{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:51:35Z","timestamp":1791381095524,"version":"4.3.3"},"reference-count":46,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Adolescent and Young Adult Oncology"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Adolescent and young adult oncology patients represent a unique group with complex needs, yet data on palliative care utilization remain scarce in the Asian population. The definition of this group remains heterogeneous across organizations, and it is unclear whether extending the age range beyond conventional cutoffs affects observed patterns of care. We conducted a retrospective cohort study to describe palliative care utilization and end-of-life outcomes among oncology patients aged 16\u201345 years at a tertiary cancer center in Singapore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Oncology patients aged 16\u201345 referred to the palliative team from 2011 to 2021 were identified using institutional databases. Chi-square tests and sensitivity analysis were used to compare outcomes across age groups. The timing of last treatment relative to palliative referral was described. Multivariable logistic regression was performed to identify predictors of aggressive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Median age was 37 years; 58.8% were female; 83.6% of patients were deceased at the time of study. There was a trend toward earlier referrals in recent years, including during the COVID-19 pandemic. Outcomes including cause of death, place of death, rates of early\/late referral, and aggressive care did not differ significantly across age groups. Timing of referral was the key independent factor associated with poor end-of-life outcomes including aggressive treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Referral patterns and end-of-life care intensity are consistent across ages through 45 years. Late palliative referrals were associated with higher usage of aggressive treatment and death in hospital. Findings support integrated, timely access to palliative care in this group and validate flexibility in the definition of age ranges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21565333251386711","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T06:21:10Z","timestamp":1760077270000},"page":"212-219","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adolescent and Young Adult Cancer Patient Characteristics and Palliative Care Trends in an Asian Tertiary Cancer Center"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2790-5186","authenticated-orcid":false,"given":"You Kai","family":"Poh","sequence":"first","affiliation":[{"name":"Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi Yun Giovanna","family":"Wong","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai Lin","family":"Goh","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ke","sequence":"additional","affiliation":[{"name":"Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Hwei May","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsoc.2023.1286208"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.04.027"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221136160"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26056"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13040770"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.9222"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2014-0265"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000000103"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.5474"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0661"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.38699"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.04.148"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0451"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2022.0078"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.22.00143"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.11.013"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2007.10.016"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/or.2023.11866"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.5602"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.03.021"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.4543"},{"key":"e_1_3_3_23_2","unstructured":"Youth Sector. Available from: https:\/\/www.mccy.gov.sg\/sector\/youth [Last accessed: October1 2024]."},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.04.033"},{"key":"e_1_3_3_25_2","unstructured":"MOH | 2023 National Strategy for Palliative Care Report. Available from: https:\/\/www.moh.gov.sg\/resources-statistics\/reports\/2023-national-strategy-for-palliative-care-report [Last accessed: October1 2024]."},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.34172\/hpp.2022.34"},{"issue":"11","key":"e_1_3_3_27_2","first-page":"e19522","article-title":"The impact of COVID-19 on palliative care: Perspective of healthcare professionals","volume":"13","author":"Tavares P","year":"2021","unstructured":"Tavares P, , Rodrigues C, , Neto IG. The impact of COVID-19 on palliative care: Perspective of healthcare professionals. Cureus, 2021; 13(11):e19522.","journal-title":"Cureus"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00542"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1421940"},{"key":"e_1_3_3_30_2","first-page":"1","article-title":"Temporal changes in head and neck cancer incidence in Thailand suggest changing oropharyngeal epidemiology in the region","volume":"5","author":"Argirion I","year":"2019","unstructured":"Argirion I, , Zarins KR, , Defever K, et al. Temporal changes in head and neck cancer incidence in Thailand suggest changing oropharyngeal epidemiology in the region. J Glob Oncol, 2019; 5:1\u201311.","journal-title":"J Glob Oncol"},{"key":"e_1_3_3_31_2","first-page":"1","article-title":"Understanding and addressing disparities in patients with hematologic malignancies: Approaches for clinicians","volume":"41","author":"Smith-Graziani D","year":"2021","unstructured":"Smith-Graziani D, , Flowers CR. Understanding and addressing disparities in patients with hematologic malignancies: Approaches for clinicians. Am Soc Clin Oncol Educ Book, 2021; 41:1\u20137.","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-023-01084-1"},{"key":"e_1_3_3_33_2","unstructured":"Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence\u2014PMC. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10074347\/ [Last accessed: October1 2024]."},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-9-9"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.1474"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.25259\/IJPC_381_20"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00557"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1080\/17441730600923117"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.4135\/9781529612448"},{"key":"e_1_3_3_40_2","unstructured":"Lien Foundation. Lien Foundation Survey on Death Attitudes. 2014."},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1177\/20101058211055279"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.09.008"},{"key":"e_1_3_3_43_2","unstructured":"MOH. | Subsidies for Acute Inpatient Care at Public Healthcare Institutions. Available from: https:\/\/www.moh.gov.sg\/healthcare-schemes-subsidies\/subsidies-for-acute-inpatient-care-at-public-healthcare-institutions# [Last accessed: October1 2024]."},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.1143"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2001.tb00294.x"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.03.015"}],"container-title":["Journal of Adolescent and Young Adult Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21565333251386711","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21565333251386711","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21565333251386711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:56:48Z","timestamp":1791377808000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21565333251386711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":46,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6,1]]}},"alternative-id":["10.1177\/21565333251386711"],"URL":"https:\/\/doi.org\/10.1177\/21565333251386711","relation":{},"ISSN":["2156-5333","2156-535X"],"issn-type":[{"value":"2156-5333","type":"print"},{"value":"2156-535X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]}}}