Quality of Life Among Long-Term Adolescent and Adult Survivors of Childhood Cancer

Maunsell, Elizabeth; Pogany, Lisa; Barrera, Maru; Shaw, Amanda; Speechley, Kathy N.

doi:10.1200/jco.2005.03.9297

Cited by 125 publications

(134 citation statements)

References 36 publications

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“…Our results extend earlier CCSS findings of increased depression and somatization in survivors of leukemia and lymphoma (9), brain tumor (8), and solid tumors (10) compared with siblings. Our findings are also consistent with earlier reports of associations between poor HRQOL and female gender (32)(33)(34)(35), older age (35), lower educational attainment (33), unemployment (33), and medical limitations (33). Others found being survivors >26 years (32) and treatment with cranial radiation or surgery (34,35) as risks for poor physical HRQOL.…”

Section: Discussionsupporting

confidence: 82%

“…Our findings are also consistent with earlier reports of associations between poor HRQOL and female gender (32)(33)(34)(35), older age (35), lower educational attainment (33), unemployment (33), and medical limitations (33). Others found being survivors >26 years (32) and treatment with cranial radiation or surgery (34,35) as risks for poor physical HRQOL. Younger age at diagnosis and decreased risk of poor physical HRQOL in our study contradicts another study of 2,152 childhood cancer survivors (35) that used the Health Utilities Index Mark III, a discrepancy possibly explained by differences in the focus of the Health Utilities Index Mark III versus SF-36.…”

Section: Discussionsupporting

confidence: 82%

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Psychosocial Outcomes and Health-Related Quality of Life in Adult Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

Zeltzer

Lü²,

Leisenring³

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

385

421

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Purpose: Psychological outcomes, health-related quality of life (HRQOL), and life satisfaction are compared between 7,147 adult childhood cancer survivors and 388 siblings from the Childhood Cancer Survivor Study, examining demographic and diagnosis/treatment outcome predictors. Methods: Psychological distress, HRQOL, and life satisfaction were measured by the Brief Symptom Inventory-18, the Medical Outcomes Survey Short Form-36, and Cantril Ladder of Life, respectively. A self-report questionnaire provided demographic/health information and medical record abstraction provided cancer/treatment data. Siblings' and survivors' scores were compared using generalized linear mixed models, and predictor effects of demographic and cancer/treatment variables were analyzed by multivariate logistic regression. Results: Although survivors report greater symptoms of global distress (mean, 49.17; SE, 0.12) than do siblings (mean, 46.64; SE, 0.51), scores remain below population norms, indicating that survivors and siblings remain psychologically healthy. Survivors scored worse than siblings on overall physical (51.30 F 0.10 versus 54.98 F 0.44; P < 0.001) but not emotional aspects of HRQOL, but effect sizes were small, other than in vitality. Most survivors reported present (mean, 7.3; SD, 0.02) and predicted future (mean, 8.6; SD, 0.02) life satisfaction. Risk factors for psychological distress and poor HRQOL were female gender, lower educational attainment, unmarried status, annual household income <$20,000, unemployment, lack of medical insurance, having a major medical condition, and treatment with cranial radiation. IntroductionAdulthood is now attainable for most children treated for cancer with 5-year survival rates at 80% (1). Increased survival may be accompanied by long-term burden for some individuals related to the unique characteristics of their cancer diagnoses and treatment and the effect of treatment on their educational, psychological, and social development. Identification of subgroups of childhood cancer survivors at risk for poor health-related quality of life (HRQOL) is important for development of intervention strategies. As treatments evolve, determination of treatments promoting long-term survival and reduced risk for poor HRQOL outcomes will be a goal.Findings in survivors are often derived from singleinstitution oncology programs or long-term follow-up clinics and suggest that psychosocial status and HRQOL are relatively good for most survivors, yet less favorable outcomes have been reported (2-6). Childhood Cancer Survivor Study (CCSS) reports have examined psychosocial outcomes and HRQOL within specific diagnostic groups (7-11). However, it is necessary to examine the entire cohort of childhood cancer survivors, compare them with siblings, and identify demographic and treatment risk factors so that risk-based treatments to enhance HRQOL of life can be developed.This report describes psychosocial status, HRQOL, and life satisfaction in the CCSS cohort, compares findings to sibling controls ...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Psychosocial Outcomes and Health-Related Quality of Life in Adult Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

