Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study

Anne Maas; Heleen Maurice-Stam; the Dutch LATER Study group; Leontien C.M. Kremer; Alied van der Aa-van Delden; Eline van Dulmen-den Broeder; Wim J.E. Tissing; Jacqueline J. Loonen; Helena J.H. van der Pal; Andrica C.H. de Vries; Marry M. van den Heuvel-Eibrink; Cécile Ronckers; Sebastian Neggers; Dorine Bresters; Marloes Louwerens; Margriet van der Heiden-van der Loo; Marloes van Gorp; Martha Grootenhuis

doi:10.1002/cncr.34795

Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study

Anne Maas^*, Heleen Maurice-Stam, the Dutch LATER Study group, Leontien C.M. Kremer, Alied van der Aa-van Delden, Eline van Dulmen-den Broeder, Wim J.E. Tissing, Jacqueline J. Loonen, Helena J.H. van der Pal, Andrica C.H. de Vries, Marry M. van den Heuvel-Eibrink, Cécile Ronckers, Sebastian Neggers, Dorine Bresters, Marloes Louwerens, Margriet van der Heiden-van der Loo, Marloes van Gorp, Martha Grootenhuis

^*Corresponding author for this work

Pediatrics

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Abstract

Background: This study compares a comprehensive range of psychosocial outcomes of adult childhood cancer survivors (CCS) to general population-based references and identifies sociodemographic and medical risk factors. Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (attained age ≥18 years, diagnosed <18 years, ≥5 years since diagnosis) completed the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Self-Rating Scale for Post-Traumatic Stress Disorder, and the Short Form-36 (Health Related Quality of Life). CCS’ scores were compared with references using analysis of variances and logistic regression analysis, controlling for age and sex (p <.05). Risk factors for worse psychosocial outcomes were assessed with regression analyses (p <.05). Results: CCS, N = 1797, mean age 35.4 years, 49.0% female, all ≥15 years since diagnosis, participated. Three percent reported posttraumatic stress disorder because of childhood cancer and 36.6% experienced clinical distress. CCS did not differ from references on self-esteem and anxiety but were less depressed (d = −.25), and scored poorer on all health-related quality of life scales, except for bodily pain (.01 ≤ d ≥ −.36). Female sex, lower educational attainment, not being in a relationship, and being unemployed were negatively associated with almost all psychosocial outcomes. Except for a central nervous system tumor diagnosis, few medical characteristics were associated with psychosocial outcomes. Conclusion: CCS appear resilient regarding mental health but have slightly poorer health-related quality of life than references. Sociodemographic characteristics and central nervous system tumors were related to most psychosocial outcomes, but no clear pattern was observed for other medical factors. Future studies should address additional factors in explaining CCS’ psychosocial functioning, such as coping, social support, and physical late effects.

Original language	English
Pages (from-to)	2553-2567
Number of pages	15
Journal	Cancer
Volume	129
Issue number	16
Early online date	14 Apr 2023
DOIs	https://doi.org/10.1002/cncr.34795
Publication status	Published - 15 Aug 2023

Bibliographical note

Funding Information:
This research was funded by the KiKa Foundation (grant no.361) and by KiKa/ODAS (grant no. 171).

Funding Information:
The authors thank all participating childhood cancer survivors for their contributions and all data managers and research assistants who contributed to the DCCSS‐LATER study. The authors further thank Prof. Ad Vingerhoets for providing the HADS reference group. This research was funded by the KiKa Foundation (grant no. 361) and by KiKa/ODAS (grant no. 171). The authors have no relevant financial or nonfinancial interests to disclose.

Publisher Copyright:
© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

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Maas, A., Maurice-Stam, H., the Dutch LATER Study group, Kremer, L. C. M., van der Aa-van Delden, A., van Dulmen-den Broeder, E., Tissing, W. J. E., Loonen, J. J., van der Pal, H. J. H., de Vries, A. C. H., van den Heuvel-Eibrink, M. M., Ronckers, C., Neggers, S., Bresters, D., Louwerens, M., van der Heiden-van der Loo, M., van Gorp, M., & Grootenhuis, M. (2023). Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study. Cancer, 129(16), 2553-2567. https://doi.org/10.1002/cncr.34795

