Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;114(2):226-235.
doi: 10.1111/add.14439. Epub 2018 Oct 19.

Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

Tara M Brinkman  1 , E Anne Lown  2 , Chenghong Li  3 , Ingrid Tonning Olsson  1 , Jordan Gilleland Marchak  4 , Margaret L Stuber  5 , Stefanie Vuotto  1 , Deokumar Srivastava  3 , Paul C Nathan  6 , Wendy M Leisenring  7 , Gregory T Armstrong  1 , Leslie L Robison  1 , Kevin R Krull  1
Affiliations

Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

Tara M Brinkman et al. Addiction. 2019 Feb.

Abstract

Aims: To estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress.

Design: Retrospective cohort study with longitudinal follow-up of self-reported health outcomes.

Setting: Childhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada.

Participants: A total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress.

Measurements: Survivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory-18 and the Posttraumatic Stress Diagnostic Scale.

Findings: After adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30% increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95% confidence interval (CI) = 1.1-1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95% CI = 1.1-1.5), anxiety (RR = 1.6; 95% CI = 1.3-2.1), and somatization (RR = 1.2; 95% CI = 1.1-1.4). Persistent heavy/risky drinking was associated with 80% increased risk of persistent psychological distress (RR = 1.8, 95% CI = 1.4-2.3).

Conclusions: Drinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.

Keywords: Alcohol; childhood cancer; emotional distress; late effects; neurocognition; survivorship.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Consort diagram of study participation.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Armstrong GT, Reddick WE, Petersen RC, Santucci A, Zhang N, Srivastava D, et al. Evaluation of memory impairment in aging adult survivors of childhood acute lymphoblastic leukemia treated with cranial radiotherapy. Journal of the National Cancer Institute. 2013;105(12):899–907. - PMC - PubMed
    1. Kadan-Lottick NS, Zeltzer LK, Liu Q, Yasui Y, Ellenberg L, Gioia G, et al. Neurocognitive functioning in adult survivors of childhood non-central nervous system cancers. Journal of the National Cancer Institute. 2010;102(12):881–93. - PMC - PubMed
    1. Krull KR, Brinkman TM, Li C, Armstrong GT, Ness KK, Srivastava DK, et al. Neurocognitive outcomes decades after treatment for childhood acute lymphoblastic leukemia: a report from the St Jude lifetime cohort study. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2013;31(35):4407–15. - PMC - PubMed
    1. Krull KR, Sabin ND, Reddick WE, Zhu L, Armstrong GT, Green DM, et al. Neurocognitive function and CNS integrity in adult survivors of childhood hodgkin lymphoma. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2012;30(29):3618–24. - PMC - PubMed
    1. Krull KR, Zhang N, Santucci A, Srivastava DK, Krasin MJ, Kun LE, et al. Long-term decline in intelligence among adult survivors of childhood acute lymphoblastic leukemia treated with cranial radiation. Blood. 2013;122(4):550–3. - PMC - PubMed

Publication types