Journal of Cancer Survivorship

, Volume 4, Issue 3, pp 210–217

Adolescent behavior and adult health status in childhood cancer survivors

  • Kevin R. Krull
  • Sujuan Huang
  • James G. Gurney
  • James L. Klosky
  • Wendy Leisenring
  • Amanda Termuhlen
  • Kirsten K. Ness
  • Deo Kumar Srivastava
  • Ann Mertens
  • Marilyn Stovall
  • Leslie L. Robison
  • Melissa M. Hudson
Article

DOI: 10.1007/s11764-010-0123-0

Cite this article as:
Krull, K.R., Huang, S., Gurney, J.G. et al. J Cancer Surviv (2010) 4: 210. doi:10.1007/s11764-010-0123-0

Abstract

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 12–17 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 = 1.5, 95% CI = 1.1–2.1) and physical inactivity (OR = 1.7, 1.1–2.5). Use of stimulant medication during adolescence was also associated with adult obesity (OR = 1.9, 1.1–3.2), while antidepressant use was associated with physical inactivity (OR = 3.2, 1.2–8.2).

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.

Keywords

Adolescence Cancer Psychological problems Obesity Oncology Childhood cancer survivor study 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • 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. 1.Department of Epidemiology and Cancer ControlSt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Department of PediatricsUniversity of MichiganAnn ArborUSA
  3. 3.Department of Behavioral MedicineSt. Jude Children’s Research HospitalMemphisUSA
  4. 4.Department of BiostatisticsFred Hutchinson Cancer Research CenterSeattleUSA
  5. 5.Department of Pediatric OncologyNationwide Children’s HospitalColumbusUSA
  6. 6.Department of BiostatisticsSt. Jude Children’s Research HospitalMemphisUSA
  7. 7.Department of PediatricsEmory UniversityAtlantaUSA
  8. 8.Department of Radiation PhysicsMD Anderson Cancer CenterHoustonUSA
  9. 9.Department of OncologySt. Jude Children’s Research HospitalMemphisUSA

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