Zeltzer

Lü²,

Leisenring³

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

385

421

View full text Add to dashboard Cite

show abstract

“…The current comparison and previous reports 22,24,25 have provided encouraging results concerning the equivalency of survivors' self-reported health status to that of the general population. Linking survivors' perceived health to more established clinical indicators supports its potential usefulness as a predictor of preclinical disease and opens a new field of study.…”

Section: Discussionmentioning

confidence: 51%

“…The focus of this study was the measurement of systolic function in childhood cancer survivors who reported no symptoms of cardiac disease. Whereas previous studies have compared selfreported health status in survivors versus a healthy control group 22,24,25 ; in the current study, we compared self-reported health in survivors who received anthracycline therapy alone (N 5 86), versus anthracycline plus RT (N 5 41), versus survivors who received neither anthracyclines nor RT (N 5 32).…”

mentioning

confidence: 99%

Subclinical late cardiac toxicity in childhood cancer survivors

Cox

Shesh

Rosenthal

et al. 2008

Cancer

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BACKGROUNDThe authors analyzed how self‐reported health and self‐reported modified New York Heart Association (NYHA) cardiac function scores were related to cardiac systolic function, cardiac risk factors, and cancer treatment history in childhood cancer survivors who reported no symptoms of cardiac disease.METHODSLong‐term survivors of pediatric cancer who were treated between 1971 and 1995 (current ages, 16–39.7 years) underwent noninvasive clinical and laboratory cardiac risk evaluation and responded to selected subscales of the Medical Outcomes Study 36‐item Short Form Health Survey. Results were compared with survivor history of anthracycline therapy alone or with radiotherapy (n = 127 patients; mean, 10 years after diagnosis) versus no anthracycline therapy (n = 32 patients; mean, 11 years after diagnosis).RESULTSSex, current age, highest school grade completed, race, age at diagnosis, diagnostic group, years off therapy, fractional shortening (FS), heart rate, and smoking status were found to be independently predictive of self‐reported health. Interaction between female sex and higher low‐density lipoprotein values and between diagnosis and abnormal FS variably predicted low reported vitality and low reported modified New York Heart Association (NYHA) scores. Echocardiographic findings, cardiac risk factors, and treatment history explained 13% to 28% of the variance in perceived health and self‐reported modified NYHA scores.CONCLUSIONSSystolic function and cardiac risk factors were linked to lower self‐reported health and NYHA scores even in the absence of clinically evident cardiotoxicity. Cancer 2008. ©2008 American Cancer Society.

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“…RAND-36 has been used in other studies to assess HRQoL in survivors of childhood cancers. 16,17 Follow-up of the assessed survivors was 1 year after their fi rst visit, in 2005 or 2006 (visit 2), and was undertaken by local family doctors who had been sent information (from the on-site coordinating family doctor at the LTFU clinic) about patients' histories, health risks, and necessary tests. Survivors were sent letters asking them to make appointments of at least half an hour with their family doctors.…”

Section: Methodsmentioning

confidence: 99%

Shared care by paediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study

Blaauwbroek

Tuinier

Jong

et al. 2008

The Lancet Oncology

103

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SummaryBackground Since 75% of children with cancer will become long-term survivors, late eff ects of treatment are an ever increasing issue for patients. Paediatric oncologists generally agree that cancer survivors should be followed up for the remainder of their lives, but they might not be the most suitable health-care providers to follow up survivors into late adulthood. We designed a 3-year study to assess whether shared-care by paediatric oncologists and family doctors in the long-term follow-up of survivors of childhood cancers is feasible, whether a shared-care model is compatible with collection of data needed for registration of late eff ects, and how a shared-care model is assessed by survivors and family doctors.

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Quality of Life Among Long-Term Adolescent and Adult Survivors of Childhood Cancer

Abstract: Overall, a sizeable majority of adolescent and adult long-term survivors of childhood cancer in Canada appear to have adapted well.

Cited by 125 publications

References 36 publications

Psychosocial Outcomes and Health-Related Quality of Life in Adult Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

Psychosocial Outcomes and Health-Related Quality of Life in Adult Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

Subclinical late cardiac toxicity in childhood cancer survivors

Shared care by paediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study

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