Céline Bolliger

Purpose: Survivors of young adult cancer (YACS) face distinct psychosocial challenges. Posttraumatic growth (PTG) and resilience may aid adaptation, though their relationship and relevance in this age group remain insufficiently understood. We aimed to (1) describe PTG and resilience among Swiss YACS and (2) investigate the associations of PTG with resilience, sociodemographic, and cancer-related characteristics. Methods: We included survivors aged 21–39 years at diagnosis, diagnosed at least two years prior. We conducted a questionnaire survey using the Posttraumatic Growth Inventory (PTGI; range:0–105) and the Connor-Davidson Resilience Scale (CD-RISC 10; range:0–40). Data were analyzed using descriptive statistics and linear regression. Results: A total of 131 YACS (62% female; mean age at study = 37.6 years, SD = 5.1) were included. The PTG sum score was 54.6 (SD = 23.0, range:1–101), and YACS reported most PTG in Appreciation of life (mean = 3.3, 95% confidence interval: 3.2–3.6) and least in Spiritual change (1.1, 0.9–1.3). The mean resilience score was 28.06 (SD = 5.91, range:10–39), and YACS reported the highest score for the item “Achieving goals despite obstacles” (3.2, 2.6–3.0), and the lowest for the item “See humorous side of things” (2.1, 2.0–2.3). PTG was higher among females and those who received chemotherapy, while resilience showed no significant association with PTG. Conclusion: These findings suggest that PTG and resilience are distinct but complementary adaptation processes in YACS. With higher PTG linked to female gender and chemotherapy, and resilience showing no direct association with PTG, personalized psychosocial support remains essential to help survivors navigate their unique cancer experiences and promote well-being.

Introduction. Adolescent and young adult (AYA, age 15-39 years) survivors of cancer are a growing population facing unique challenges. We conducted the first Swiss study to characterize this population.Methods. We collected registry data on cancers diagnosed in children and AYAs residing in Switzerland, including cancer type, treatment information, and vital status and general population data during 1980-2019. We estimated the prevalence of AYA survivors of cancer and described their demographic and clinical characteristics.Results. We included 50,151 cancer cases diagnosed in children and AYAs between 1980-2019. We estimated that 17,930 AYA survivors of cancer lived in Switzerland on 31.12.2019 (a proportion of 665/100,000 AYAs). Overall, the most common types of cancer among survivors were carcinomas (26% of all AYA survivors), lymphomas (16%), gonadal and related tumors (16%), central nervous system (CNS) tumors (11%), malignant melanomas (11%), and leukemias (10%), with notable differences in the distribution of cancer types by age group and sex. Almost half (44%) of AYA survivors of cancer had received radiotherapy, chemotherapy, or both. The number of AYA survivors diagnosed in the year before the index dates 31.12.2009 and 31.12.2019 increased by 15%, from 1,655 to 1,910.Conclusions. Our study found that one in 150 AYAs living in Switzerland had received a cancer diagnosis in their live and showed that this population of AYA survivors of cancer is growing. The increasing number of AYA survivors of cancer underscores the need for estimating and updating prevalence to help clinicians and policymakers plan follow-up and cancer survivor care.

Cancers in adolescents and young adults (AYAs, aged 15–39 years) have distinct features and distribution of cancer types. This study investigated incidence, mortality, and cumulative risk of AYA cancers in Switzerland. Data on adolescent cancers (15–19 years; Swiss Childhood Cancer Registry) and young adult cancers (20–39 years; National Agency for Cancer Registration) were combined. We calculated age-standardized incidence and mortality rates, and accounted for incomplete regional coverage of cancer registration. We used joinpoint regression to investigate cancer incidence and mortality trends and estimate average annual percent changes. We included 44,048 cancers recorded between 1980 and 2019 and, after adjusting for incomplete coverage, we estimated a total of 69,901 cancers. Cancer incidence increased from 56.6 [95% confidence interval: 55.3, 58.0] per 100,000 person-years in 1980–1989 to 72.2 [71.1, 73.3] in 2010–2019, with a steeper increase for females. The most common cancers were carcinomas, mainly of the breast (9,629 cancers estimated), gastrointestinal tract (5,033) and thyroid (4,785), gonadal and related tumors (11,303), melanomas (9,695), and lymphomas (8,208). There were 9,865 AYA cancer deaths recorded over the study period. The age-standardized mortality rate declined from 13.3 [12.8, 13.7] per 100,000 person-years in 1980–1989 to 6.2 [5.9, 6.5] in 2010–2019, showing similar decreases in both sexes. This first comprehensive, nationwide study of AYA cancers in Switzerland showed increasing incidence and declining mortality, potentially due to changes in lifestyle or improved cancer registration and screening practices. Our results emphasize the need for ongoing surveillance and preventive strategies with a focus on AYAs.

