Adolescent survivors of childhood cancer: are they vulnerable for psychological distress?

Psychooncology. 2013 Sep;22(9):2051-8. doi: 10.1002/pon.3249. Epub 2013 Feb 11.


Objectives: We aimed to (i) evaluate psychological distress in adolescent survivors of childhood cancer and compare them to siblings and a norm population; (ii) compare the severity of distress of distressed survivors and siblings with that of psychotherapy patients; and (iii) determine risk factors for psychological distress in survivors.

Methods: We sent a questionnaire to all childhood cancer survivors aged <16 years when diagnosed, who had survived ≥ 5 years and were aged 16-19 years at the time of study. Our control groups were same-aged siblings, a norm population, and psychotherapy patients. Psychological distress was measured with the Brief Symptom Inventory-18 (BSI-18) assessing somatization, depression, anxiety, and a global severity index (GSI). Participants with a T-score ≥ 57 were defined as distressed. We used logistic regression to determine risk factors.

Results: We evaluated the BSI-18 in 407 survivors and 102 siblings. Fifty-two survivors (13%) and 11 siblings (11%) had scores above the distress threshold (T ≥ 57). Distressed survivors scored significantly higher in somatization (p=0.027) and GSI (p=0.016) than distressed siblings, and also scored higher in somatization (p ≤ 0.001) and anxiety (p=0.002) than psychotherapy patients. In the multivariable regression, psychological distress was associated with female sex, self-reported late effects, and low perceived parental support.

Conclusions: The majority of survivors did not report psychological distress. However, the severity of distress of distressed survivors exceeded that of distressed siblings and psychotherapy patients. Systematic psychological follow-up can help to identify survivors at risk and support them during the challenging period of adolescence.

Keywords: adolescent survivors; childhood cancer; cohort study; oncology; psychological distress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Neoplasms / epidemiology
  • Neoplasms / psychology*
  • Quality of Life
  • Risk Factors
  • Sex Factors
  • Siblings
  • Social Support
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Survivors / statistics & numerical data
  • Young Adult