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J Clin Oncol. 2015 Aug 10;33(23):2545-52. doi: 10.1200/JCO.2014.57.7528. Epub 2015 Jul 6.

Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study.

Author information

1
Pinki K. Prasad, Louisiana State University School of Medicine, New Orleans, LA; Kristina K. Hardy, Children's National Medical Center, Washington, DC; Nan Zhang, Deokumar Srivastava, Gregory T. Armstrong, Leslie L. Robison, and Kevin Krull, St Jude Children's Research Hospital, Memphis, TN; Lonnie Zeltzer, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Nita L. Seibel, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kim Edelstein, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. pprasa@lsuhsc.edu.
2
Pinki K. Prasad, Louisiana State University School of Medicine, New Orleans, LA; Kristina K. Hardy, Children's National Medical Center, Washington, DC; Nan Zhang, Deokumar Srivastava, Gregory T. Armstrong, Leslie L. Robison, and Kevin Krull, St Jude Children's Research Hospital, Memphis, TN; Lonnie Zeltzer, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Nita L. Seibel, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD; Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kim Edelstein, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

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.

PMID:
26150441
PMCID:
PMC4525049
DOI:
10.1200/JCO.2014.57.7528
[Indexed for MEDLINE]
Free PMC Article

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