Predictors of Locus of Care in Adolescents and Young Adults with Cancer

Introduction: Adolescents and young adults (AYAs) with cancer represent a unique and underserviced population. Methods: Administrative databases were used to identify adolescents diagnosed with cancer between 1994 and 2004, in Ontario. Associations between demographic, disease, and health-care system factors and adolescents’ initial treatment centre (pediatric/adult) were examined. In addition, a Triple-I policy analysis was used to compare Canadian, Australian and English AYA cancer-care delivery policies. Results: Adolescents’ age, cancer diagnosis, time period of diagnosis, distance of residence from pediatric centre, residing in a LHIN with a pediatric centre and PCP speciality were significantly associated with their initial treatment centre. Although Canadian AYA oncology policies were similar those from Australia and England, they were not as well developed. Conclusion: Adolescents’ initial treatment location is be influenced by patient, diagnostic and health-care system factors as well as health-care policy. Future AYA cancer care policies must consider these variables during their development.%%%%M.Sc.