title: Quality of life among long-term adolescent and adult survivors of childhood cancer.
abstract: OBJECTIVE
  We assessed effects of childhood or adolescent cancer on quality of life among adolescent and adult cancer survivors, a group who are thought to be at particular risk for adverse late effects.
  
  
  METHODS
  We studied 1,334 survivors and 1,477 age- and sex-matched, general population controls from across Canada using a mailed questionnaire which included the Short Form-36 (SF-36) and measures of self-esteem, optimism, and life satisfaction. General linear models and logistic regression were used. Survivor-control differences corresponding to an effect size (ES) > or = 0.5 were considered clinically important.
  
  
  RESULTS
  Participants were age 15 years to 37 years. Most survivors (83.8%) were diagnosed > or = 10 years earlier. Fewer survivors (62.1%) than controls (71.1%) reported very good or excellent general health (adjusted odds ratio, 0.6; 95% CI, 0.5 to 0.7). However, quality of life differences between survivors and controls were small, and for the most part probably not clinically important. Three clinical characteristics-having had CNS or bone cancer, more than one treatment series, and > or = two organs with a dysfunction at treatment end-were independently associated with poorer quality of life in the physical dimensions. Only survivors with > or = two organs with dysfunction (8.7%) reported poorer quality of life in both physical and psychosocial domains, with several clinically important ES. The largest ES for the SF-36 physical summary scores were found in the 8% of survivors with two or three of these characteristics simultaneously, compared with those survivors who had none (-0.79 and -1.13, respectively).
  
  
  CONCLUSIONS
  Overall, a sizeable majority of adolescent and adult long-term survivors of childhood cancer in Canada appear to have adapted well.
authors.affiliation: Unité de recherche en santé des populations, Centre de recherche du Centre Hospitalier Affilié Universitaire de Québec, Québec, Canada. elizabeth.maunsell@uresp.ulaval.ca
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maunsell
authors.forename: Lisa
authors.initials: L
authors.lastname: Pogany
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Shaw
authors.forename: Kathy N
authors.initials: KN
authors.lastname: Speechley
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D013694:Temperament; D013997:Time Factors