Health status in survivors of cancer in childhood and adolescence.
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, 2,152 long-term survivors and 2,432 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.


RESULTS
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.
Pogany
Lisa
L
Public Health Agency of Canada, Centre for Chronic Disease Prevention and Control, Ottawa, Canada. lisa_pogany@phac-aspc.gc.ca
Barr
Ronald D
RD
Shaw
Amanda
A
Speechley
Kathy N
KN
Barrera
Maru
M
Maunsell
Elizabeth
E
D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000503:physiopathology / Q000534:rehabilitation*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011594:Psychometrics / Q000295:instrumentation; D011596:Psychomotor Disorders / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data