@article{5ea1a6c24ee9429da929cf64d3b2b190,

title = "Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study",

abstract = "Background: This study compares a comprehensive range of psychosocial outcomes of adult childhood cancer survivors (CCS) to general population-based references and identifies sociodemographic and medical risk factors. Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (attained age ≥18 years, diagnosed <18 years, ≥5 years since diagnosis) completed the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Self-Rating Scale for Post-Traumatic Stress Disorder, and the Short Form-36 (Health Related Quality of Life). CCS{\textquoteright} scores were compared with references using analysis of variances and logistic regression analysis, controlling for age and sex (p <.05). Risk factors for worse psychosocial outcomes were assessed with regression analyses (p <.05). Results: CCS, N = 1797, mean age 35.4 years, 49.0% female, all ≥15 years since diagnosis, participated. Three percent reported posttraumatic stress disorder because of childhood cancer and 36.6% experienced clinical distress. CCS did not differ from references on self-esteem and anxiety but were less depressed (d = −.25), and scored poorer on all health-related quality of life scales, except for bodily pain (.01 ≤ d ≥ −.36). Female sex, lower educational attainment, not being in a relationship, and being unemployed were negatively associated with almost all psychosocial outcomes. Except for a central nervous system tumor diagnosis, few medical characteristics were associated with psychosocial outcomes. Conclusion: CCS appear resilient regarding mental health but have slightly poorer health-related quality of life than references. Sociodemographic characteristics and central nervous system tumors were related to most psychosocial outcomes, but no clear pattern was observed for other medical factors. Future studies should address additional factors in explaining CCS{\textquoteright} psychosocial functioning, such as coping, social support, and physical late effects.",

author = "Anne Maas and Heleen Maurice-Stam and {the Dutch LATER Study group} and Kremer, {Leontien C.M.} and {van der Aa-van Delden}, Alied and {van Dulmen-den Broeder}, Eline and Tissing, {Wim J.E.} and Loonen, {Jacqueline J.} and {van der Pal}, {Helena J.H.} and {de Vries}, {Andrica C.H.} and {van den Heuvel-Eibrink}, {Marry M.} and C{\'e}cile Ronckers and Sebastian Neggers and Dorine Bresters and Marloes Louwerens and {van der Heiden-van der Loo}, Margriet and {van Gorp}, Marloes and Martha Grootenhuis",

note = "Funding Information: This research was funded by the KiKa Foundation (grant no.361) and by KiKa/ODAS (grant no. 171). Funding Information: The authors thank all participating childhood cancer survivors for their contributions and all data managers and research assistants who contributed to the DCCSS‐LATER study. The authors further thank Prof. Ad Vingerhoets for providing the HADS reference group. This research was funded by the KiKa Foundation (grant no. 361) and by KiKa/ODAS (grant no. 171). The authors have no relevant financial or nonfinancial interests to disclose. Publisher Copyright: {\textcopyright} 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.",

year = "2023",

month = aug,

day = "15",

doi = "10.1002/cncr.34795",

language = "English",

volume = "129",

pages = "2553--2567",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley & Sons Inc.",

number = "16",

}

Maas, A, Maurice-Stam, H, the Dutch LATER Study group, Kremer, LCM, van der Aa-van Delden, A, van Dulmen-den Broeder, E, Tissing, WJE, Loonen, JJ, van der Pal, HJH, de Vries, ACH , van den Heuvel-Eibrink, MM, Ronckers, C, Neggers, S, Bresters, D, Louwerens, M, van der Heiden-van der Loo, M, van Gorp, M & Grootenhuis, M 2023, 'Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study', Cancer, vol. 129, no. 16, pp. 2553-2567. https://doi.org/10.1002/cncr.34795

TY - JOUR

T1 - Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer

T2 - The DCCSS-LATER 2 psycho-oncology study

AU - Maas, Anne

AU - Maurice-Stam, Heleen

AU - the Dutch LATER Study group

AU - Kremer, Leontien C.M.

AU - van der Aa-van Delden, Alied

AU - van Dulmen-den Broeder, Eline

AU - Tissing, Wim J.E.

AU - Loonen, Jacqueline J.

AU - van der Pal, Helena J.H.

AU - de Vries, Andrica C.H.

AU - van den Heuvel-Eibrink, Marry M.

