Emotional, behavioral, and physical health consequences of loneliness in young adult survivors of childhood cancer: Results from the Childhood Cancer Survivor Study

Abstract

Background Young adults in the general population are at risk of experiencing loneliness, which has been associated with physical and mental health morbidities. The prevalence and consequences of loneliness in young adult survivors of childhood cancer remain unknown. Methods A total of 9664 young adult survivors of childhood cancer (median age at diagnosis 10.5 years [interquartile range (IQR), 5–15], 27.1 years at baseline [IQR, 23–32]) and 2221 siblings enrolled in the Childhood Cancer Survivor Study completed a self‐reported survey question assessing loneliness on the Brief Symptom Inventory‐18 at baseline and follow‐up (median follow‐up, 6.6 years). Multivariable models evaluated the prevalence of loneliness at baseline only, follow‐up only, and baseline + follow‐up, and its associations with emotional distress, health behaviors, and chronic conditions at follow‐up. Results Survivors were more likely than siblings to report loneliness at baseline + follow‐up (prevalence ratio [PR] 2.2; 95% confidence interval [CI], 1.7–3.0) and at follow‐up only (PR, 1.4; 95% CI, 1.1–1.7). Loneliness at baseline + follow‐up was associated with elevated risk of anxiety (relative risk [RR], 9.8; 95% CI, 7.5–12.7), depression (RR, 17.9; 95% CI, 14.1–22.7), and current smoking (odds ratio [OR], 1.7; 95% CI, 1.3–2.3) at follow‐up. Loneliness at follow‐up only was associated with suicidal ideation (RR, 1.5; 95% CI, 1.1–2.1), heavy/risky alcohol consumption (RR, 1.3; 95% CI, 1.1–1.5), and new‐onset grade 2–4 chronic conditions (RR, 1.3; 95% CI, 1.0–1.7). Conclusions Young adult survivors of childhood cancer have elevated risk of experiencing loneliness, which is associated with future emotional distress, risky health behaviors, and new‐onset chronic conditions.

Social impairment in survivors of pediatric brain tumors via reduced social attention and emotion‐specific facial expression recognition

“…However, analyses revealed an indirect association between reduced social attention and more social impairments through angry FER. These findings are significant given the risks posed by poor social adjustment and isolation to the wellbeing of SPBT, including increased psychological distress, 37 suicidal ideation, risky health behaviors, and new‐onset chronic conditions 7 . Moreover, social information processing—and more specifically, underlying social affective functions—influences social behavior and social adjustment 14,15 .…”

“…These findings are significant given the risks posed by poor social adjustment and isolation to the wellbeing of SPBT, including increased psychological distress, 37 suicidal ideation, risky health behaviors, and new-onset chronic conditions. 7 Moreover, social information processing-and more specifically, underlying social affective functions-influences social behavior and social adjustment. 14,15 Previous research with SPBT has focused on social attention and face processing as predictors of social impairments, 17,[20][21][22] less and worse peer interactions, 18 and fewer friendships.…”

“…The health-related consequences of treatment for a PBT occur across a multitude of domains, including neurological, 2 physical, 3 psychological, 4 cognitive, 5 and social, 6 and intersect across the lifespan. A recent study also revealed that SPBT are less likely to be employed full-time, college educated, living independently, and married 7 The cumulative toll of these effects is significant, as SPBT have the lowest health-related quality of life of all childhood cancer survivors. 8 Social outcomes are particularly important to consider given their influence on the overall wellbeing of SPBT 9 and their connectedness to key developmental milestones (e.g., formation of a positive self-concept).…”

Factors Influencing Social Isolation among Cancer Patients: A Systematic Review

“…With the growing interest in investigating social isolation in recent years, researchers have confirmed that social isolation, or loneliness, has numerous adverse effects on the health status of cancer patients [19,20]. Studies have found that social isolation or loneliness was a risk factor for the following physical and mental statuses: malnutrition, new-onset chronic conditions, risky health behaviors, anxiety, constructive coping, depression, illness acceptance, and suicidal ideation [21][22][23][24]. Additionally, there was evidence that social isolation and loneliness were even related to all-cause and cancer mortality [25].…”

Perception of Korean healthy adolescents on cancer and adolescent cancer survivors: a cross-sectional survey

“…In addition to concerns and management of their ongoing or potential health issues, adolescent cancer survivors face tasks common to of their peers, such as navigating the social landscape of school, building a career path towards independent adulthood, and finding their place as contributing members of society [5][6][7][8]. Prior studies have indicated that adolescent cancer survivors who experience difficulties returning to normal life may be at increased risk of unemployment and social isolation [8][9][10][11]. A study conducted in ROK on 145 adolescent cancer survivors aged 13-18 years revealed that 49.7% reported experiencing at least one type of peer exclusion and victimization in school [12].…”