Higher general practice-reported health condition rates among adolescent and young adult (18−39 years) cancer survivors up to 22 years after diagnosis in the Netherlands: a retrospective cohort study

Abstract

Knowledge about survivorship-related health effects in Adolescents and Young Adults (AYAs) remains limited. This study aimed to investigate the number and types of long-term and late general practice-reported health conditions among AYA cancer survivors compared to matched controls up to 22 years post-diagnosis, using national cancer registry and routinely recorded general practice health data. Additionally, we explored possible demographic-, tumour-, and treatment-related determinants for having any health condition among AYA cancer survivors. Demographic, tumour and treatment data of AYAs (18–39 years) diagnosed with a malignant tumour in the Netherlands between 1999–2020 were retrieved from the Netherlands Cancer Registry. Routinely recorded general practice health data were retrieved from the Nivel Primary Care Database. With a minimum follow-up time of one year, comparison of reported health conditions among AYA survivors with matched controls and exploration of determinants among AYA survivors was done with negative binomial regression analysis. A total of n = 3,347 AYA survivors were matched to n = 10,041 controls (1:3 ratio). AYA survivors more often consulted their general practitioner (GP) regardless of follow-up time and attained age in most situations. Overall, AYA survivors were 1.3-times more likely to consult their GP for any health condition. Additional risk ranged from 1.1-times for musculoskeletal and eye conditions to 13.6-times for malignancy-related conditions. In contrast, AYA survivors were overall 30% less likely to seek consultation for pregnancy-related conditions. Exploration of determinants showed that AYA survivors were more likely to consult their GP for any health condition if female, with higher age at diagnosis, with increased follow-up time, and if diagnosed more recently. AYA survivors in the Netherlands more often consult their GP for most health condition types up to 22 years post-diagnosis, with malignancy-related conditions being the most prominent reason. Consequently, GPs play an important role in the care process of AYA cancer survivors.

The authors' abstract, as published at the source. BMC Public Health, 2026 · DOI ↗