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Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study |
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| Authors: | Anne Maas MSc Heleen Maurice-Stam PhD Leontien C M Kremer MD PhD Alied van der Aa-van Delden MSc Eline van Dulmen-den Broeder PhD Wim J E Tissing MD PhD Jacqueline J Loonen MD PhD Helena J H van der Pal MD PhD Andrica C H de Vries MD PhD Marry M van den Heuvel-Eibrink MD PhD Cécile Ronckers PhD Sebastian Neggers MD PhD Dorine Bresters MD PhD Marloes Louwerens MD Margriet van der Heiden-van der Loo PhD Marloes van Gorp PhD Martha Grootenhuis PhD Dutch LATER study group |
| Institution: | 1. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands;2. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands;3. Amsterdam UMC/location VUmc, Amsterdam, The Netherlands;4. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands;5. Radboud University Medical Center, Nijmegen, The Netherlands;6. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands;7. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany;8. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Department of Medicine, Section Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands;9. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, The Netherlands;10. Leiden University Medical Center, Leiden, The Netherlands |
| Abstract: | BackgroundThis study compares a comprehensive range of psychosocial outcomes of adult childhood cancer survivors (CCS) to general population-based references and identifies sociodemographic and medical risk factors.MethodsCCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (attained age ≥18 years, diagnosed <18 years, ≥5 years since diagnosis) completed the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Self-Rating Scale for Post-Traumatic Stress Disorder, and the Short Form-36 (Health Related Quality of Life). CCS’ scores were compared with references using analysis of variances and logistic regression analysis, controlling for age and sex (p < .05). Risk factors for worse psychosocial outcomes were assessed with regression analyses (p < .05).ResultsCCS, N = 1797, mean age 35.4 years, 49.0% female, all ≥15 years since diagnosis, participated. Three percent reported posttraumatic stress disorder because of childhood cancer and 36.6% experienced clinical distress. CCS did not differ from references on self-esteem and anxiety but were less depressed (d = −.25), and scored poorer on all health-related quality of life scales, except for bodily pain (.01 ≤ d ≥ −.36). Female sex, lower educational attainment, not being in a relationship, and being unemployed were negatively associated with almost all psychosocial outcomes. Except for a central nervous system tumor diagnosis, few medical characteristics were associated with psychosocial outcomes.ConclusionCCS appear resilient regarding mental health but have slightly poorer health-related quality of life than references. Sociodemographic characteristics and central nervous system tumors were related to most psychosocial outcomes, but no clear pattern was observed for other medical factors. Future studies should address additional factors in explaining CCS’ psychosocial functioning, such as coping, social support, and physical late effects. |
| Keywords: | anxiety childhood cancer survivors cohort study depression distress health-related quality of life post-traumatic stress self-esteem |