Psychosocial and Neurocognitive Impairment in Adult Survivors of Adolescent and Young Adult Cancer
In an analysis from the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Prasad et al found evidence of impaired psychosocial and neurocognitive function among long-term cancer survivors diagnosed during adolescence and young adulthood.
Risk of Impairment
In the Childhood Cancer Survivor Study, 6,192 survivors and 390 siblings completed the Brief Symptom Inventory-18 and a neurocognitive questionnaire. Among survivors, 2,589 were diagnosed at 11 to 21 years of age (adolescence and young adulthood).
After adjustment for current age and sex, these patients, compared with siblings, had higher rates of depression (11.7% vs 8.0%, odds ratio [OR] = 1.55, 95% confidence interval [CI] = 1.04–2.30) and anxiety (7.4% vs 4.4%, OR = 2.00, 95% CI = 1.17–3.43) and more difficulties with task efficiency (17.2% vs 10.8%, OR = 1.72, 95% CI = 1.21–2.43), emotional regulation (19.1% vs 14.1%, OR = 1.74, 95% CI = 1.26–2.40), and memory (25.9% vs 19.0%, OR = 1.44, 95% CI = 1.09–1.89).
Unemployment was associated with impaired task efficiency (OR = 2.93, 95% CI = 2.28–3.77), somatization (OR = 2.29, 95% CI = 1.77–2.98), and depression (OR = 1.94, 95% CI = 1.43–2.63) among survivors.
Although there were few differences between survivors diagnosed with leukemia or CNS tumors before 11 years of age vs in later adolescence, those diagnosed with lymphoma or sarcoma during adolescence and young adulthood vs earlier in life had a reduced risk for psychosocial and neurocognitive impairment.
The investigators concluded: “We demonstrated that risk for poor functional outcome is not limited to survivors’ diagnoses in early childhood. [Adolescence and early young adulthood] is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment.”
Pinki K. Prasad, MD, of Louisiana State University School of Medicine, is the corresponding author of the Journal of Clinical Oncology article.
The study was supported by the National Cancer Institute.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
