title: Association between the prevalence of symptoms and health-related quality of life in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort study.
abstract: OBJECTIVE
  We investigated the association between prevalence of symptoms and health-related quality of life (HRQOL) in adult survivors of childhood cancer enrolled in the St Jude Lifetime Cohort study.
  
  
  METHODS
  Eligibility criteria include childhood malignancy treated at St Jude, survival ≥ 10 years from diagnosis, and current age ≥ 18 years. Study participants were 1,667 survivors (response rate = 65%). Symptoms were self-reported by using a comprehensive health questionnaire and categorized into 12 classes: cardiac; pulmonary; motor/movement; pain in head; pain in back/neck; pain involving sites other than head, neck, and back; sensation abnormalities; disfigurement; learning/memory; anxiety; depression; and somatization. HRQOL was measured by using physical/mental component summary (PCS/MCS) and six domain scores of the Medical Outcomes Study 36-Item Short-Form Health Survey. Multivariable regression analysis was performed to investigate associations between symptom classes and HRQOL. Cumulative prevalence of symptom classes in relation to time from diagnosis was estimated.
  
  
  RESULTS
  Pain involving sites other than head, neck and back, and disfigurement represented the most frequent symptom classes, endorsed by 58.7% and 56.3% of survivors, respectively. Approximately 87% of survivors reported multiple symptom classes. Greater symptom prevalence was associated with poorer HRQOL. In multivariable analysis, symptom classes explained up to 60% of the variance in PCS and 56% of the variance in MCS; demographic and clinical variables explained up to 15% of the variance in PCS and 10% of the variance in MCS. Longer time since diagnosis was associated with higher cumulative prevalence in all symptom classes.
  
  
  CONCLUSIONS
  A large proportion of survivors suffered from many symptom classes, which was associated with HRQOL impairment.
authors.affiliation: I-Chan Huang, Kelly Kenzik, and Elizabeth Shenkman, University of Florida, Gainesville, FL; and Tara M. Brinkman, James G. Gurney, Kirsten K. Ness, Jennifer Lanctot, Leslie L. Robison, Melissa M. Hudson, and Kevin R. Krull, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Huang
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.forename: Kelly
authors.initials: K
authors.lastname: Kenzik
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lanctot
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shenkman
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult