Young adults after childhood cancer: Health and psychosocial consequences of treatment and illness

Abstract

Young adults after childhood cancer: Health and psychosocial consequences of treatment and illness Degree Project thesis, Programme in Medicine: Amanda Rosendahl Supervisor: Marianne Jarfelt, MD, PhD , Institute of Clinical Sciences Programme in Medicine Gothenburg, Sweden 2015 Abstract Introduction: Malignant disease during childhood is rare, age standardized incidence in Europe is 140 in 1 million children. In recent decades survival from childhood cancer has increased to over 80%, unfortunately with risk for long term complications. Sweden has 11000 individuals that have or have had cancer during childhood, of whom 6000-7000 are adults today. The number of complications increases with time after diagnosis up to a complication rate of 88% in survivors 20 years after treatment. Aim: To summarize general distress, self-reported concerns and complications, and possible correlations between them, in a cohort of survivors of childhood cancer from the long-term follow-up clinic in Gothenburg. Method: A retrospective descriptive study of individuals visiting a Long-term followup clinic. All participants were over 18 years, had survived childhood cancer with >5 years since last treatment. One hundred and six individuals (50 women and 56 men) fulfilled the criteria for inclusion and gave permission to use the data. Data was collected from medical journals and a questionnaire. Distress was measured using the Distress Thermometer. Results: Complication was found in 86 individuals (81%). Mean number of complications was 2.29. Radiotherapy was associated to higher risk of complications (p=0.001). New complications were diagnosed in 30% of participants. Mean score of general distress was 2.52.There was a correlation between high amount of complications and higher score of general distress (p=0.01). Women scored significantly higher than men, 3.2 and 1.8 respectively (p=0.005). Women were more likely to have moderate to severe distress (≥4) (p=0.02). Conclusion: Many childhood cancer survivors develop complications. New complications were found in 30% of participants and higher levels of distress were found in women and individuals with previously known complications. The results indicate that specialized follow-up clinics are helpful for maintaining a good health among childhood cancer survivors.