title: Perceived positive impact of cancer among long-term survivors of childhood cancer: a report from the childhood cancer survivor study.
abstract: OBJECTIVE
  Investigations examining psychosocial adjustment among childhood cancer survivors have focused primarily on negative effects and psychopathology. Emergent literature suggests the existence of positive impact or adjustment experienced after cancer, as well. The purpose of this study is to examine the distribution of Perceived Positive Impact (PPI) and its correlates in young adult survivors of childhood cancer.
  
  
  METHODS
  6425 survivors and 360 siblings completed a comprehensive health survey, inclusive of a modified version of the Post-traumatic Growth Inventory (PTGI) as a measure of PPI. Linear regression models were used to examine demographic, disease and treatment characteristics associated with PPI.
  
  
  RESULTS
  Survivors were significantly more likely than siblings to report PPI. Endorsement of PPI was significantly greater among female and non-white survivors, and among survivors exposed to at least one intense therapy, a second malignancy or cancer recurrence. Survivors diagnosed at older ages and fewer years since diagnosis were more likely to report PPI. Income, education and marital/relationship status appeared to have varied relationships to PPI depending upon the subscale being evaluated.
  
  
  CONCLUSIONS
  The existence and variability of PPI in survivors in this study suggest that individual characteristics, inclusive of race, gender, cancer type, intensity of treatment, age at diagnosis and time since diagnosis, have unique and specific associations with different aspects of perceived positive outcomes of childhood cancer.
authors.affiliation: School of Social Work, University of Michigan and University of Michigan Comprehensive Cancer Center, Ann Arbor, MI 48109-1106, USA. zebrack@umich.edu
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Zebrack
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Stuber
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Meeske
authors.forename: Sean
authors.initials: S
authors.lastname: Phipps
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Carla
authors.initials: C
authors.lastname: Parry
authors.forename: Rachel
authors.initials: R
authors.lastname: Hamilton
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Lonnie K
authors.initials: LK
authors.lastname: Zeltzer
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010465:Perception; D011788:Quality of Life; D035781:Siblings / Q000523:psychology*; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult