New risk model flags young cancer survivors most likely to need emergency care

A validated predictive model can now identify adolescent and young adult (AYA) cancer survivors — those diagnosed between ages 15 and 39 — who are at high risk for hospitalizations or emergency department visits during early survivorship (2–5 years post-diagnosis). The study, published in JCO Oncology Practice, analyzed data from over 7,300 AYA patients in North Carolina, finding that nearly half experienced at least one acute care event (ACE) during the observation period.

The model factors in age, race, insurance type, cancer stage, treatment type, comorbidities, mood disorders, tobacco use, and prior acute care history. It was designed for seamless integration into electronic health records, making it a practical tool for busy clinical settings.

Key Takeaways:

• The final model achieved an AUC of 0.76 and a positive predictive value of 0.84 — meaning it reliably flags truly high-risk patients
• Black patients, women, and those on Medicaid were disproportionately represented among those experiencing ACEs
• 71% of patients with ACEs had no claims for active cancer treatment, underscoring that survivorship — not just active treatment — carries significant risk

Why it matters: AYA cancer survivors are a fast-growing population with unique health needs that often fall through the cracks between pediatric and adult care. This first-of-its-kind model gives clinicians a data-driven way to proactively support the most vulnerable survivors before a crisis hits.