Psychosocial and neurocognitive outcomes in adult survivors of adolescent and early young adult cancer

A report from the Childhood Cancer Survivor Study

Pinki K. Prasad, Kristina K. Hardy, Nan Zhang, Kim Edelstein, Deokumar Srivastava, Lonnie Zeltzer, Marilyn Stovall, Nita L. Seibel, Wendy Leisenring, Gregory Armstrong, Leslie L. Robison, Kevin Krull

Research output: Contribution to journalArticle

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Abstract

Purpose: To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods: Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Results: Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). Conclusion: We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment.

Original languageEnglish (US)
Pages (from-to)2545-2552
Number of pages8
JournalJournal of Clinical Oncology
Volume33
Issue number23
DOIs
StatePublished - Aug 10 2015

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Survivors
Young Adult
Odds Ratio
Neoplasms
Siblings
Logistic Models
Depression
Efficiency
Unemployment
Sarcoma
Self Report
Lymphoma
Leukemia
Anxiety
Demography
Psychology
Education
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Psychosocial and neurocognitive outcomes in adult survivors of adolescent and early young adult cancer : A report from the Childhood Cancer Survivor Study. / Prasad, Pinki K.; Hardy, Kristina K.; Zhang, Nan; Edelstein, Kim; Srivastava, Deokumar; Zeltzer, Lonnie; Stovall, Marilyn; Seibel, Nita L.; Leisenring, Wendy; Armstrong, Gregory; Robison, Leslie L.; Krull, Kevin.

In: Journal of Clinical Oncology, Vol. 33, No. 23, 10.08.2015, p. 2545-2552.

Research output: Contribution to journalArticle

Prasad, PK, Hardy, KK, Zhang, N, Edelstein, K, Srivastava, D, Zeltzer, L, Stovall, M, Seibel, NL, Leisenring, W, Armstrong, G, Robison, LL & Krull, K 2015, 'Psychosocial and neurocognitive outcomes in adult survivors of adolescent and early young adult cancer: A report from the Childhood Cancer Survivor Study', Journal of Clinical Oncology, vol. 33, no. 23, pp. 2545-2552. https://doi.org/10.1200/JCO.2014.57.7528
Prasad, Pinki K. ; Hardy, Kristina K. ; Zhang, Nan ; Edelstein, Kim ; Srivastava, Deokumar ; Zeltzer, Lonnie ; Stovall, Marilyn ; Seibel, Nita L. ; Leisenring, Wendy ; Armstrong, Gregory ; Robison, Leslie L. ; Krull, Kevin. / Psychosocial and neurocognitive outcomes in adult survivors of adolescent and early young adult cancer : A report from the Childhood Cancer Survivor Study. In: Journal of Clinical Oncology. 2015 ; Vol. 33, No. 23. pp. 2545-2552.
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abstract = "Purpose: To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods: Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95{\%} CIs. Results: Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7{\%} v 8.0{\%}, respectively; OR, 1.55; 95{\%} CI, 1.04 to 2.30) and anxiety (7.4{\%} v 4.4{\%}, respectively; OR, 2.00; 95{\%} CI, 1.17 to 3.43) and more problems with task efficiency (17.2{\%} v 10.8{\%}, respectively; OR, 1.72; 95{\%} CI, 1.21 to 2.43), emotional regulation (19.1{\%} v 14.1{\%}, respectively; OR, 1.74; 95{\%} CI, 1.26 to 2.40), and memory (25.9{\%} v 19.0{\%}, respectively; OR, 1.44; 95{\%} CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95{\%} CI, 2.28 to 3.77), somatization (OR, 2.29; 95{\%} CI, 1.77 to 2.98), and depression (OR, 1.94; 95{\%} CI, 1.43 to 2.63). Conclusion: We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment.",
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AU - Prasad, Pinki K.

AU - Hardy, Kristina K.

AU - Zhang, Nan

AU - Edelstein, Kim

AU - Srivastava, Deokumar

AU - Zeltzer, Lonnie

AU - Stovall, Marilyn

AU - Seibel, Nita L.

AU - Leisenring, Wendy

AU - Armstrong, Gregory

AU - Robison, Leslie L.

AU - Krull, Kevin

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N2 - Purpose: To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods: Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Results: Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). Conclusion: We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment.

AB - Purpose: To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods: Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Results: Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). Conclusion: We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment.

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