Social outcomes in the Childhood Cancer Survivor Study cohort

J Clin Oncol. 2009 May 10;27(14):2390-5. doi: 10.1200/JCO.2008.21.1458. Epub 2009 Feb 17.

Abstract

Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / adverse effects
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / etiology
  • Causality
  • Child
  • Comorbidity
  • Educational Measurement
  • Educational Status
  • Employment / statistics & numerical data
  • Female
  • Friends
  • Hearing Loss / epidemiology
  • Hearing Loss / etiology
  • Humans
  • Learning Disabilities / epidemiology
  • Learning Disabilities / etiology
  • Male
  • Marriage / statistics & numerical data
  • Neoplasms / mortality
  • Neoplasms / psychology*
  • Neoplasms / rehabilitation*
  • Neoplasms / therapy
  • Radiotherapy / adverse effects
  • Risk Assessment
  • Social Adjustment
  • Social Problems / prevention & control*
  • Social Problems / statistics & numerical data*
  • Survivors / psychology*
  • Survivors / statistics & numerical data*
  • United States / epidemiology
  • Young Adult

Substances

  • Antineoplastic Agents