AU - Ronckers, Cécile

AU - Neggers, Sebastian

AU - Bresters, Dorine

AU - Louwerens, Marloes

AU - van der Heiden-van der Loo, Margriet

AU - van Gorp, Marloes

AU - Grootenhuis, Martha

N1 - Funding Information: This research was funded by the KiKa Foundation (grant no.361) and by KiKa/ODAS (grant no. 171). Funding Information: The authors thank all participating childhood cancer survivors for their contributions and all data managers and research assistants who contributed to the DCCSS‐LATER study. The authors further thank Prof. Ad Vingerhoets for providing the HADS reference group. This research was funded by the KiKa Foundation (grant no. 361) and by KiKa/ODAS (grant no. 171). The authors have no relevant financial or nonfinancial interests to disclose. Publisher Copyright: © 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

PY - 2023/8/15

Y1 - 2023/8/15

N2 - Background: This study compares a comprehensive range of psychosocial outcomes of adult childhood cancer survivors (CCS) to general population-based references and identifies sociodemographic and medical risk factors. Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (attained age ≥18 years, diagnosed <18 years, ≥5 years since diagnosis) completed the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Self-Rating Scale for Post-Traumatic Stress Disorder, and the Short Form-36 (Health Related Quality of Life). CCS’ scores were compared with references using analysis of variances and logistic regression analysis, controlling for age and sex (p <.05). Risk factors for worse psychosocial outcomes were assessed with regression analyses (p <.05). Results: CCS, N = 1797, mean age 35.4 years, 49.0% female, all ≥15 years since diagnosis, participated. Three percent reported posttraumatic stress disorder because of childhood cancer and 36.6% experienced clinical distress. CCS did not differ from references on self-esteem and anxiety but were less depressed (d = −.25), and scored poorer on all health-related quality of life scales, except for bodily pain (.01 ≤ d ≥ −.36). Female sex, lower educational attainment, not being in a relationship, and being unemployed were negatively associated with almost all psychosocial outcomes. Except for a central nervous system tumor diagnosis, few medical characteristics were associated with psychosocial outcomes. Conclusion: CCS appear resilient regarding mental health but have slightly poorer health-related quality of life than references. Sociodemographic characteristics and central nervous system tumors were related to most psychosocial outcomes, but no clear pattern was observed for other medical factors. Future studies should address additional factors in explaining CCS’ psychosocial functioning, such as coping, social support, and physical late effects.

AB - Background: This study compares a comprehensive range of psychosocial outcomes of adult childhood cancer survivors (CCS) to general population-based references and identifies sociodemographic and medical risk factors. Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963–2001) part 2 (attained age ≥18 years, diagnosed <18 years, ≥5 years since diagnosis) completed the Rosenberg Self-Esteem Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Self-Rating Scale for Post-Traumatic Stress Disorder, and the Short Form-36 (Health Related Quality of Life). CCS’ scores were compared with references using analysis of variances and logistic regression analysis, controlling for age and sex (p <.05). Risk factors for worse psychosocial outcomes were assessed with regression analyses (p <.05). Results: CCS, N = 1797, mean age 35.4 years, 49.0% female, all ≥15 years since diagnosis, participated. Three percent reported posttraumatic stress disorder because of childhood cancer and 36.6% experienced clinical distress. CCS did not differ from references on self-esteem and anxiety but were less depressed (d = −.25), and scored poorer on all health-related quality of life scales, except for bodily pain (.01 ≤ d ≥ −.36). Female sex, lower educational attainment, not being in a relationship, and being unemployed were negatively associated with almost all psychosocial outcomes. Except for a central nervous system tumor diagnosis, few medical characteristics were associated with psychosocial outcomes. Conclusion: CCS appear resilient regarding mental health but have slightly poorer health-related quality of life than references. Sociodemographic characteristics and central nervous system tumors were related to most psychosocial outcomes, but no clear pattern was observed for other medical factors. Future studies should address additional factors in explaining CCS’ psychosocial functioning, such as coping, social support, and physical late effects.

UR - http://www.scopus.com/inward/record.url?scp=85152959866&partnerID=8YFLogxK

U2 - 10.1002/cncr.34795

DO - 10.1002/cncr.34795

M3 - Article

C2 - 37057358

AN - SCOPUS:85152959866

SN - 0008-543X

VL - 129

SP - 2553

EP - 2567

JO - Cancer

JF - Cancer

IS - 16

ER -

Psychosocial outcomes in long-term Dutch adult survivors of childhood cancer: The DCCSS-LATER 2 psycho-oncology study

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