Access to Physical Activity Programmes and Cancer Support in Young Adults Living with and Beyond Cancer Through the Lens of Cancer Inequalities

The number of young adults who receive a cancer diagnosis is increasing, with estimates suggesting more than 14,600 individuals in their 20s and 30s are diagnosed each year in the UK. This age bracket is under researched within the literature, despite the distinct needs of young adults facing a potentially life-threatening diagnosis. Developments in cancer care have markedly improved the survival rates of adolescent and young adult cancer survivors, whereby an increased number of individuals are living beyond cancer. For young adult cancer survivors, this can mean a significant proportion of their life is spent with increased risks and comorbidities. Young adults diagnosed with cancer therefore represent a vulnerable sub-group of the population, who, from both a psychological and physiological perspective face number of unique challenges; having passed puberty, but not yet reached the needs of older adult services. It has therefore been recognised that interventions and evidence-based provisions are needed for young adults, to promote physical and psychosocial wellbeing throughout the cancer care continuum and beyond.

UK-based cancer charity, Trekstock, work to ensure young adults in their 20s and 30s living with and beyond cancer have access to essential, tailored support to deal with the psychosocial and physical impact of a cancer diagnosis. With robust evidence highlighting the importance of physical activity to improve psychosocial wellbeing outcomes for individuals living with cancer, one aspect of their provision involves access to structured physical activity programmes for young adults. It is widely acknowledged within the literature that physical activity can improve a multitude of health measures and reduce the risk of disability throughout the cancer care continuum. Evidence suggests high rates of sedentary behaviour in young adults with cancer may result in worse quality of life and increased symptomology during treatment. Similarly, research suggests that physical activity can benefit individuals following the end of cancer treatment, both in terms of emotional wellbeing and in living with the physical after-effects of cancer treatment. However, despite the known benefits, physical activity levels remain low amongst this population group, both during and following a cancer diagnosis.

The present research project therefore aims to evaluate and optimise Trekstock's physical activity service provision, with particular emphasis on cancer inequalities in this age group. It is evident from the literature that research in this field is dominated by participants identifying as female and white British. In this proposed study, we aim to explore this disparity with the ambition of ensuring all young adults facing cancer can access tailored physical activity support. Initially, a systematic review of published and grey literature will be undertaken to explore the gap in knowledge surrounding these inequalities. Further, this research will examine the barriers and facilitators to engaging in physical activity experienced by individuals living both with and beyond cancer. Proposed research questions include: 1) What inequalities affect access to cancer support programmes? 2) How can these inequalities in accessing physical activity programmes be addressed? 3) What are the gaps in current physical activity services and how can they be addressed? 4) What is the impact of tailoring physical activity programmes to address inequalities in young people living with and beyond cancer? With implications for other population groups facing a similar treatment burden and after-effects, this research intends to advance knowledge in this field, and increase the accessibility of physical activity programmes for all young adults facing a cancer diagnosis.