# Project 3: Chronic Medical Conditions and Late Effects in the AYA Cancer Population

> **NIH NIH P01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2024 · $275,421

## Abstract

ABSTRACT – Project 3, Late Effects in the AYA Cancer Population
 Few studies have evaluated long-term medical outcomes in US survivors of adolescent and young
(AYA) cancers, a population with among the greatest number of life-years affected by cancer. Studies on AYA
survivors find elevated risks of medical conditions such as asthma, diabetes, and second cancers, but typically
do not consider treatment in detail or examine results by clinical or patient factors to identify those at higher
risk for late effects and poorer survival. This limited research hinders creating long-term care guidelines and
interventions to improve health outcomes in this population. To address these evidence gaps, we propose a
detailed examination of clinical care factors and their association with late effects in AYA cancer survivors
using integrated P01 data resources: the clinical and research infrastructure of Kaiser Permanente (KP); the
population-based California Cancer Registry (CCR) and Utah Cancer Registry (UCR), both linked to statewide
healthcare data; and survey data from ~5,000 AYAs with cancer, including from North Carolina. The KP
Northern California (KPNC) and Southern California (KPSC) integrated healthcare systems provide
comprehensive healthcare services and use electronic health records that facilitate investigating late effects of
cancer and its treatment. The CCR-hospitalization are from linking one of the largest, most diverse U.S.
cancer registries with statewide hospitalization, emergency department, and ambulatory surgery data. The
UCR-hospitalization are from similar sources for many rural and medically underserved residents. With these
diverse resources, this study will assess chronic medical conditions and late effects (collectively called late
effects) in AYA cancer survivors and will: 1) determine the incidence of late effects, examining how risks vary
by primary cancer type, specific treatment approaches, race/ethnicity, neighborhood socioeconomic status,
and health insurance coverage; 2) examine how guideline-concordant survivorship care and inpatient and
outpatient visits to multiple provider types are associated with the risk of late effects; and 3) evaluate the
influence of patient-reported barriers to care on late effects. We will use a cohort of ~53,000 AYAs diagnosed
with cancer from 2006 through 2019 in California; ~13,000 will have been diagnosed and treated at KPNC or
KPSC. Data from KPNC, KPSC and California hospitals allows medical outcome follow-up of AYA cancer
survivors who leave or seek coverage outside the KP system and facilitates comparisons between those
seeking care within and outside an integrated care system for late effects requiring hospitalization. Our
analyses will be enhanced by approximately 8,400 AYAs from Utah, of whom ~1,700 are rural residents. We
hypothesize a higher burden of late effects among AYAs with care barriers such as insurance and financial
concerns that impact both initial and survivorship care. ...

## Key facts

- **NIH application ID:** 10911982
- **Project number:** 5P01CA233432-05
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Theresa H M Keegan
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $275,421
- **Award type:** 5
- **Project period:** 2020-09-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10911982

## Citation

> US National Institutes of Health, RePORTER application 10911982, Project 3: Chronic Medical Conditions and Late Effects in the AYA Cancer Population (5P01CA233432-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10911982. Licensed CC0.

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