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Quality of Life Research

, Volume 15, Issue 1, pp 143–157 | Cite as

Health Status in Survivors of Cancer in Childhood and Adolescence

  • Lisa PoganyEmail author
  • Ronald D. Barr
  • Amanda Shaw
  • Kathy N. Speechley
  • Maru Barrera
  • Elizabeth Maunsell
Article

Abstract

Background: Assessing health status in survivors of childhood cancer is increasingly important due to improved survival rates. However, there are limited estimates available for this population based on large samples and compared to population controls.Methods: In a retrospective cohort study, 2152 long-term survivors and 2432 controls, aged 5–37, who had survived cancer during childhood or adolescence were compared on the Health Utilities Index Mark III (HUI3). Descriptive and logistic regression analyses were used to assess the effect of age at diagnosis, type of cancer and therapy received on HUI3 domains.Major findings: More survivors than controls showed deficits in dexterity, ambulation, hearing, speech and cognition but not in vision, emotion or pain. The largest numbers of survivors reporting excess impairment was found in the cognition attribute. Survivors of central nervous system tumors were most likely to show impairments across multiple domains. Lastly, impairments in cognition were found most commonly in survivors exposed to cranio-spinal radiation at young ages.Conclusions: Seventy-five percent of childhood cancer survivors and 80% of controls were found to have two or fewer impaired attributes. Those reporting impairments that were most likely to be of clinical relevance were among survivors diagnosed with central nervous system and bone tumours, and those exposed to cranial radiation as young children. Tools assessing health status should be included in prospective trials to more clearly assess the contribution of therapy to reduced long-term health status.

Keywords

Adolescent cancer Cancer survivors Childhood cancer Health related quality of life Health Utilities Index 

Abbreviations

ALL

acute lymphoblastic leukemia

CI

confidence interval

CNS

central nervous system

HRQL

health related quality of life

HUI3

Health Utilities Index Mark III

ICCC

International Classification of Childhood Cancer

ORadj

adjusted odds ratio

SD

standard deviation

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Copyright information

© Springer 2006

Authors and Affiliations

  • Lisa Pogany
    • 1
    Email author
  • Ronald D. Barr
    • 2
  • Amanda Shaw
    • 1
  • Kathy N. Speechley
    • 3
  • Maru Barrera
    • 4
  • Elizabeth Maunsell
    • 5
  1. 1.Public Health Agency of CanadaCentre for Chronic Disease Prevention and ControlOttawaCanada
  2. 2.Faculty of Health SciencesMcMaster UniversityHamiltonCanada
  3. 3.Departments of Pediatrics and Epidemiology and BiostatisticsThe University of Western Ontario and Child Health Research InstituteLondonCanada
  4. 4.Department of Psychology, Population Health Sciences, Research Institute, Hospital for Sick Children and Department of Population Health Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada
  5. 5.Department of Social and Preventive MedicinePopulation Health Research Unit, Université LavalCanada

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