Patterns and predictors of survivorship clinic attendance in a population-based sample of pediatric and young adult childhood cancer survivors

Abstract Purpose This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer. Methods YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses. Results YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47). Conclusion YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.

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Genetic and treatment risks for diabetes mellitus (DM) in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS) and St. Jude Lifetime (SJLIFE) cohorts.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10014 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10014-10014

Author(s):

Melissa A. Richard ◽

Sogol Mostoufi-Moab ◽

Nisha Rathore ◽

Austin L. Brown ◽

Stephen J. Chanock ◽

...

Keyword(s):

Risk Factors ◽

Cancer Survivors ◽

Cancer Treatment ◽

Childhood Cancer ◽

Regulatory Region ◽

Childhood Cancer Survivors ◽

Population Based ◽

European Ancestry ◽

Radiation Group ◽

Increased Risk

10014 Background: Childhood cancer survivors face increased risk for DM, a polygenic trait also attributable to cancer treatment exposures, particularly abdominal radiation. We aimed to characterize the role of genetic and treatment risk factors for DM among two large cohorts of childhood cancer survivors. Methods: We performed a nested case-control genome-wide association study for DM managed with oral medications in the original CCSS cohort (diagnosed 1970-1986). Logistic regression was conducted in the total sample (N = 5083) and stratified by 1) European ancestry (EA) and 2) abdominal radiation. Replication of suggestive variants (P < 1×10-7) using Fisher’s exact test was performed in independent cohorts: i) CCSS expansion diagnosed 1987-1999 (N = 2588) and ii) SJLIFE diagnosed 1962-2012 (N = 2182). To evaluate the effect of cancer treatment on the background genetic predisposition to DM, we estimated standardized effect sizes (Z’) among EA survivors in each abdominal radiation group for 398 index variants from the largest population-based EA DM study. Radiation group Z’ estimates were compared using linear regression. Results: In the original CCSS cohort we identified nine variants associated with DM and provide further support for four linked variants in the ERCC6L2 locus. Among all survivors, the rs55849673-A allele was associated with increased odds for DM among survivors in the original CCSS cohort (minor allele frequency [MAF]-cases = 0.055; MAF-controls = 0.024; adjusted odds ratio [aOR] = 2.9, 95% CI: 2.0-4.2, P = 3.7×10-8). Allele frequencies were consistent in the CCSS expansion (MAF-cases = 0.075; MAF-controls = 0.028; P = 0.07) and SJLIFE (MAF-cases = 0.036; MAF-controls = 0.027; P = 0.5). Additionally, rs55849673-A estimates were consistent among EA survivors and stronger among survivors not treated with abdominal radiation (MAF-cases = 0.052; MAF-controls = 0.021; aOR = 3.6, P = 1.6×10-6). Notably, in the CCSS expansion all rs55849673-A EA carriers who developed DM did not receive abdominal radiation (MAF-cases = 0.1; MAF-controls = 0.026; P = 0.04). More broadly, the Z’ of population-based DM index variants were 78% lower in survivors treated with abdominal radiation than survivors not treated with abdominal radiation (beta = 0.22; P = 0.01), indicating the background genetic risk for DM may be altered by treatment. Conclusions: We provide evidence for a novel locus of DM in childhood cancer survivors. This locus is a regulatory region associated with expression of ERCC6L2, a gene implicated in an East Asian population-based DM study. Taken together, our findings support the overwhelming effect of abdominal radiation on DM risk in childhood cancer survivors, relative to other risk factors, and provide insight on a genetic locus that may be useful for DM risk prediction in the context of cancer treatment.

