Clinical Study

Journal of Neuro-Oncology

, Volume 112, Issue 1, pp 99-106

Disability, body image and sports/physical activity in adult survivors of childhood CNS tumors: population-based outcomes from a cohort study

  • Krister K. BomanAffiliated withChildhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet Email author 
  • , Lina HörnquistAffiliated withChildhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet
  • , Lisanne De GraaffAffiliated withFaculty of Medicine, Academic Medical Centre, University of Amsterdam
  • , Jenny RickardssonAffiliated withChildhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet
  • , Birgitta LanneringAffiliated withDepartment of Clinical Sciences, Paediatric Oncology, University of Gothenburg
  • , Göran GustafssonAffiliated withChildhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet

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Abstract

Childhood CNS tumor survivors risk health and functional impairments that threaten normal psychological development and self-perception. This study investigated the extent to which health and functional ability predict adult survivors’ body image (BI) and self-confidence regarding sports and physical activity. The study cohort covered 708 eligible ≥18 year old CNS tumor survivors, and data from 528 (75 %) were analyzed. Disability was estimated using the Health Utilities Index™ Mark2/3, a multidimensional self-report instrument. Physical self-confidence in terms of BI and sports/physical activity-related self-confidence (SPAS) were assessed using the BI and the Sports/Athletics modules of a standardized self-report assessment scale. In adjusted regression models, global health and functional status (GHFS) predicted BI (B = 0.94, 95 % CI 0.69–1.19) and SPAS (B = 0.79, 95 % CI 0.55–1.04). Emotion and pain, and to a lesser degree cognition, speech and vision disability, were associated with poorer BI and SPAS. Gender, sub-diagnosis, and time since diagnosis influenced the relationship between health status and physical self-confidence outcomes. Females had poorer GHFS, BI and SPAS than males. Decreased health and functional ability following childhood CNS cancer intrudes on physical self-confidence, with females being at heightened risk for both disability and negative self-confidence. Identified disability and gender-related risk calls for a follow-up plan that integrates treatment of psychological sequelae in lifetime monitoring of childhood CNS tumor survivors to restore and protect self-image and self-confidence, essential mental health correlates. An expanded plan should recognize the need for such services, optimizing life-long quality of survival for CNS tumor survivors.

Keywords

Childhood CNS tumors Adult survivors Late effects follow-up Body image Self-confidence Sports activities