title: Burden of illness in adult survivors of childhood cancers: findings from a population-based national sample.
abstract: BACKGROUND
  The number of adult survivors of childhood cancer in the United States is increasing because of effective treatments and improved survival. The purpose of this study was to use a national, population-based sample to estimate the burden of illness in adult survivors of childhood cancer.
  
  
  METHODS
  A total of 410 adult survivors of childhood cancer and 294,641 individuals without cancer were identified from multiple years of the National Health Interview Survey. Multiple measures of burden, general health, and lost productivity were compared using multivariate regression analyses including: logistic, polytomous logit, proportional odds, and linear models.
  
  
  RESULTS
  Controlling for the effects of age, sex, race/ethnicity, and survey year, adult survivors of childhood cancer reported poorer outcomes across the majority of general health measures and productivity measures than individuals without cancer. Survivors were more likely to report their health status as fair or poor (24.3% vs 10.9%; P<.001); having any health limitation in any way (12.9% vs 3.4%; P<.001); being unable to work because of health problems (20.9% vs 6.3%; P<.001); and being limited in the amount/kind of work because of health problems (30.9% vs 10.6%; P<.001). When categorized by time since diagnosis, cancer survivors had poor health outcomes in every time interval, with the greatest limitations in the initial 4 years after diagnosis and 30 or more years after diagnosis.
  
  
  CONCLUSIONS
  Across multiple measures, adult survivors of childhood cancers have poorer health outcomes and more health limitations than similar individuals without cancer.
authors.affiliation: Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-7344, USA. dowlinge@mail.nih.gov
authors.forename: Emily
authors.initials: E
authors.lastname: Dowling
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
authors.forename: Angela
authors.initials: A
authors.lastname: Mariotto
authors.forename: Timothy
authors.initials: T
authors.lastname: McNeel
authors.forename: Christopher
authors.initials: C
authors.lastname: Zeruto
authors.forename: Dennis
authors.initials: D
authors.lastname: Buckman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004526:Efficiency; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D011159:Population Surveillance; D018434:Sickness Impact Profile; D017741:Survivors