BishtRef
Articles Journals Publishers Authors Subjects Most Cited New Papers Year Stats Open Access
journal article Aug 20, 2007

Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Kris Ann P. Schultz ORCID Kirsten K. Ness ORCID John Whitton Christopher Recklitis Brad Zebrack ORCID Leslie L. Robison ORCID Lonnie Zeltzer Ann C. Mertens
Journal of Clinical Oncology Vol. 25 No. 24 pp. 3649-3656 · American Society of Clinical Oncology (ASCO)
View at Publisher Save 10.1200/jco.2006.09.2486
Abstract
Purpose Adolescents, regardless of medical history, may face behavioral and social challenges. Cancer and related treatments represent additional challenges for teens navigating the transition from childhood to adulthood. This study was conducted to evaluate behavioral and social outcomes of adolescent childhood cancer survivors using data from the Childhood Cancer Survivor Study. Patients and Methods We evaluated 2,979 survivors and 649 siblings of cancer survivors to determine the incidence of difficulty in six behavioral and social domains (depression/anxiety, headstrong, attention deficit, peer conflict/social withdrawal, antisocial behaviors, and social competence). Outcomes were determined by calculating parent-reported scores to questions from the behavior problem index. Results Survivors and siblings were similar in age at the time of interview (mean: 14.8, survivors; 14.9, siblings; range, 12 to 17 years). Overall, multivariate analyses showed that survivors were 1.5 times (99% CI, 1.1 to 2.1) more likely than siblings to have symptoms of depression/anxiety and 1.7 times (99% CI, 1.3 to 2.2) more likely to have antisocial behaviors. Scores in the depression/anxiety, attention deficit, and antisocial domains were significantly elevated in adolescents treated for leukemia or CNS tumors when compared with siblings. In addition, survivors of neuroblastoma had difficulty in the depression/anxiety and antisocial domains. Treatments with cranial radiation and/or intrathecal methotrexate were specific risk factors. Conclusion Adolescent survivors of childhood cancer, especially those with a history of leukemia, CNS tumors, or neuroblastoma, may be at increased risk for adverse behavioral and social outcomes. Increased surveillance of this population, in combination with development of interventional strategies, should be a priority.
Topics

No keywords indexed for this article. Browse by subject →

References
38
[1]
Ries LAG, Eisner MP, Kosary CL, SEER cancer statistics review , 1975-2001. Bethesda, MD, National Cancer Institute. 2004 http://seer.cancer.gov/csr/1975_2001/
[3]
Zebrack BJ, Zeltzer LK, Whitton J, et al: Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin's disease and non-Hodgkin's lymphoma: A report from the childhood cancer survivor study Pediatrics 110:42,2002-52, 10.1542/peds.110.1.42
[11]
St Jude Children's Research Hospital: Long-term follow-up and Childhood Cancer and Survivor Study. www.stjude.org/ccss
[12]
Zill N, Peterson J: Behavior Problems Index. Washington, DC, Child Trends Inc, 1986 10.1037/t05908-000
[13]
Achenbach TM: Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, VT, University of Vermont Department of Psychiatry, 1991
[14]
Gortmaker SL, Walker DK, Weitzman M, et al: Chronic conditions, socioeconomic risks and behavioral problems in children and adolescents. Pediatrics 85:267,1990-276, 10.1542/peds.85.3.267
[17]
Hochberg Y, Ajit C: Tamhane, Multiple Comparison Procedures , John Wiley & Sons, 1987 10.1002/9780470316672
[18]
Westfall PH, Tobias RD, Rom D, et al: Multiple Comparisons and Multiple Tests Using the SAS System. Cary, NC, SAS Institute, 1999
[31]
Love B, Byrne C, Roberts J, et al: Adult psychosocial adjustment following childhood injury: The effect of disfigurement. J Burn Care Rehabil 4:280,1987-285, 10.1097/00004630-198707000-00008
Cited By
265
Eye Movements and White Matter are Associated with Emotional Control in Children Treated for Brain Tumors

Iska Moxon-Emre, Margot J. Taylor · 2020

Journal of the International Neurop...
Behavioral outcome among survivors of childhood brain tumor: a case control study

Hamidah Alias, Sasirekha Krisnan Morthy · 2020

BMC Pediatrics
Social competence in childhood brain tumor survivors: a comprehensive review

Fiona Schulte, Maru Barrera · 2010

Supportive Care in Cancer
Metrics
265
Citations
38
References
Details
Published
Aug 20, 2007
Vol/Issue
25(24)
Pages
3649-3656
Authors
K
Kris Ann P. Schultz

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

K
Kirsten K. Ness

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

J
John Whitton

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

C
Christopher Recklitis

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

B
Brad Zebrack

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

L
Leslie L. Robison

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

L
Lonnie Zeltzer

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

A
Ann C. Mertens

From the Department of Pediatrics, University of Minnesota, Minneapolis, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Southern California School of Social Work; UCLA Medical Center, Los Angeles, CA; Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN; and the Department of Pediatrics, Emory University, Atlanta, GA

Cite This Article
Kris Ann P. Schultz, Kirsten K. Ness, John Whitton, et al. (2007). Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 25(24), 3649-3656. https://doi.org/10.1200/jco.2006.09.2486
Related

You May Also Like

The Functional Assessment of Cancer Therapy scale: development and validation of the general measure.

D F Cella, D S Tulsky · 1993

4,946 citations

Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification

Bruce D. Cheson, Richard I. Fisher · 2014

4,702 citations

Revised Response Criteria for Malignant Lymphoma

Bruce D. Cheson, Beate Pfistner · 2007

3,841 citations

Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Update

Antonio C. Wolff, M. Elizabeth H. Hammond · 2013

3,356 citations

Updated Response Assessment Criteria for High-Grade Gliomas: Response Assessment in Neuro-Oncology Working Group

Patrick Y. Wen, David R. Macdonald · 2010

3,341 citations