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Young adult and adolescent cancer survivors show consistently high levels of anxiety and depression throughout their lives, but only anxiety symptoms appear to stabilize as they age, according to researchers from the University of Michigan.

The results are detailed in a recent study released in JAMA Network Open, which illuminates the persistent mental health challenges encountered by those diagnosed with cancer between the ages of 15 and 39.

In the U.S., over 2.1 million adult cancer survivors received their diagnoses during adolescence or young adulthood. While the mental health implications during treatment have been thoroughly recorded, the long-term psychological trajectories of these survivors into later adulthood remain largely unexplored.

Given the continually increasing population of young cancer survivors, this research is crucial for identifying and mitigating these ongoing challenges to improve their overall quality of life, the researchers indicated.

“This study emphasizes a significant necessity for ongoing mental health support for this specific demographic,” stated Anao Zhang, associate professor of social work at U-M and the study’s primary author.

Zhang and her colleagues employed nationally representative data from the Health and Retirement Study, comprising nearly 40,000 individuals, applicable to over 100 million U.S. residents aged 50 and older. Participants were classified into three categories: those with a history of adolescent/young adult cancer, those diagnosed in adulthood, and those without any cancer history. Respondents answered various inquiries concerning their mental health, including depression and anxiety levels.

By utilizing growth curve models to examine participants’ symptoms, the study revealed a distinct “U-shaped curve” in depression symptoms across the lifespan, with adolescent/young adult survivors displaying notably higher levels.

This indicates that the stressors associated with their cancer experiences leave a lasting impact, said Zhang.

Conversely, the analysis presented that anxiety symptoms among these survivors tend to stabilize over time, suggesting a potential evolution of resilience.

Adult survivors of cancer diagnosed during adolescence and young adulthood faced the most significant mental health issues in middle and later adulthood compared to individuals diagnosed in adulthood or those without a cancer history. When younger, this group encountered unique challenges, such as fertility issues, cardiotoxicity, and financial difficulties, according to the study.

The researchers pointed out that cancer care providers should be aware of the mental health challenges faced by this demographic as they enter middle age and beyond.

Alongside Zhang, other authors of the study included Emily Urban-Wojcik, lead statistician, and Meghan Seewald, manager of data and design core, both affiliated with U-M’s Eisenberg Family Depression Center; and Bradley Zebrack, professor of social work and researcher at the U-M Institute for Healthcare Policy and Innovation.

The dataset utilized was supported by the National Institute on Aging (NIA U01AG009740 and NIA R01AG073289) and the Social Security Administration.

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