Addressing cancer survivorship needs in adolescents and young adults through a survivorship-focused primary care clinic.

532 Background: Adolescent and young adult (AYA) cancer survivors face unique risks of cancer- and treatment-related effects. This study evaluates how an adult, survivorship-focused primary care clinic led by a medical oncologist addresses needs in AYAs compared to non-AYAs. Methods: We performed electronic chart review of patients seen in the Primary Care for Cancer Survivorship clinic at an academic center between November 1, 2021 and November 30, 2023. Patients aged 39 and younger were categorized as AYAs. Demographic and clinical data were analyzed, with group comparisons performed via Fisher’s exact test (p < 0.05 considered significant). Results: Among 219 patients, 49 (22%) were AYAs. Their mean age was 31.5 years (range 19 to 39), and 57% were female. The most common cancers were lymphoma (25%), leukemia (22%), and breast cancer (14%). Most (90%) no longer had active disease. Referrals primarily came from hematology or oncology (39%), self-referrals (25%), and a pediatric survivorship transition clinic (20%). Surveillance for recurrence was addressed in 85% and secondary cancer screening in 84%. No recurrences or secondary cancers were diagnosed. Secondary cancer screening was addressed significantly more often in non-AYAs compared to AYAs (94% vs. 84%, p = 0.03). Long-term and late effects were managed in all AYAs, with the most common being cardiovascular risk (86%), mental health (86%), fertility (65%), bone health (49%), and sexual health (18%). Among these, only fertility differed significantly between groups, addressed more in AYAs (65% vs. 4%, p < 0.05). Referrals for fertility were also significantly higher among AYAs (31% vs. 1%, p < 0.05). Mental health referrals were more common in AYAs but did not reach significance (18% vs. 14%, p = 0.09). At least one primary care issue was addressed in all patients. There were no significant differences in discussion of nutrition or exercise between groups. Conclusions: The complex cancer survivorship and primary care needs of AYA survivors can be met by an adult, survivorship-focused primary care clinic. Across most domains, survivors’ needs were met as often in AYAs as in non-AYAs. While a significant difference favoring fertility discussions and referrals in AYAs can be explained by age, further research is needed to determine if additional factors contribute to reduced secondary cancer screening. Systematically assessing needs met in survivorship clinics is vital to delivering tailored, age-appropriate care. Comparison of cancer survivorship metrics between AYAs and non-AYAs. Care Metrics AYA Survivors (%) Non-AYA Survivors (%) Secondary cancers screened 84 94 Cardiovascular risks addressed 86 94 Mental health addressed 86 73 Fertility addressed 65 4 Bone health addressed 49 65 Sexual health addressed 18 20 Fertility referrals 31 1 Mental health referrals 18 14 Exercise discussed 61 61 Nutrition discussed 49 56