An Investigation of Social Status among Adolescents and Young Adults Who Have Been Diagnosed with Cancer in Canada

SIMPLE SUMMARY: Adolescents and young adults (AYAs) diagnosed with cancer are a particularly vulnerable patient population. Cancer and the long-term effects of treatment can impact a young person’s ability to progress through typical developmental stages, negatively impacting their social status including education, employment, relationships status and independent living. The study aims were to: (1) compare social status among AYAs diagnosed with cancer to a community population; (2) describe AYAs’ change in employment/education status; and (3) examine predictors of social status. We showed that AYAs diagnosed with cancer were less likely to be employed and more likely to be living at home with parents when compared to a community sample. These challenges may have many long-term financial and quality of life implications for these patients. ABSTRACT: Background: Aims were to: (1) compare social status among AYAs diagnosed with cancer to a community population; (2) describe AYAs’ change in employment/education status; and (3) examine predictors of social status. Method: Social status (i.e., education, employment, relationship status, and living arrangement) was captured from young adults diagnosed with cancer recruited via social media through a community-based organization from across Canada and randomly matched to a community sample by sex, age, province of residence, total household income and race/ethnicity at a ratio of 1:3. Results: AYAs with cancer (N = 622) were an average of 4.45 (SD = 5.42) years from the completion of treatment and were less likely to be employed (χ(2) = 96.35, p < 0.001) and more likely to be living at home with parents (χ(2) = 17.00, p < 0.001). There were no differences in education or relationship status. Overall, 41% and 45% of AYAs reported quitting school or work, respectively. Non-metastatic disease (AOR 3.23, 95% CI 1.08–9.62), and better physical (AOR 1.07 95% CI 1.04–1.10) and mental quality of life (QOL)(AOR 1.06 95% CI 1.03–1.09), were associated with employment. Worse mental QOL (AOR 1.04 95% CI 1.01–1.07), less post-traumatic growth (AOR 1.01 95% CI 1.00–1.03), and social support (AOR 0.27, 95% CI 0.18–0.41) were associated with being single. Non-White race (AOR 3.19 95% CI 1.02–9.97) and less post-traumatic growth (AOR 0.97 95% CI 0.95–0.99) were associated with living with parents. Conclusions: AYAs diagnosed with cancer experience differences in attainment of employment and independent living compared to a community sample. These challenges may have implications for physical and mental QOL.