Health‐status of adult survivors of childhood cancer: A large‐scale population‐based study from the British childhood cancer survivor study

Abstract

The purpose of this study was to investigate the effect of childhood cancer and its treatment on self-reported health-status in 10,189 adult survivors of childhood cancer in Britain. Age-and sexadjusted scores on the SF-36 Mental and Physical Component Summary scales (MCS, PCS, respectively) were compared between survivors and UK norms, and between subgroups of survivors, by multiple regression. Survivors had comparable scores to UK-norms on the MCS scale (difference (D) 5 20.1, 99% CI: 20.5, 0.3). The difference in scores between survivors and UKnorms on the PCS scale varied by age (p heterogeneity < 0.001). Young survivors (16-19 years) scored similarly to UK-norms (D 5 0.5, (21.1, 2.2), whereas the age groups of 25 and older scored statistically and clinically significantly below UK-norms (all p-values < 0.0001), with Ds ranging between 22.3 (23.5, 21.2) and 23.7 (25.0, 22.4). Survivors of central nervous system (CNS) and bone tumors scored significantly (p-value at all ages <0.003) below UK-norms on the PCS scale. Specifically, these survivors were substantially more limited in specific daily activities such as, for example, walking a mile (40, 63%, respectively) when compared to UK-norms (16%). In conclusion, childhood cancer survivors rate their mental health broadly similarly to those in the general population. Survivors of CNS and bone tumors report their physical health-status to be importantly below population norms. Although self-reported physical health is at least as good as in the general population among young survivors, this study suggests that perceived physical health declines more rapidly over time than in the general population. ' 2007 Wiley-Liss, Inc.Key words: SF-36; health-status; childhood cancer survivors; epidemiology With the improvements in survival rates after childhood cancer, 1 in every 1,000 young adults currently has a history of childhood cancer, and this proportion is likely to increase.1 This increase, the potential for late effects, and the many decades of potential life ahead for most survivors means that it is critical to investigate the health-status of adults who have survived childhood cancer. Although many previous studies have investigated health-status by objective measures of health, relatively few studies have investigated self-reported health-status among survivors of childhood cancer. Investigating self-reported health-status is important because it may identify needs that may not be identified by objective measures of health such as, for example, a standard medical evaluation. Results from most studies 3-9 conducted so far indicate that the self-reported health-status of survivors is apparently broadly good. However, many earlier studies had design problems such as small sample size, lack of appropriate control group or use of a nonrepresentative sample of survivors. Because of these limitations the interpretation of much previous work may be questioned. We conducted an analysis using data from a British cohort study that was population-based and substantially la...

Health status and quality of life in long-term survivors of childhood leukaemia: the impact of haematopoietic stem cell transplantation

“…In the British Childhood Cancer Survivor Study, however, no evidence was found that survivors other than survivors of CNS and bone tumours scored significantly below UK-norms on the physical composite score of SF36. 26 Little information is available in survivors under 18. A Canadian study has compared parent-reported HRQL of child and adolescent cancer survivors to that of controls who had had no history of cancer.…”

“…[13][14][15] Several studies have recently evaluated quality of life (QoL) among survivors of childhood cancer. [16][17][18][19][20][21][22][23][24][25][26] However, it is not known if prior HSCT affects QoL of childhood AL survivors more than conventional treatment. We initiated a late effect program (the 'LEA' program) in 2003 for children with AL treated in two French geographic areas (west PACA-Corse and Lorraine) to study the health status and QoL of long-term survivors.…”

Self-reported health-related quality of life of children and adolescent survivors of extracranial childhood malignancies: a Finnish nationwide survey

“…Despite the increasing numbers of HRQL studies on adult or young adult childhood cancer survivors [2][3][4][5], there is a lack of information regarding young survivors' own assessment of their HRQL. Some publications report on the situation of young survivors in countries where survival rates are not comparable with the Scandinavian ones [6,7].…”

Ejercicio físico y calidad de vida en adolescentes supervivientes a un cáncer

“…Es más, el GS ha mostrado una percepción de bienestar psicológico (MCS) significativamente superior a la del GN. Esto podría explicarse porque haber sobrevivido a un cáncer puede llevar a estos adolescentes a valorar más su estado de salud actual o incluso, en cierta medida, a sobrestimarlo (41,42) . Otra posible explicación es que hayan experimentado cierta maduración personal o crecimiento postraumático que podría estar vinculado a una mayor percepción de bienestar psicológico, tal y como han señalado algunos autores (43)(44)(45)(46) .…”

“…Es importante resaltar que el diseño longitudinal nos permitiría controlar el efecto del tiempo transcurrido desde la finalización del tratamiento sobre la salud percibida, ya que algunos estudios parecen indicar que la percepción de la misma, presenta un declive más rápido que el que se da en la población general, sobre todo, en lo que a salud física se refiere (41) . Como ya hemos comentado previamente, los estudios empíricos con población pediátrica en nuestro país son escasos, y más aún en el ámbito específi-co de la psico-oncología; por todo ello, es necesaria más investigación acerca de la CVRS y de las variables favorecedoras de la misma en el colectivo de supervivientes.…”