Psychosocial outcomes and health-related quality of life in adult childhood cancer survivors

A report from the Childhood Cancer Survivor Study

Lonnie K. Zeltzer, Qian Lu, Wendy Leisenring, Jennie C.I. Tsao, Christopher Recklitis, Gregory Armstrong, Ann C. Mertens, Leslie L. Robison, Kirsten K. Ness

Research output: Contribution to journalArticle

239 Citations (Scopus)

Abstract

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 ± 0.10 versus 54.98 ± 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. Conclusion: Compared with population norms, childhood cancer survivors and siblings report positive psychological health, good HRQOL, and life satisfaction. The findings identify targeted subgroups of survivors for intervention.

Original languageEnglish (US)
Pages (from-to)435-446
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number2
DOIs
StatePublished - Feb 1 2008

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Survivors
Quality of Life
Siblings
Neoplasms
Psychology
Demography
Unemployment
Health
Insurance
Self Report
Population
Medical Records
Linear Models
Therapeutics
Logistic Models
Radiation
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

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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, Lonnie K.; Lu, Qian; Leisenring, Wendy; Tsao, Jennie C.I.; Recklitis, Christopher; Armstrong, Gregory; Mertens, Ann C.; Robison, Leslie L.; Ness, Kirsten K.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 17, No. 2, 01.02.2008, p. 435-446.

Research output: Contribution to journalArticle

Zeltzer, Lonnie K. ; Lu, Qian ; Leisenring, Wendy ; Tsao, Jennie C.I. ; Recklitis, Christopher ; Armstrong, Gregory ; Mertens, Ann C. ; Robison, Leslie L. ; Ness, Kirsten K. / Psychosocial outcomes and health-related quality of life in adult childhood cancer survivors : A report from the Childhood Cancer Survivor Study. In: Cancer Epidemiology Biomarkers and Prevention. 2008 ; Vol. 17, No. 2. pp. 435-446.
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abstract = "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 ± 0.10 versus 54.98 ± 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. Conclusion: Compared with population norms, childhood cancer survivors and siblings report positive psychological health, good HRQOL, and life satisfaction. The findings identify targeted subgroups of survivors for intervention.",
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AU - Leisenring, Wendy

AU - Tsao, Jennie C.I.

AU - Recklitis, Christopher

AU - Armstrong, Gregory

AU - Mertens, Ann C.

AU - Robison, Leslie L.

AU - Ness, Kirsten K.

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N2 - 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 ± 0.10 versus 54.98 ± 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. Conclusion: Compared with population norms, childhood cancer survivors and siblings report positive psychological health, good HRQOL, and life satisfaction. The findings identify targeted subgroups of survivors for intervention.

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