Professor in LSU Health School of Public Health (SPH) and Louisiana Tumor Registry Director Dr. Xiao-Chen Wu, is lead author of “Impact of the AYA HOPE Comorbidity Index on Assessing Health Care Services Needs and Health Status among Adolescents and Young Adults with Cancer” in the current issue of Cancer Epidemiology Biomarkers Prevention. Dr. Pinki K. Prasad, pediatric oncologist at New Orleans Children’s Hospital was second author, and LSU SPH alumnus Mr. Ian Landry, third author of the paper. Other authors include public health professionals and academicians from NCI, Detroit, Seattle/Puget Sound, Los Angeles, San Francisco/Oakland, 13 other California counties and the State of Iowa.
Using data from the NCI-funded Adolescent and Young Adult (AYA) Health Outcomes and Patient Experience (HOPE), the authors developed the AYA HOPE comorbidity index to assess the impact of comorbidities on healthcare service needs and general health status among AYA cancer survivors. While other studies resulted in indices, specifically the Carlson and NCI indices, the AYA HOPE index expands those existing cardiovascular, neurologic, gastrointestinal, and renal categories and added mental health and obesity/overweight categories in the existing comorbidity indices but important to health outcomes and can affect treatment, service needs and survival for AYA cancer patients.
The article recognizes that “AYA cancer survivors with comorbidities identified by AYA HOPE index were more likely than those without comorbidities to need mental health and pain management services and AYA survivors with more than 2 comorbidities were more likely than those without comorbidity to have fair/poor general health status.”
Out of 485 study participants, 40 percent of them need for some type of supportive care. Mental health care led (25.2 percent) needs, along with support group, physical/occupational therapy, pain management and nursing home services, in descending order.
The study examined the association of comorbidities with each type of service need and health status (i.e., fair/poor, good, very good, and excellent).
The AYA HOPE index uses data from patients with selected types of cancers, and the medical records defining all comorbid conditions, including histories of disease or health problems, noted at the time of initial diagnosis and during the first course of treatment, and may not include comorbidities occurring after the first course of treatment and for in the entire AYA population. These limitations may affect the generalizability of the findings.
However, the “AYA HOPE comorbidity index serves as a starting point to quantify the breadth of comorbidities AYA cancer survivors may face as they progress through treatment and survivorship.”