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. 2021 Aug 1;127(15):2743-2751.
doi: 10.1002/cncr.33563. Epub 2021 Apr 12.

Prevalence and predictors of cancer-related worry and associations with health behaviors in adult survivors of childhood cancer

Glynnis A McDonnell  1   2 , Tara M Brinkman  1   3 , Mingjuan Wang  4 , Todd M Gibson  5 , Lauren C Heathcote  6 , Matthew J Ehrhardt  3   7 , Deo Kumar Srivastava  4 , Leslie L Robison  3 , Melissa M Hudson  3   7 , Nicole M Alberts  1   8
Affiliations

Prevalence and predictors of cancer-related worry and associations with health behaviors in adult survivors of childhood cancer

Glynnis A McDonnell et al. Cancer. .

Abstract

Background: Cancer-related worry (CRW) is common among cancer survivors; however, little is known about factors associated with CRW or its impact on health behaviors in adult survivors of childhood cancer.

Methods: Survivors in the St. Jude Lifetime Cohort Study (n = 3211; 51% male; mean age, 31.2 years [SD, 8.4 years]; mean time after diagnosis, 22.8 years [SD, 8.3 years]) underwent medical evaluations and completed ratings of CRW, psychological symptoms, and health behaviors. Multivariable modified Poisson regression models examined associations between CRW and treatment exposures, chronic health conditions, psychological symptoms, and health behaviors.

Results: Sixty-four percent of survivors (95% confidence interval [CI], 62.6-65.9) reported worry about subsequent malignancy, 45% (95% CI, 43.5-46.9) reported worry about physical problems related to cancer, and 33% (95% CI, 31.2-34.4) reported worry about relapse. Multiple psychological symptoms, treatment exposures, and chronic conditions significantly increased the risk of CRW. Survivors reporting CRW were at increased risk for substance use, inadequate physical activity, and increased health care utilization after adjustments for chronic conditions. For example, with adjustments for chronic conditions, those who endorsed CRW were more likely to have ≥5 cancer-related physician visits, ≥5 physician visits related to cancer, and ≥5 calls to a physician's office in the previous 2 years in comparison with survivors who were not worried. CRW was also associated with an increased risk of current tobacco use, past marijuana use, and current marijuana use.

Conclusions: A substantial proportion of adult survivors of childhood cancer reported CRW associated with increased health care utilization. CRW may serve as an intervention target to promote well-being and adaptive health behaviors.

Keywords: cancer survivors; childhood cancer; health behavior; health care utilization; worry.

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Conflict of interest statement

Conflicts of interest:

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Participant flow diagram. SJLT indicates St. Jude Lifetime Cohort.
See this image and copyright information in PMC

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