Abstract B125: Risk of late effects and acute care utilization among childhood, adolescent, and young adult cancer survivors with Medicaid coverage

Abstract Introduction: Remarkable progress in the survival of childhood cancer comes at a significant cost with late therapy-associated toxicities. Late effects of treatment include chronic health conditions and subsequent malignant neoplasms, which vary by original cancer diagnosis and treatment received. While key factors impacting long-term survivorship health outcomes have been identified, there remains a gap in understanding healthcare utilization within the first few years after cancer diagnosis. Methods: We conducted a retrospective cohort study to assess the relationship between risk stratification for late effects of cancer and both emergency department visits and subsequent hospitalizations, occurring 3-10 years after the cancer diagnosis. We identified cancer survivors from the University of Oklahoma (OU) Health cancer registry and linked with claims data from the Oklahoma Health Care Authority (OHCA), which maintains data for the state’s Medicaid program. We included survivors diagnosed with cancer between 2010 and 2017 who were aged 0-29 years at the time of diagnosis. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CI) to account for potential confounding factors. Results: We identified 494 survivors that linked with an OHCA claims record. Approximately half of survivors were female (51%) and a child at diagnosis (49% compared to adolescent [16%] or young adult [35%]). Nearly half of survivors were at intermediate risk of late effects (49%), followed by low risk (35%), and high risk (13%). In our multivariable models, we found no association between risk stratification and hospitalizations (High risk RR: 1.08, 95% CI: 0.53, 2.20; Intermediate risk RR: 1.31, 95% CI: 0.82, 2.08 compared to low risk) or emergency department visits (High risk RR: 0.95, 95% CI: 0.68, 1.34; Intermediate risk RR: 0.97, 95% CI: 0.77, 1.22, compared to low risk). Discussion: We observed no significant differences in acute healthcare utilization among cancer survivors within 3-10 years after their cancer diagnosis. However, we were unable to measure healthcare utilization during periods when survivors were not covered by Medicaid, which may be particularly challenging for survivors transitioning into adulthood as eligibility for Medicaid requires lower income than during childhood. Citation Format: Amanda Janitz, Kamryn Ford, Talayeh Razzaghi, David Noyd. Risk of late effects and acute care utilization among childhood, adolescent, and young adult cancer survivors with Medicaid coverage [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B125.