Background: The psychosocial needs of survivors of cancer in young adulthood in Switzerland remain poorly understood. With this study, we aimed to (1) describe psychosocial support needs of young adult cancer survivors (YACS) during treatment and survivorship, (2) determine whether these needs change from treatment to survivorship, and (3) identify characteristics associated with unmet needs. Methods: We included survivors aged 21–39 years at diagnosis, diagnosed at least two years prior to our questionnaire survey. We used descriptive statistics to analyze distributions of psychosocial support needs during treatment and survivorship. McNemar's tests assessed changes in these needs over time, and logistic regressions identified determinants of unmet needs. Results: A total of 131 YACS (mean age at study = 37.5 years; 61% female) participated in our study. Most YACS reported that their needs were met in all support domains, both during treatment and survivorship. During treatment, unmet needs were highest for insurance support ( n = 30; 23%), support for friends ( n = 20; 15%) and family ( n = 17; 13%). During survivorship, unmet needs were most pronounced for insurance support ( n = 15; 12%), information on cancer and late effects ( n = 10; 8%), and work‐related support ( n = 9; 7%). Intrapersonal needs (e.g., information, psychological), remained stable, while unmet interpersonal (e.g., family, friends), and institutional/systemic (e.g., insurance, work) support needs declined during survivorship. Younger age and shorter time since diagnosis were associated with unmet intrapersonal needs during survivorship, while male sex predicted unmet interpersonal needs during treatment. Conclusion: Although most support needs are met, targeted efforts are needed to address the remaining unmet needs of Swiss YACS in order to ensure they receive adequate survivorship care.

Social skills training (SST) is often used to teach basic and specific social skills in the treatment of social anxiety disorder (SAD). However, the content, duration, and form of such training vary. This systematic review aimed to (a) to examine the demographic and clinical characteristics of the populations for whom these interventions have been used, such as age, gender, and the composition of the subgroups, (b) to describe the main elements of different SST programs, and (c) to evaluate the effectiveness of SST, including session duration, setting, content, population, and techniques, and analyze the effects of reducing symptoms of social anxiety. We conducted a systematic literature review using three databases to identify the literature on SST. The search was restricted to peer-reviewed studies published from January 2000 to December 2023 that used SST to treat SAD in any age group. We found 14 different SST programs used with individuals aged 6 to 78 years. The content of these programs was mainly similar. However, there was considerable variation in small-group sessions’ duration and frequency, and how they were delivered and/or integrated into daily life. SST showed positive effects in the majority of included trials. Symptom reduction was maintained or further reduced after 6 months to 5 years of follow-up. Our review found a need for more research focusing on methodological rigor, standardization, the role of parental involvement, the role of supervision, and the comparison of SST with other therapies.

Objective: This review explores the impact of cancer on adolescents' and young adults' (AYAs) romantic and sexual relationships, examining both challenges and opportunities. Methods: Qualitative studies on AYAs with cancer and/or their partners were searched based on a sub‐set of studies identified in a previous literature review within the EU Horizon STRONG‐AYA project, and supplemented with an additional search on romantic/sexual relationships. Articles were screened, reviewed in Rayyan and data extracted using a structured framework. Study quality was appraised, and findings were synthesised thematically. Results: Twenty studies were included. Findings revealed how cancer altered AYAs' sense of self, affecting the navigation of romantic relationships and sexual intimacy across four themes: (1) Romantic relationship development‐connection, isolation and changing priorities : Disrupted romantic trajectories and fears of being undesirable hindered relationship formation, though some re‐evaluated priorities, deepening emotional connections, (2) The disclosure dance: Finding the right time and way : AYAs struggled with when and how to disclose their diagnosis, with anxiety about burdening partners or altering dynamics. Open and honest communication fostered intimacy, (3) Body image, sexuality, intimacy, and fertility : Challenges in these areas impacted self‐worth, but also led to sexual empowerment and adapted intimacy, (4) Partnerships and social support during cancer : Unsupportive partners heightened isolation, while supportive partners reinforced self‐worth. Many AYAs experienced growth, resilience and a deeper understanding of themselves/their relationships. Conclusion: Results may inform age‐appropriate interventions to adequately address the unique challenges AYAs with cancer face in navigating romantic relationships and sexual intimacy.

