Social outcomes in young adult survivors of low incidence childhood cancers

Abstract

Introduction: The intensity and duration of childhood cancer treatment may disrupt psychosocial development and thereby cause difficulties in transition into adulthood. The study objective was to assess social outcomes in early adulthood after successful treatment for childhood acute myeloid leukemia (AML), Wilms tumor (WT) and infratentorial astrocytoma (IA).

Methods: Nordic patients treated for AML, WT and IA from 1985 to 2001 identified from a database administered by NOPHO (Nordic Society of Paediatric Haematology and Oncology) were invited to participate in a postal survey. All cancer-free survivors treated at age >1 year who were >19 years at time of study were eligible. Seventy-four percent; 247/335 responded. An age-equivalent group (N = 1,814) from a Norwegian Census Study served as controls.

Results: Mean age of survivors was 23 years (range 19-34), 55% females. The proportion with academic education (>/=4 years) was similar in survivors and controls (28 vs. 32%). Fifty-nine percent of survivors were employed compared to 77% among controls (p < .01). More survivors were recipients of social benefits (6.7 vs. 3.1%, p < .01). There were no differences in marital status but parenthood was more common among controls (37 vs. 27%, p = .01). Controls lived longer in their parental homes (p = .01). Cancer type or treatment intensity had no statistically significant impact on results, except for parenthood.

Conclusions and implications for cancer survivors: The study revealed important differences in social outcomes between survivors and controls early in adult life. Specific difficulties pertain to studying social status in early adulthood because of the natural transition characteristics for this age group. Therefore, longer follow-up is warranted.