Childhood Cancer Survivorship and Substance Use Behaviors: A Matched Case-Control Study Among Hispanic Adolescents and Young Adults

Milam, Joel; Slaughter, Rhona I.; Tobin, Jessica; Unger, Jennifer B.; Ritt-Olson, Anamara; Freyer, David R.; Soto, Daniel W.; Hamilton, Ann S.

doi:10.1016/j.jadohealth.2018.02.005

Cited by 8 publications

(6 citation statements)

References 10 publications

(9 reference statements)

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“…Larger studies of survivors of pediatric cancer have depended on cohorts that were not population‐based 14 . Many of these studies reported that young cancer survivors were equally or less likely to use tobacco, alcohol, or illicit drugs and to experience substance‐related disorders compared with the general population or siblings 11,13,14 . Our estimates may have differed from these studies because of differences in study design, measures of substance use and SUDs, and sampling approach for data collection.…”

Section: Discussionmentioning

confidence: 98%

“…Several studies have examined substance use patterns in AYA and adult survivors of pediatric cancer. Of the existing studies, the majority have been limited by a single institution, 12,13,27 a restricted geographic area, 10,11 or small sample sizes 12,27 . Larger studies of survivors of pediatric cancer have depended on cohorts that were not population‐based 14 .…”

Section: Discussionmentioning

confidence: 99%

“…To better inform interventions to prevent and reduce substance use, it is crucial to understand the current prevalence of substance use, misuse, and addiction among AYA cancer survivors compared with the general population. However, the existing studies examining the association between AYA survivorship and substance use have been based primarily on a small sample of survivors or larger cohort studies that are not population‐based 11‐16 . To date, national estimates of the prevalence of substance use among AYA cancer survivors in the United States have been lacking.…”

Section: Introductionmentioning

confidence: 99%

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Substance use, substance use disorders, and treatment in adolescent and young adult cancer survivors—Results from a national survey

Cummings

Mertens

et al. 2021

Cancer

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Background Substance use can exacerbate cancer‐related morbidity and mortality in adolescent/young adult (AYA) cancer survivors and place them at increased risk for adverse health outcomes. The objective of this study was to assess substance use, misuse, and substance use disorders [SUDs], as well as receipt of treatment for SUDs, among AYA cancer survivors. Methods The authors used data from the National Survey of Drug Use and Health (2015‐2018) to identify a nationally representative sample of AYAs aged 12 to 34 years. Outcomes assessed past‐year tobacco, alcohol, marijuana, and illicit drug use; misuse of prescription opioids; SUDs; and SUD treatment. Multiple logistic regression was estimated to compare outcomes between 832 AYAs who reported a cancer history (survivors) and 140,826 AYAs who did not, adjusting sequentially for sociodemographic characteristics and health status. Results In regressions adjusting for sociodemographic characteristics, survivors were more likely than a noncancer comparison group of peers to use alcohol (6% relative increase; P = .048) and illicit drugs (34% relative increase; P = .012), to misuse prescription opioids (59% relative increase; P < .001), and to have a marijuana (67% relative increase; P = .011), illicit drug (77% relative increase; P < .001), or prescription opioid (67% relative increase; P = .048) SUD. When further adjusting for health status, survivors were still 41% more likely (P < .001) to misuse prescription opioids than noncancer peers. Among those with SUDs, survivors were more likely than peers to receive treatment (unadjusted, 21.5% vs 8.0%; adjusted, P < .05). Conclusions AYA survivors were as likely as or more likely than noncancer peers to report substance use problems. These findings underscore the importance of interventions to reduce substance use and improve SUD treatment among AYA cancer survivors. Lay Summary The authors assessed substance use, misuse, and substance use disorders, as well as the receipt of treatment for substance use disorders, among adolescent and young adult (AYA) cancer survivors. In a nationally representative AYA sample, cancer survivors, despite their increased risk for morbidity and early mortality, were as likely as or more likely than peers without cancer to experience substance use problems. In particular, survivors had a significantly higher rate of prescription opioid misuse than peers. However, only 1 in 5 AYA survivors who experienced substance use disorders received treatment. These findings underscore the importance of interventions toward reducing substance use and improving access to treatment among AYA survivors.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Substance use, substance use disorders, and treatment in adolescent and young adult cancer survivors—Results from a national survey

Cummings

Mertens

et al. 2021

Cancer

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“…Second, study participants were not compared to non-cancer peers based on demographic data. Although previous case-control investigations have found no difference in substance use between YACCSs and their non-cancer peers (Milam et al, 2018), future work should include an age-matched control group to further investigate protective and risk factors of drug use in comparison with cancer non-affected peers. Finally, survey instruments did not measure the amount or type of prevention or substance use counseling patients received at their health care visits.…”

