Adolescent behavior and adult health status in childhood cancer survivors

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• 作者：Kevin R. Krull (1)
  Sujuan Huang (1)
  James G. Gurney (2)
  James L. Klosky (3)
  Wendy Leisenring (4)
  Amanda Termuhlen (5)
  Kirsten K. Ness (1)
  Deo Kumar Srivastava (6)
  Ann Mertens (7)
  Marilyn Stovall (8)
  Leslie L. Robison (1)
  Melissa M. Hudson (9)
  
• 关键词：Adolescence ; Cancer ; Psychological problems ; Obesity ; Oncology ; Childhood cancer survivor study
• 刊名：Journal of Cancer Survivorship
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：4
• 期：3
• 页码：210-217
• 全文大小：151KB
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• 作者单位：Kevin R. Krull (1)
  Sujuan Huang (1)
  James G. Gurney (2)
  James L. Klosky (3)
  Wendy Leisenring (4)
  Amanda Termuhlen (5)
  Kirsten K. Ness (1)
  Deo Kumar Srivastava (6)
  Ann Mertens (7)
  Marilyn Stovall (8)
  Leslie L. Robison (1)
  Melissa M. Hudson (9)
  
  1. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
  2. Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
  3. Department of Behavioral Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA
  4. Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
  5. Department of Pediatric Oncology, Nationwide Children’s Hospital, Columbus, OH, USA
  6. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
  7. Department of Pediatrics, Emory University, Atlanta, GA, USA
  8. Department of Radiation Physics, MD Anderson Cancer Center, Houston, TX, USA
  9. Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
  

文摘

Introduction This study examined the longitudinal association between adolescent psychological problems following cancer treatment and obesity, limited exercise, smoking, and excess sun exposure during adulthood in the Childhood Cancer Survivor Study cohort. Methods Participants included 1,652 adolescent survivors of childhood cancer and 406 siblings of cancer survivors, initially evaluated at 12-7?years of age and ?5?years post-diagnosis. A follow-up survey of these participants was conducted roughly 7?years later and included assessment of health status and health behaviors. Logistic regression models were used to assess the association between adolescent psychological problems and adult health behavior outcomes. Results During adolescence, survivors demonstrated higher rates of attention deficits, emotional problems, externalizing behavior and social withdrawal compared to sibling controls. Social withdrawal was associated with adult obesity (OR--.5, 95% CI--.1-.1) and physical inactivity (OR--.7, 1.1-.5). Use of stimulant medication during adolescence was also associated with adult obesity (OR--.9, 1.1-.2), while antidepressant use was associated with physical inactivity (OR--.2, 1.2-.2). Discussion/Conclusions Adolescent survivors of childhood cancer display higher rates of psychological problems compared to siblings of cancer survivors. These psychological problems are associated with an increased risk for obesity and poor heath behavior in adulthood, which may increase future risk for chronic health conditions and secondary neoplasms. Implications In order to decrease risk of future health problems, adolescent survivors of childhood cancer should be routinely screened and treated for psychological problems following cancer therapy.