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

Research output: Contribution to journalArticleAcademicpeer-review

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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 languageEnglish
Pages (from-to)2553-2567
Number of pages15
Issue number16
Early online date14 Apr 2023
Publication statusPublished - 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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