The experience of Japanese adolescents and young adults after losing siblings to childhood cancer: three types of narratives.

PubMed

Kamibeppu, Kiyoko; Sato, Iori; Hoshi, Yasutaka

2015-01-01

The aim of this study was to describe Japanese adolescents' and young adults' experiences after losing siblings to childhood cancer. A conceptual framework of the transition and analysis based on narrative method were adopted from qualitative data from 6 Japanese adolescents and young adults who had lost their siblings to childhood cancer. It was revealed that the participants' psychological experience after the sibling's death was directed by their perceptions of their mothers' responses to bereavement. We also found that the psychological distance between participants and their mothers could be an important factor in enabling transition into mourning and in orienting the lost sibling in their mind. The stories obtained from these 6 participants were categorized into the following 3 types of narratives: "Mother in another world and the sibling who became a god," "Return of the loving mother and the sibling as savior," and "The poor mother and the sibling who needs my help to carry on her legacy." This typology will serve as a framework for grief care and future research. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Developing Interventions for Cancer-Related Cognitive Dysfunction in Childhood Cancer Survivors

PubMed Central

Ullrich, Nicole J.; Whelen, Megan J.; Lange, Beverly J.

2014-01-01

Survivors of childhood cancer frequently experience cancer-related cognitive dysfunction, commonly months to years after treatment for pediatric brain tumors, acute lymphoblastic leukemia (ALL), or tumors involving the head and neck. Risk factors for cancer-related cognitive dysfunction include young age at diagnosis, treatment with cranial irradiation, use of parenteral or intrathecal methotrexate, female sex, and pre-existing comorbidities. Limiting use and reducing doses and volume of cranial irradiation while intensifying chemotherapy have improved survival and reduced the severity of cognitive dysfunction, especially in leukemia. Nonetheless, problems in core functional domains of attention, processing speed, working memory and visual-motor integration continue to compromise quality of life and performance. We review the epidemiology, pathophysiology and assessment of cancer-related cognitive dysfunction, the impact of treatment changes for prevention, and the broad strategies for educational and pharmacological interventions to remediate established cognitive dysfunction following childhood cancer. The increased years of life saved after childhood cancer warrants continued study toward the prevention and remediation of cancer-related cognitive dysfunction, using uniform assessments anchored in functional outcomes. PMID:25080574

A French national breast and thyroid cancer screening programme for survivors of childhood, adolescent and young adult (CAYA) cancers - DeNaCaPST programme.

PubMed

Demoor-Goldschmidt, Charlotte; Drui, Delphine; Doutriaux, Isabelle; Michel, Gérard; Auquier, Pascal; Dumas, Agnès; Berger, Claire; Bernier, Valérie; Bohrer, Sandrine; Bondiau, Pierre-Yves; Filhon, Bruno; Fresneau, Brice; Freycon, Claire; Stefan, Dinu; Helfre, Sylvie; Jackson, Angela; Kerr, Christine; Laprie, Anne; Leseur, Julie; Mahé, Marc-André; Oudot, Caroline; Pluchard, Claire; Proust, Stéphanie; Sudour-Bonnange, Hélène; Vigneron, Céline; Lassau, Nathalie; Schlumberger, Martin; Conter, Cécile Faure; de Vathaire, Florent

2017-05-12

Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening. DeNaCaPST trial is coordinated by the INSERM 1018 unit in cooperation with the LEA (French Childhood Cancer Survivor Study for Leukaemia) study's coordinators, the long term follow up committee and the paediatric radiation committee of the SFCE (French Society of Childhood Cancers). A total of 35 centres spread across metropolitan France and la Reunion will participate. FCCSS (French Childhood Cancer Survivor Study), LEA and central registry will be interrogated to identify eligible patients. To participate, centers agreed to perform a complete "long-term follow-up consultations" according to good clinical practice and the guidelines of the SFCE (French Society of Children Cancers). As survival has greatly improved in childhood cancers, detection of therapy-related malignancies has become a priority even if new radiation techniques will lead to better protection for organs at risk. International guidelines have been put in place because of the evidence for increased lifetime risk of breast and thyroid cancer. DeNaCaPST is based on these international recommendations but it is important to recognize that they are based on expert consensus opinion and are supported by neither nonrandomized observational studies nor prospective randomized trials in this specific population. Over-diagnosis is a phenomenon inherent in any screening program and

Design and Rationale for a Parent-Led Intervention to Increase Fruit and Vegetable Intake in Young Childhood Cancer Survivors (Reboot): Protocol for a Pilot Study

PubMed Central

Cohen, Jennifer; Wakefield, Claire; Grech, Allison; Garnett, Sarah; Gohil, Paayal; Cohn, Richard

2018-01-01

Background Poor dietary habits are common among childhood cancer survivors, despite increasing their risk of cardio metabolic complications after cancer treatment. Here, we describe the design and rationale for a pilot telephone-based, parent-led intervention aimed at increasing fruit and vegetable intake in young cancer survivors (Reboot). Objective This pilot study aims to assess the feasibility and acceptability of delivering evidence-based telephone support to parents of childhood cancer survivors. A secondary aim includes assessing the effect of Reboot on improving childhood cancer survivors’ dietary quality by increasing child fruit and vegetable intake and variety and its contribution to overall nutrient intake. Methods We aim to recruit parents of 15 young cancer survivors aged 2 to 12 years who have completed cancer treatment less than five years ago. The intervention comprises of 4 weekly 45-minute telephone sessions led by a health professional and one booster session 6 weeks later. Sessions address the effects of cancer treatment on children’s diets, recommended fruit and vegetable intake for children, and evidence-based strategies to promote the consumption of fruit and vegetables as well as to manage fussy eating. Results Reboot is based on an existing, evidence-based parent nutrition intervention and modified for childhood cancer survivors following extensive collaboration with experts in the field. Primary outcomes of feasibility and acceptability will be measured by the number of participants who complete all five sessions, average session length (minutes), length between sessions (days) and parent Likert ratings of the usefulness and impact of the intervention collected after the booster session. Of the 15 participants we aim to recruit, 3 have completed the intervention, 1 declined to participate, 11 are actively completing the intervention and 2 participants are providing written consent. The remaining 3 participants will be recruited via

