Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer.
OBJECTIVE
This study compared the prevalence of symptoms of posttraumatic stress disorder (PTSD), with functional impairment and/or clinical distress, among very long-term survivors of childhood cancer and a group of healthy siblings.


METHODS
A total of 6542 childhood cancer survivors >18 years of age who received diagnoses between 1970 and 1986 and 368 siblings of cancer survivors completed a comprehensive demographic and health survey.


RESULTS
A total of 589 survivors (9%) and 8 siblings (2%) reported functional impairment and/or clinical distress in addition to the set of symptoms consistent with a full diagnosis of PTSD. Survivors had more than fourfold greater risk of PTSD, compared with siblings (odds ratio [OR]: 4.14 [95% confidence interval [CI]: 2.08-8.25]). With controlling for demographic and treatment variables, increased risk of PTSD was associated with educational level of high school or less (OR: 1.51 [95% CI: 1.16-1.98]), being unmarried (OR: 1.99 [95% CI: 1.58-2.50]), having annual income below $20,000 (OR: 1.63 [95% CI: 1.21-2.20]), and being unemployed (OR: 2.01 [95% CI: 1.62-2.51]). Intensive treatment also was associated with increased risk of full PTSD (OR: 1.36 [95% CI: 1.06-1.74]).


CONCLUSIONS
PTSD was reported significantly more often by survivors of childhood cancer than by sibling control subjects. Although most survivors apparently are faring well, a subset reported significant impairment that may warrant targeted intervention.
Stuber
Margaret L
ML
Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, California, USA. mstuber@mednet.ucla.edu
Meeske
Kathleen A
KA
Krull
Kevin R
KR
Leisenring
Wendy
W
Stratton
Kayla
K
Kazak
Anne E
AE
Huber
Marc
M
Zebrack
Bradley
B
Uijtdehaage
Sebastian H
SH
Mertens
Ann C
AC
Robison
Leslie L
LL
Zeltzer
Lonnie K
LK
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D012307:Risk Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult