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Pediatr Blood Cancer. 2018 Feb;65(2). doi: 10.1002/pbc.26860. Epub 2017 Oct 27.

Increased prescription rates of anxiolytics and hypnotics to survivors of cancer in childhood, adolescence, and young adulthood-A population-based study.

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National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital, Oslo, Norway.
Deparment of Pediatric Hematology/Oncology, Oslo University Hospital, Oslo, Norway.
Department of Oncology, Regional Advisory Unit for Palliative Care, Oslo University Hospital, Oslo, Norway.
Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.
Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.



Survivors of cancer diagnosed in childhood, adolescence, or young adulthood (CAYACS) risk psychological morbidities later in life. The study compares prescription rates of anxiolytics and hypnotics among survivors to rates in age- and gender-matched controls.


The population-based cohort included 5,341 cancer survivors, diagnosed ≤25 years of age during 1965-2000. For each survivor, three age- and gender-matched controls were randomly selected from the general population. Data were identified from the Norwegian Cancer and Population registries and linked to the Norwegian Prescription Database. A Cox proportional hazard model was applied to estimate hazard ratios (HRs) of prescriptions during 2004-2012 to the survivors with controls as referents.


Survivors had an increased risk of being prescribed anxiolytics with crude rates of 16.9/1,000 person years compared to 11.8/1,000 person years in controls (HR 1.41; 95% confidence interval [CI] 1.29-1.54). The relative risk was highest for survivors of neuroblastomas (HR 2.62; 95% CI 1.11-6.16), bone tumors (HR 2.00; 95% CI 1.26-3.18), and central nervous system tumors (HR 1.90; 95% CI 1.40-2.51). The risk of being prescribed hypnotics was increased with crude rates of 20.8/1,000 person years compared to 14.3/1,000 person years in controls (HR 1.44; 95% CI 1.32-1.56). The relative risk was highest for survivors of gastrointestinal tumors (HR 1.80; 95% CI 1.04-3.10), leukemias (HR 1.78; 95% CI 1.32-2.38), and soft tissue cancers (HR 1.70; 95% CI 1.09-2.64).


Certain groups of CAYACS have an increased risk for being prescribed anxiolytics or hypnotics compared to controls. Diagnostic reasons for prescriptions are unknown, but the results indicate an increased emotional burden among these groups of survivors.


anxiolytics; hypnotics; late effects; mental health; population based

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