Treatment Decision-Making Roles and Preferences Among Adolescents and Young Adults With Cancer

Area of Science:

• Oncology
• Adolescent and Young Adult (AYA) Medicine
• Health Services Research

Background:

• Decision-making (DM) in cancer treatment for AYAs, parents, and oncologists is understudied in diverse populations.
• This study addresses cancer treatment DM preferences in an ethnically and socioeconomically diverse group of AYAs and their parents.

Purpose of the Study:

• To examine cancer treatment DM preferences among diverse AYAs and their parents.
• To compare preferred and actual DM roles within AYA-parent pairs.
• To explore associations between DM roles, care transition discussions, and clinical/sociodemographic factors.

Main Methods:

• Surveyed 75 AYAs with cancer and 52 parents from the Texas KidsCanSeq study.
• Compared preferred and actual treatment DM roles in AYA-parent pairs.
• Analyzed associations with pediatric-to-adult care transition discussions and patient characteristics.

Main Results:

• AYA DM preferences varied: 44% preferred shared DM, 31% AYA-led, 25% parent-led.
• Actual DM roles largely matched AYA preferences (73%).
• Half of AYAs reported recent care transition discussions; DM preferences and discussions showed no significant clinical/sociodemographic differences.

Conclusions:

• AYAs with cancer desire active engagement in treatment DM and shared decision-making (SDM).
• While specific role preferences differ, there are opportunities to enhance discussions regarding pediatric-to-adult care transition.