title: Self-reported health-related quality of life of children and adolescent survivors of extracranial childhood malignancies: a Finnish nationwide survey.
abstract: OBJECTIVE
  The purpose of this Finnish total cohort survey was to assess and compare the self-reported health-related quality of life (HRQL) in childhood cancer survivors to that of matched controls, to analyse demographic and disease-related factors explaining survivors' HRQL, and to compare the results of two different HRQL instruments, 16D/17D and PedsQL™.
  
  
  METHODS
  Questionnaires were mailed to 384 childhood cancer survivors and their randomly selected gender-, age- and living place-matched controls. Eligible survivors (aged 11-18 years) had been treated for extracranial malignancies ≤16 years of age, had survived ≥4 years after the diagnosis, and were currently free of cancer.
  
  
  RESULTS
  Of them, 203 (52.9%) survivors and 266 (30.4%) controls replied. Survivors reported higher HRQL than their controls. Diagnostic group, additional non-cancer diagnosis, need of remedial education, and self-rated unhappiness correlated significantly with HRQL. The survivors of Wilms tumor, or neuroblastoma, had lower HRQL scores than the reference group (leukemia). The studied variables explained only 28% of the variation in HRQL scores among survivors. Instrument correlations were moderate (R = 0.40-0.65).
  
  
  CONCLUSIONS
  Our findings suggest that the diagnosis of Wilms tumor or neuroblastoma may carry substantial risks for lower HRQL. The available background variables, however, explained less than one-third of the variation in the HRQL scores. Thus, other factors than demographic or cancer-related seem to play a significant role as determinants of HRQL.
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland. susanna.mort@utu.fi
authors.forename: Susanna
authors.initials: S
authors.lastname: Mört
authors.forename: Sanna
authors.initials: S
authors.lastname: Salanterä
authors.forename: Jaakko
authors.initials: J
authors.lastname: Matomäki
authors.forename: Toivo T
authors.initials: TT
authors.lastname: Salmi
authors.forename: Päivi M
authors.initials: PM
authors.lastname: Lähteenmäki
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D005260:Female; D005387:Finland / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D012044:Regression Analysis; D057566:Self Report; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*