Introduction.: The death of a child profoundly impacts parents, often leading to anxiety, depression, and posttraumatic stress. However, factors such as resilience—defined as the capacity to adapt to adversity—are less explored. Resilience may mitigate grief-related distress. This study aimed to: (a) describe and compare resilience levels between bereaved parents and parents of childhood cancer survivors (CCS parents), (b) identify sociodemographic and cancer-related determinants of resilience among bereaved parents, and (c) investigate resilience’s association with psychological distress and prolonged grief disorder. Methods.: This is a cross-sectional study done in Switzerland. Bereaved parents were recruited from three hospitals and through patient advocacy groups. CCS parents were taken from a nationwide, population-based study (Swiss Childhood Cancer Survivor Study-Parents). Resilience, psychological distress, and prolonged grief disorder were assessed using the Connor-Davidson Resilience Scale (CD-RISC 10), Brief Symptom Inventory-18 (BSI-18), and Prolonged Grief 13 (PG-13), respectively. Regression analysis (linear and logistic) was used to identify factors associated with resilience, and the association of resilience with psychological distress and prolonged grief disorder (adjusted for age, sex, and time since death). Results.: We included 103 bereaved parents and 345 CCS parents in the analysis. Bereaved parents were younger compared to CCS parents (mean 53.7, SD 8.3 vs. 62.5, SD 6.7 years, p < 0.001), with both groups predominantly female (66% and 58%). Bereaved parents reported higher resilience scores than CCS parents (crude mean: 29.8 vs. 27.9; p = 0.005), with adjusted analyses confirming this finding. High risk of poverty was the only significant determinant of lower resilience (adjusted β = -7.37, 95% CI: -11.21, -3.54; p < 0.001). Higher resilience was associated with lower likelihood to report psychological distress (adjusted OR = 0.83, 95% CI: 0.74, 0.93, p = 0.002) and prolonged grief disorder (adjusted OR = 0.73, 95% CI: 0.58, 0.92, p = 0.008). Conclusion.: Bereaved parents exhibited higher resilience than CCS parents. Resilience in bereaved parents was strongly associated with reduced psychological distress and lower likelihood of having prolonged grief disorder. Targeting modifiable factors such as poverty may enhance resilience and thereby help to improve mental health outcomes for bereaved parents.

This cross-sectional study examined the relationship of sports and perceived social support with social anxiety in young adults. We aimed to find out whether participation in sports and good social support were associated with lower social anxiety symptoms in individuals aged 18–40 years in Switzerland. Participants aged 18–40 years were recruited through an online panel, which included company data pools, mail/email invitations, and social media. The survey included validated instruments: the Social Phobia and Anxiety Inventory (SPAI) for social anxiety, the Physical Activity and Sports Questionnaire (BSA-F) for sports participation, and the German Questionnaire for Social Support (F-SozU). Sociodemographic data and sports duration were also collected, with sports classified by type and duration. We fitted linear regression models to explore associations between social anxiety, sports type, duration, and perceived social support. Analyses were adjusted for sociodemographic characteristics. A total of 104 participants (51% female; mean age = 30.2 years, SD = 6.2) completed the survey, with 65.4% reporting recent sports participation, averaging 4.5 h/week. Social anxiety scores did not differ significantly across no sport, individual sport, or group sport participants. However, longer sports duration was associated with lower social anxiety scores, even after adjusting for perceived social support and sociodemographic factors. Social support was independently and negatively associated with social anxiety, highlighting its protective role regardless of sport type or duration. Our findings suggest that sports involvement and supportive social networks are associated with lower social anxiety. Sports and social support should be considered to treat social anxiety, along with primary treatments such as psychotherapy and pharmacotherapy.

Background: A cancer diagnosis early in life can leave a legacy in terms of compromised Quality of Life (QoL). There is a lack of clarity regarding the impact on QoL according to age at diagnosis, with childhood cancer survivors (CCS) and adolescents and young adult cancer survivors (AYACS) often combined. As part of an EORTC Quality of Life Group study, this umbrella review aims to (1) identify the QoL outcomes reported in the literature for both CCS and AYACS, and (2) investigate the similarities and differences in QoL challenges between both groups. Methods: A systematic literature search of systematic reviews and meta-analyses was conducted in December 2023 using PubMed, PsychInfo, and CINAHL. Methodological quality was evaluated using the AMSTAR tool. Results: Overall, 1457 articles were assessed, and 39 systematic reviews and meta-analyses met the inclusion criteria. QoL outcomes were categorized into eight QoL domains, all of which were reported in both groups of young survivors. However, reviews on CCS often focused on outcomes relating to emotional functioning, cognitive difficulties, social challenges, school functioning, body image and overall happiness, whereas AYACS reviews had a greater focus on depressive symptoms, outcomes related to sexual health and reproductive health, employment, financial difficulties, self-image and identity and the impact of cancer. Conclusion: This umbrella review comprehensively explores QoL outcomes among CCS and AYACS, revealing both shared and distinct challenges. Future research should focus on developing tailored questionnaires, emphasizing transition periods and incorporating a life perspective to capture unique developmental tasks of young survivors.