Introduction: In the United States there are a growing number of Adolescent and Young Adult (AYA) cancer survivors. Cancer treatments that are saving AYA cancer patients have been associated with negative consequences such as accelerated or premature aging. A biological marker known as p16 is one way to measure this. In addition to intensive cancer treatments, AYA patients experience social determinants of health (SDOH) that can impact their health outcomes. One way to measure socioeconomic disparities is the Area Deprivation Index (ADI). Objective: The primary objective of this study is to estimate the association between accelerated aging and socioeconomic disparities among children, adolescents and young adults with cancer. Methods: The Area Deprivation Index, pre-treatment and post-treatment p16 values were collected for 33 AYA cancer survivors who were seen for survivorship care at UNC Hospitals from 2017-2022. A linear regression model was used to estimate the association between ADI decile as exposure and p16 expression as outcome. Results: Thirty-three participants had complete data (ADI, pre- and post- treatment p16 values). All participants experienced a statistically significant increase in p16 values from pre-treatment to post-treatment. Participants were categorized by ADI decile groups 1-3, 4-7 and 8-10 with 11 participants in each category. Pre-treatment p16 levels were higher for participants from areas with higher ADI scores. Conclusion: Patients who live in areas with resource disparities experience accelerated cellular aging at diagnosis and with cancer treatment.
Amanda Martin (Sun,) studied this question.