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Incidence of Influenza Among Childhood Cancer Survivors in South Korea: A Population-based Retrospective Analysis

In Vivo ◽

10.21873/invivo.11860 ◽

2020 ◽

Vol 34 (2) ◽

pp. 929-933 ◽

Cited By ~ 1

Author(s):

JAESUNG HEO ◽

HYUN JOO JUNG ◽

O KYU NOH ◽

LOGYOUNG KIM ◽

JUN EUN PARK

Keyword(s):

South Korea ◽

Cancer Survivors ◽

Childhood Cancer ◽

Retrospective Analysis ◽

Childhood Cancer Survivors ◽

Population Based

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Re: “Dysautonomia in Childhood Cancer Survivors: A Widely Underestimated Risk” by Berger et al. (J Adolesc Young Adult Oncol. 2019;8(1):9–17)

Journal of Adolescent and Young Adult Oncology ◽

10.1089/jayao.2018.0145 ◽

2019 ◽

Vol 8 (2) ◽

pp. 225-226

Author(s):

Maxime Caru ◽

Daniel Curnier

Keyword(s):

Young Adult ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors

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An investigation of survivorship clinic attendance among childhood cancer survivors living in a five-state rural region

Journal of Cancer Survivorship ◽

10.1007/s11764-017-0658-4 ◽

2017 ◽

Vol 12 (2) ◽

pp. 196-205 ◽

Cited By ~ 4

Author(s):

Judy Y. Ou ◽

Rochelle R. Smits-Seemann ◽

Yelena P. Wu ◽

Jennifer Wright ◽

Anne C. Kirchhoff

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Clinic Attendance ◽

Rural Region

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Evaluating sexual function in adolescent and young adult childhood cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24180 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24180-e24180

Author(s):

Jenna Sopfe ◽

Rebekah Marsh ◽

Leslie C. Appiah ◽

James L. Klosky ◽

Pamela N Peterson ◽

...

Keyword(s):

Young Adult ◽

Cancer Survivors ◽

Childhood Cancer ◽

Screening Tool ◽

Childhood Cancer Survivors ◽

Adolescent And Young Adult ◽

Structured Interviews ◽

Written Information ◽

Promising Tool ◽

Prior Experiences

e24180 Background: Up to half of adolescent and young adult (AYA) childhood cancer survivors (CCS) experience sexual dysfunction (SD) as a result cancer or its treatment. SD in CCS is under-recognized, with low levels of routine screening due to barriers such as discomfort, time, and awareness. This study explores solutions to these barriers by describing AYA CCS preferences for implementation of screening for SD and evaluating the utility of a validated adult screening tool (PROMIS SexFS Brief) in this population. Methods: 16 AYA CCS (aged 15-24 years) completed semi-structured interviews followed by questionnaire completion. Interviews explored patients’ prior experiences with SD screening, along with preferences for screening type (e.g., discussion, screening tool), delivery modality, and timing. Patients then completed the PROMIS SexFS Brief while verbalizing their thoughts and providing open-ended responses to each item. Transcribed interviews were inductively coded and analyzed, guided by content analysis methodology. Results: This analysis represents 2/3 of planned interviews, and all will be completed by April 1, 2020. Interviews were performed with 11 females and 5 males (median age 21). Preliminary analysis demonstrates that participants had minimal experience with SD conversations, but had preferences regarding by whom, how, and when screening/education should occur. Who: Participants felt providers should have preexisting rapport with their patients; preferences existed for provider role and sex/age. How: A combination of written materials and in-person conversations was preferred. Several acknowledged a desire to have a “warning” that the conversation would happen, such as through a questionnaire. Participants did not have a preference regarding delivery modality (paper vs. online). The PROMIS SexFS Brief appeared to demonstrate content validity and acceptability in AYA CCS. When: Participants wanted education and screening to occur regularly throughout cancer therapy and survivorship. SD conversations should be tailored developmentally to the patient. Conclusions: Our results demonstrate a theme throughout interviews of the importance of patient/provider rapport. Further, while AYA CCS prefer in-person conversations about SD, conversations should be preceded by written information or a questionnaire to increase patient preparedness/comfort. Preliminary findings suggest that the PROMIS SexFS Brief is a promising tool for screening SD in this population; further studies evaluating use in clinical settings is warranted.

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