Section: Study Limitationsmentioning

confidence: 88%

“…For example, among YACCSs aged 18–25 years, 20% currently engaged in binge drinking, 15% engaged in drug use (including marijuana), and 22% were current smokers (Marjerrison et al, 2016), compared to 34.9%, 34.8%, and 19.1% of young adults, respectively (SAMHSA, 2019). Additionally, a case-control study conducted by Milam et al, found that YACCSs under 21 years reported lower levels of substance use compared to controls, whereas there was no difference in substance use levels for YACCSs 21 years and older (Milam et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study

Cappelli

Miller

Ritt-Olson

et al. 2021

J Pediatr Oncol Nurs

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Objectives: Substance use among young adult childhood cancer survivors (YACCSs) has been found to increase during survivorship, resulting in increased risk of developing long-term negative health outcomes. This investigation sought to determine various risk and protective factors of tobacco, alcohol, or marijuana use over time among a sample of YACCSs. Methods: 127 YACCSs (57% Hispanic, 55% female, average age at diagnosis 12.4 years) who were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical centers in Los Angeles County between 2000 and 2007 responded to two surveys separated by ∼5 years. Bivariate logistic regression models were used to assess independent clinical and psychosocial Time 1 variables associated with each substance use outcome at Time 2. Time 1 variables significant at p < .10 were included in multivariable logistic regression models for each Time 2 substance use variable. Results: Rates of 30-day use increased over time for binge drinking alcohol (from 25.6% to 37.7%), marijuana (from 10.6% to 22.1%), and cigarette/tobacco (from 8.9% to 12.2%). Of the following Time 1 variables, marijuana use, cigarette use, and binge drinking were associated with Time 2 marijuana, cigarette, and binge drinking, respectively. Of the following clinical factors, receipt of more intensive cancer treatment was associated with decreased tobacco use. All other psychosocial and clinical factors analyzed were not associated with any increase or decrease in substance use. Conclusions: A greater emphasis on early health education efforts regarding the health risks of tobacco, alcohol, and marijuana use is needed in this at-risk population.

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Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood

Hernádfői,

Koch,

Kói

et al. 2024

JAMA Pediatr

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ImportanceSignificant advancements in pediatric oncology have led to a continuously growing population of survivors. Although extensive research is being conducted on the short-, medium-, and long-term somatic effects, reports on psychosocial reintegration are often conflicting; therefore, there is an urgent need to synthesize the evidence to obtain the clearest understanding and the most comprehensive answer.ObjectiveTo provide a comprehensive review and analysis of the socioeconomic attainment of childhood cancer survivors (CCSs) compared with their unaffected peers.Data SourcesA systematic review and meta-analysis was conducted using data obtained from a comprehensive search of MEDLINE (via PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases on October 23, 2021; the search was updated until July 31, 2023.Study SelectionEligible articles reported on educational attainment, employment, family formation, quality of life (QoL), or health-risk behavior-related outcomes of CCSs, and compared them with their unaffected peers. Study selection was performed in duplicate by 4 blinded independent coauthors.Data Extraction and SynthesisData extraction was performed in duplicate by 4 independent authors following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcome measures were odds ratios (ORs) and mean differences with 95% CIs; data were pooled using a random-effects model.ResultsThe search identified 43 913 articles, 280 of which were eligible for analysis, reporting data on a total of 389 502 survivors. CCSs were less likely to complete higher levels of education (OR, 0.69; 95% CI, 0.40-1.18), had higher odds of health-related unemployment (OR, 2.94; 95% CI, 1.90-4.57), and showed lower rates of marriage (OR, 0.72; 95% CI, 0.63-0.84) and parenthood (OR, 0.60; 95% CI, 0.49-0.74) compared with population-based controls.Conclusion and RelevanceStudy findings suggest that CCSs face several socioeconomic difficulties; as a result, the next goal of pediatric oncology should be to minimize adverse effects, as well as to provide lifelong survivorship support aimed at maximizing social reintegration.

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Childhood Cancer Survivorship and Substance Use Behaviors: A Matched Case-Control Study Among Hispanic Adolescents and Young Adults

Abstract: Lower levels of substance use among Hispanic adolescent and young adult survivors of childhood cancers (vs. controls) are most apparent at younger ages. Future work needs to examine a potential delay in initiation of use among survivors.

Cited by 8 publications

References 10 publications

Substance use, substance use disorders, and treatment in adolescent and young adult cancer survivors—Results from a national survey

Substance use, substance use disorders, and treatment in adolescent and young adult cancer survivors—Results from a national survey

Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study

Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood

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