said she believed this was the largest study ever published involving young adults who survived cancer. Her team examined data from the Ontario Cancer Registry from 1992 to 1999 on 20,275 people who had their first cancer diagnosis between the ages of 20 and 44 and had lived 5 years cancer-free. They were compared with 101,344 non-cancer controls.

Baxter said having a better understanding of health-care utilization and late effects in the young adult cancer population may help counsel young adult survivors on their future quality of life, identify areas where preventative strategies could be employed and highlight the need, where treatment options exist, to consider alternatives not associated with long-term health consequences.