01 Jun ASCO25: University of Cincinnati Provides Primary Care for Adolescent and Young Adult Cancer Survivors

MedicalResearch.com Interview with:

Dr. Topalian

Alique Topalian, PhD, MPH
Research Scientist
Family & Community Medicine | College of Medicine
University of Cincinatti

MedicalResearch.com: What is the background for this study?

Response: Adolescent and young adult (AYA) cancer survivors are diagnosed between the ages of 18-39. We have seen increases in cancer diagnoses in this younger population of about 1-2% per year with an estimated total increase of 30% between 2019-2030.  Adolescent and young adult (AYA) cancer survivors experience early development of chronic medical conditions compared to healthy peers. Due to their young age at diagnosis and living decades beyond treatment, they are also at higher risk for second primary malignancies (SPM) and late effects than older adult-onset cancer survivors. Primary care providers are responsible for most long-term care of survivors and many are unfamiliar with the effects of cancer treatment in younger populations.

MedicalResearch.com: What are the main findings?

Response:  Here at the University of Cincinnati we are lucky to have one of the only oncology primary care clinics in the country. Oncology primary care is a relatively new concept and area of focus in survivorship care. We have also created a clinical registry for all patients seen in the oncology primary care clinic to measure longitudinal outcomes. We believe that oncology primary care providers are uniquely positioned to address the increased needs the AYA population may face across the lifespan.  We decided to look at the baseline characteristics of AYA patients seen in our oncology primary care clinic.

MedicalResearch.com: What types of cancers were most frequent in this population?

Response:  Approximately 10% of our clinic’s population was diagnosed as AYA. Hematologic cancers (37%) were the most common diagnoses followed by breast (13%) and brain (9%). Shockingly, 14% of patients were diagnosed with a second primary malignancy. The most common SPM were breast, GI, hematologic and thyroid cancers. Comorbid conditions were prevalent with 60% of patients having cardiovascular disease such as hypertension. Neurologic (46%), endocrine (44%), and psychologic (71%) co-morbidities were also common. Over half of patients were overweight/obese (68%) and many patients were former (19%) or current (7%) smokers. Further, many eligible patients received their recommended cancer screening including breast (82%), colon (60%), and cervical (40%).

MedicalResearch.com: What should readers take away from your report?

Response: We know our adolescent and young adult cancer survivors are at high risk for early onset of comorbid conditions, late effects of treatment,  and second primary malignancies. Many of these patients feel lost in the primary care setting and do not realize they are at higher risk for comorbidities and secondary cancers. Many providers don’t feel comfortable providing primary care to this population. Oncology primary care helps to fill this gap by providing survivorship focused primary care services. Oncology primary care providers are uniquely positioned to address increased needs of AYA patients because of their additional survivorship expertise. The face of cancer is changing, and people are living longer post diagnosis than ever before, our research and interventions must adapt to change with it.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Oncology primary care is currently an area of focus of the National Cancer Institute INSPiRE: Interdisciplinary Network for Survivorship and Primary Care Research and Education initiative. Our next steps include longitudinal monitoring of this population to look for changes in health outcomes and strategies to improve care of these long-term survivors. We would love a comparison of our clinic’s population to survivors seen in a general primary care practice where survivorship issues may not be a primary area of focus. There is still so much to learn about our early onset cancer survivors and complications they face as they age, making comprehensive primary care services and longitudinal monitoring imperative in this high-risk population. Tailored education and outreach efforts for providers and patients should address preventative health services and comorbid condition management.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: This year ASCO has included AYA cancers as its own topical submission category for the first time. This has been a great success of the AYA Community of Practice in which I serve on as a working group co-chair. Previous presentations on this population would be grouped in with pediatric or adult sessions. As a cancer survivor diagnosed as an AYA, I am happy to see our professional organizations taking this important step in raising awareness and encouraging research to improve the health outcomes of this population.

I have no disclosures.

Learn more at Dr. Topalian’s personal journey with AML:
https://canceradvocacy.org/alique-topalian-childhood-cancer-and-the-frightening-realities-of-survivorship/

Citation: ASCO 2025 abstract:

Oncology primary care clinics for comprehensive care of high-risk adolescent and young adult (AYA) cancer survivors.
Alique Topalian, Melinda Butsch Kovacic, Elizabeth Shaughnessy, Melissa Erickson
University of Cincinnati, Cincinnati, OH, University of Cincinnati College of Medicine, University of Cincinnati Medical Center, Cincinnati, OH
https://meetings.asco.org/abstracts-presentations/245419

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Last Updated on June 4, 2025 by Marie Benz MD FAAD