Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer

a report from the Childhood Cancer Survivor Study

Tara M. Brinkman, E. Anne Lown, Chenghong Li, Ingrid Tonning Olsson, Jordan Gilleland Marchak, Margaret L. Stuber, Stefanie Vuotto, Deokumar Srivastava, Paul C. Nathan, Wendy M. Leisenring, Gregory Armstrong, Leslie L. Robison, Kevin R. Krull

Research output: Contribution to journalArticle

Abstract

Aims: To estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress. Design: Retrospective cohort study with longitudinal follow-up of self-reported health outcomes. Setting: Childhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada. Participants: A total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress. Measurements: Survivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory–18 and the Posttraumatic Stress Diagnostic Scale. Findings: After adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30% increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95% confidence interval (CI) = 1.1–1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95% CI = 1.1–1.5), anxiety (RR = 1.6; 95% CI = 1.3–2.1), and somatization (RR = 1.2; 95% CI = 1.1–1.4). Persistent heavy/risky drinking was associated with 80% increased risk of persistent psychological distress (RR = 1.8, 95% CI = 1.4–2.3). Conclusions: Drinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.

Original languageEnglish (US)
Pages (from-to)226-235
Number of pages10
JournalAddiction
Volume114
Issue number2
DOIs
StatePublished - Feb 1 2019

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Alcohol Drinking
Survivors
Drinking
Odds Ratio
Confidence Intervals
Neoplasms
Alcohols
Canada
Siblings
Cohort Studies
Radiotherapy
Anxiety
Retrospective Studies
Depression
Psychology
Health

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer : a report from the Childhood Cancer Survivor Study. / Brinkman, Tara M.; Lown, E. Anne; Li, Chenghong; Olsson, Ingrid Tonning; Marchak, Jordan Gilleland; Stuber, Margaret L.; Vuotto, Stefanie; Srivastava, Deokumar; Nathan, Paul C.; Leisenring, Wendy M.; Armstrong, Gregory; Robison, Leslie L.; Krull, Kevin R.

In: Addiction, Vol. 114, No. 2, 01.02.2019, p. 226-235.

Research output: Contribution to journalArticle

Brinkman, TM, Lown, EA, Li, C, Olsson, IT, Marchak, JG, Stuber, ML, Vuotto, S, Srivastava, D, Nathan, PC, Leisenring, WM, Armstrong, G, Robison, LL & Krull, KR 2019, 'Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study', Addiction, vol. 114, no. 2, pp. 226-235. https://doi.org/10.1111/add.14439
Brinkman, Tara M. ; Lown, E. Anne ; Li, Chenghong ; Olsson, Ingrid Tonning ; Marchak, Jordan Gilleland ; Stuber, Margaret L. ; Vuotto, Stefanie ; Srivastava, Deokumar ; Nathan, Paul C. ; Leisenring, Wendy M. ; Armstrong, Gregory ; Robison, Leslie L. ; Krull, Kevin R. / Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer : a report from the Childhood Cancer Survivor Study. In: Addiction. 2019 ; Vol. 114, No. 2. pp. 226-235.
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title = "Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study",
abstract = "Aims: To estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress. Design: Retrospective cohort study with longitudinal follow-up of self-reported health outcomes. Setting: Childhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada. Participants: A total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress. Measurements: Survivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory–18 and the Posttraumatic Stress Diagnostic Scale. Findings: After adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30{\%} increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95{\%} confidence interval (CI) = 1.1–1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95{\%} CI = 1.1–1.5), anxiety (RR = 1.6; 95{\%} CI = 1.3–2.1), and somatization (RR = 1.2; 95{\%} CI = 1.1–1.4). Persistent heavy/risky drinking was associated with 80{\%} increased risk of persistent psychological distress (RR = 1.8, 95{\%} CI = 1.4–2.3). Conclusions: Drinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.",
author = "Brinkman, {Tara M.} and Lown, {E. Anne} and Chenghong Li and Olsson, {Ingrid Tonning} and Marchak, {Jordan Gilleland} and Stuber, {Margaret L.} and Stefanie Vuotto and Deokumar Srivastava and Nathan, {Paul C.} and Leisenring, {Wendy M.} and Gregory Armstrong and Robison, {Leslie L.} and Krull, {Kevin R.}",
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T1 - Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer

T2 - a report from the Childhood Cancer Survivor Study

AU - Brinkman, Tara M.

AU - Lown, E. Anne

AU - Li, Chenghong

AU - Olsson, Ingrid Tonning

AU - Marchak, Jordan Gilleland

AU - Stuber, Margaret L.

AU - Vuotto, Stefanie

AU - Srivastava, Deokumar

AU - Nathan, Paul C.

AU - Leisenring, Wendy M.

AU - Armstrong, Gregory

AU - Robison, Leslie L.

AU - Krull, Kevin R.

PY - 2019/2/1

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N2 - Aims: To estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress. Design: Retrospective cohort study with longitudinal follow-up of self-reported health outcomes. Setting: Childhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada. Participants: A total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress. Measurements: Survivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory–18 and the Posttraumatic Stress Diagnostic Scale. Findings: After adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30% increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95% confidence interval (CI) = 1.1–1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95% CI = 1.1–1.5), anxiety (RR = 1.6; 95% CI = 1.3–2.1), and somatization (RR = 1.2; 95% CI = 1.1–1.4). Persistent heavy/risky drinking was associated with 80% increased risk of persistent psychological distress (RR = 1.8, 95% CI = 1.4–2.3). Conclusions: Drinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.

AB - Aims: To estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress. Design: Retrospective cohort study with longitudinal follow-up of self-reported health outcomes. Setting: Childhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada. Participants: A total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress. Measurements: Survivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory–18 and the Posttraumatic Stress Diagnostic Scale. Findings: After adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30% increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95% confidence interval (CI) = 1.1–1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95% CI = 1.1–1.5), anxiety (RR = 1.6; 95% CI = 1.3–2.1), and somatization (RR = 1.2; 95% CI = 1.1–1.4). Persistent heavy/risky drinking was associated with 80% increased risk of persistent psychological distress (RR = 1.8, 95% CI = 1.4–2.3). Conclusions: Drinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.

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