Emotional distress among adult survivors of childhood cancer

Abstract

Purpose To estimate the prevalence of emotional distress in a large cohort of adult survivors of childhood cancer and evaluate the interrelationship of risk factors including cancer-related late effects. Methods 1,863 adult survivors of childhood cancer, median age of 32 years at follow-up, completed comprehensive medical evaluations. Clinically relevant emotional distress was assessed using the Brief Symptom Inventory-18 and was defined as T-scores ≥63. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression models to identify risk factors for distress. Path analysis was used to examine associations among identified risk factors. Results Elevated global distress was reported by 15.1% of survivors. Cancer-related pain was associated with elevated distress (OR 8.72; 95% CI, 5.32 – 14.31). Survivors who reported moderate learning or memory problems were more likely to have elevated distress than survivors who reported no learning or memory problems (OR 3.27; 95% CI, 2.17 – 4.93). Path analysis implied that cancer-related pain has a direct effect on distress symptoms and an indirect effect through socioeconomic status and learning or memory problems. Similar results were observed for learning or memory problems. Conclusions Childhood cancer-related morbidities including pain and learning or memory problems appear to be directly and indirectly associated with elevated distress symptoms decades after treatment. Understanding these associations may help inform intervention targets for survivors of childhood cancer experiencing symptoms of distress. Implications for cancer survivors A subset of long-term childhood cancer survivors experience significant emotional distress. Physical and cognitive late effects may contribute to these symptoms.

A systematic review of self‐reported pain in childhood cancer survivors

“…Regarding diagnostic groups, 17 studies included patients with heterogeneous diagnoses . Furthermore, nine studies focused on specific homogenous subgroups of patients with diagnoses such as acute lymphoblastic leukaemia (ALL), leukaemia, lymphoma, Hodgkin's lymphoma, rhabdomyosarcoma, osteosarcoma, soft tissue sarcoma, Ewing's sarcoma, other bone tumours and CNS tumours …”

Racial Disparities in Emotional Distress Among Cancer Survivors: Insights from the Health Information National Trends Survey (HINTS)

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Physical activity and quality of life in children treated for leukaemia

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