Journal of Cancer Survivorship

, Volume 7, Issue 3, pp 500–510

Factors related to decision making and substance use in adolescent survivors of childhood cancer: a presenting clinical profile

  • P. J. Hollen
  • V. L. Tyc
  • S. V. Shannon
  • S. F. Donnangelo
  • W. L. Hobbie
  • M. M. Hudson
  • M. C. O’Laughlen
  • M. E. Smolkin
  • G. R. Petroni
Article

DOI: 10.1007/s11764-013-0287-5

Cite this article as:
Hollen, P.J., Tyc, V.L., Shannon, S.V. et al. J Cancer Surviv (2013) 7: 500. doi:10.1007/s11764-013-0287-5

Abstract

Background

Adolescent survivors of childhood cancer are more vulnerable to the consequences of health risk behaviors because of the late effects of their disease and its treatment. Decision making related to risk behaviors is important as they have reached an age during which initiation of substance use risk behavior is common.

Objective

Factors associated with decision making and substance use behaviors (smoking, alcohol use, and illicit drug use) were identified among adolescent survivors of childhood cancer, the role of cognitive function was examined, and their rates of substance use behaviors were compared to a sample from the general population.

Methods

A cohort of 243 adolescent survivors, ages 14–19 years, participated who were recruited from three cancer centers (St. Jude Children’s Research Hospital, Hackensack University, and Long Beach Medical Center). A cross-sectional survey was used to assess cognitive and psychosocial factors for a presenting clinical profile to predict quality decision making and substance use behaviors. Validated measures using online data entry were obtained at the time of their annual visit for evaluation of late effects of treatment. Cancer and treatment factors were abstracted from the medical record. Eight factors (nine for substance use risk behavior) were examined in two regression models, quality decision making and substance use.

Results

In the model to predict poor-quality decision making for this cohort, gender and risk motivation (a surrogate for resiliency to social influence) were each significant predictors, with male gender and less resiliency each associated with poor decision making. Significant predictors of lifetime substance use were older presenting age, lower resiliency to social influence, poorer abstract ability (representing executive function impairment), history of current school problems, and negative substance use risk behavior modeling by household members and closest friend; CNS-associated late effects were only marginally associated. For current substance use, three factors remained significant in this cohort: older presenting age, lower resiliency, and negative risk behavior modeling.

Implications for Cancer Survivors

Study results characterize a presenting clinical profile for adolescent survivors with poor-quality decision making regarding substance use risk behaviors that will be helpful to health professionals counseling teen survivors about the impact of risk behaviors on disease-and treatment-related late effects.

Keywords

Childhood cancerAdolescentsDecision makingSubstance use

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • P. J. Hollen
    • 1
  • V. L. Tyc
    • 2
  • S. V. Shannon
    • 3
  • S. F. Donnangelo
    • 4
  • W. L. Hobbie
    • 5
  • M. M. Hudson
    • 2
  • M. C. O’Laughlen
    • 1
  • M. E. Smolkin
    • 1
  • G. R. Petroni
    • 1
  1. 1.University of VirginiaCharlottesvilleUSA
  2. 2.St. Jude Children’s Research HospitalMemphisUSA
  3. 3.Long Beach Memorial Medical CenterLong BeachUSA
  4. 4.Hackensack University Medical CenterHackensackUSA
  5. 5.University of Pennsylvania and Children’s Hospital of PhiladelphiaPhiladelphiaUSA