Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peers.
OBJECTIVE
This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described.


METHODS
Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774).


METHODS
Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured.


RESULTS
Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8-1.0] and heavy drinkers (ORadj = 0.8; CI 0.7-0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18-21 years (ORadj = 2.0; 95% CI 1.5-2.6), male (ORadj = 2.1; 95% CI 1.8-2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7-4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4-10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective.


CONCLUSIONS
Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking.
Lown
E Anne
EA
Alcohol Research Group, Emeryville, CA 94608, USA. alown@arg.org
Goldsby
Robert
R
Mertens
Ann C
AC
Greenfield
Thomas
T
Bond
Jason
J
Whitton
John
J
Korcha
Rachael
R
Robison
Leslie L
LL
Zeltzer
Lonnie K
LK
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010379:Peer Group; D012307:Risk Factors; D035781:Siblings / Q000523:psychology; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*