Life Milestone Achievement Among Young Adult Childhood Cancer Survivors: A Population-Based Cohort and Matched...

Young adult childhood cancer survivors (YACCS) experience persistent challenges that could delay their transition to independent adulthood. This study examined disparities in life milestone achievement between YACCS and a matched population-based control group and assessed the impact of clinical and demographic factors, including time since diagnosis, treatment intensity, and race/ethnicity.

This matched case-control study utilized data from Project Forward and the California Health Interview Survey. YACCS were matched to general population controls at a 1:3 ratio based on age, sex, year of survey, and race/ethnicity. Multivariable logistic regression models were used to compare life milestone achievement between the groups and to examine associations between survivor characteristics and life milestone achievement, adjusting for neighborhood socioeconomic status.

The study included 1106 YACCS and 3292 matched controls. YACCS were less likely to attain a college degree (OR = 0.79, 95% CI: 0.66-0.95), be employed full-time (OR = 0.39, 95% CI: 0.33-0.45), or be married/partnered (OR = 0.69, 95% CI: 0.58-0.82). Conversely, they were more likely to be unemployed (OR = 1.89, 95% CI: 1.61-2.23), work part-time (OR = 1.67, 95% CI: 1.38-2.02), and live with a parent (OR = 3.34, 95% CI: 2.78-4.00). Long-term survivors (15+ years) and those who received more intensive treatments continue to encounter difficulties, particularly with achieving independent living and securing stable employment.

YACCS experience significant delays in achieving key life milestones compared to their peers, highlighting the lasting socioeconomic impact of childhood cancer. Intensive treatments further exacerbate these disparities. Targeted interventions and survivorship support programs are needed to address these challenges and improve long-term outcomes.