Adolescent and Young Adult Cancer Survivorship: A Concept Analysis.

Abstract

BackgroundWith an estimated 2.1 million adolescent and young adult (AYA) cancer survivors in the United States, this population experiences disproportionate long-term treatment effects, financial toxicity, psychosocial distress, and disruptions to identity formation. Historically, AYA survivorship has been grouped with either pediatric or adult survivorship models, overlooking the unique needs of this population. The aim of this concept analysis was to define AYA cancer survivorship as a distinct entity.MethodsA concept analysis using Walker and Avant's method was performed. A literature review using CINAHL, PubMed, and PsycINFO databases was conducted and yielded 7,203 articles. Titles and abstracts were reviewed, and 56 key articles were included.ResultsFour defining attributes of AYA Cancer Survivorship emerged: establishing a new normal, redefining identity, relational changes, and the complexity of navigating post-cancer care. The primary antecedent was a cancer diagnosis between the ages of 15 and 39 years. AYA cancer survivorship has physical, psychosocial, financial, and vocational consequences. These consequences can vary in intensity and can persist throughout the duration of their lives.DiscussionAYAs navigate emerging adulthood, identity formation, intimate relationships, financial independence, and career development. These factors compound the impact of cancer treatment, making AYAs vulnerable to psychosocial distress, vocational disruption, and financial toxicity. There is a need to develop holistic care models tailored to the unique interconnected needs of this growing population. Future efforts must aim to build clinical guidelines and develop models of care that empower AYA survivors to thrive beyond cancer.