Breast Cancer Risk in Childhood Cancer Survivors Without a History of Chest Radiotherapy: A Report From the Childhood Cancer Survivor Study

PubMed Central

Moskowitz, Chaya S.; Chou, Joanne F.; Bradbury, Angela R.; Neglia, Joseph Phillip; Dang, Chau T.; Onel, Kenan; Novetsky Friedman, Danielle; Bhatia, Smita; Strong, Louise C.; Stovall, Marilyn; Kenney, Lisa B.; Barnea, Dana; Lorenzi, Elena; Hammond, Sue; Leisenring, Wendy M.; Robison, Leslie L.; Armstrong, Gregory T.; Diller, Lisa R.; Oeffinger, Kevin C.

2016-01-01

Purpose Little is known about the breast cancer risk among childhood cancer survivors who did not receive chest radiotherapy. We sought to determine the magnitude of risk and associated risk factors for breast cancer among these women. Patients and Methods We evaluated cumulative breast cancer risk in 3,768 female childhood cancer survivors without a history of chest radiotherapy who were participants in the Childhood Cancer Survivor Study. Results With median follow up of 25.5 years (range, 8 to 39 years), 47 women developed breast cancer at a median age of 38.0 years (range, 22 to 47 years) and median of 24.0 years (range, 10 to 34 years) from primary cancer to breast cancer. A four-fold increased breast cancer risk (standardized incidence ratio [SIR] = 4.0; 95% CI, 3.0 to 5.3) was observed when compared with the general population. Risk was highest among sarcoma and leukemia survivors (SIR = 5.3; 95% CI, 3.6 to 7.8 and SIR = 4.1; 95% CI, 2.4 to 6.9, respectively). By the age of 45 years, the cumulative incidence of breast cancer in sarcoma and leukemia survivors was 5.8% (95% CI, 3.7 to 8.4) and 6.3% (95% CI, 3.0 to 11.3), respectively. No other primary cancer diagnosis was associated with an elevated risk. Alkylators and anthracyclines were associated with an increased breast cancer risk in a dose-dependent manner (P values from test for trend were both < .01). Conclusions Women not exposed to chest radiotherapy who survive childhood sarcoma or leukemia have an increased risk of breast cancer at a young age. The data suggest high-dose alkylator and anthracycline chemotherapy increase the risk of breast cancer. This may suggest a possible underlying gene-environment interaction that warrants further study. PMID:26700127

Trajectories of social isolation in adult survivors of childhood cancer.

PubMed

Howard, A Fuchsia; Tan de Bibiana, Jason; Smillie, Kirsten; Goddard, Karen; Pritchard, Sheila; Olson, Rob; Kazanjian, Arminee

2014-03-01

Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer. Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods. Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on. Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge. Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.

Childhood Origins of Young Adult Environmental Behavior.

PubMed

Evans, Gary W; Otto, Siegmar; Kaiser, Florian G

2018-05-01

Prospective, longitudinal analyses revealed that over a 12-year period from ages 6 to 18, individuals who grew up with mothers with more proenvironmental attitudes engaged in more proenvironmental behavior as young adults. A similar marginal association was uncovered between mothers' proenvironmental behaviors and the proenvironmental behavior of their young adult offspring. Maternal educational attainment, but not political ideology, was also associated with more proenvironmental behavior as children matured. Moreover, childhood time spent outdoors was positively associated with increased environmentally responsible behavior in young adulthood. Interestingly, one's own childhood proenvironmental behavior and attitude, at least as assessed at age 6, bear little on one's eventual proenvironmental behavior as a young adult. Finally, among this set of childhood factors, maternal education and childhood time spent outdoors were independent predictors of positive changes in environmental behavior from early childhood to young adulthood.

Including Young Children With "New" Chronic Illnesses in an Early Childhood Education Setting.

ERIC Educational Resources Information Center

Fauvre, Mary

1988-01-01

Presents suggestions for successfully including young children with "new" life-threatening, chronic illnesses -- various types of cancer, heart, liver, and kidney diseases -- in early childhood education classes. (BB)

The course of life of survivors of childhood cancer.

PubMed

Stam, H; Grootenhuis, M A; Last, B F

2005-03-01

The developmental consequences in adulthood of growing up with childhood cancer are not well understood. The Course of life questionnaire was developed to assess the attainment of developmental milestones retrospectively and socio-demographic outcomes in young adulthood. The aim of this study was to assess the course of life and socio-demographic outcomes in young adult survivors of childhood cancer. Knowledge about possible gaps in the course of life could enable health care providers to aim for the most favourable course of life. A total of 353 Dutch survivors and a comparison group of 508 peers without a history of cancer, all aged between 18 and 30, filled in the Course of life questionnaire. The course of life of the survivors was found to be hampered. The young adult survivors of childhood cancer in the Netherlands turned out to have achieved fewer milestones than their peers with respect to autonomy development, social development, and psycho-sexual development, or to have achieved the milestones when they were older than their peers. In addition, survivors displayed less risk behaviour than the comparison group. The survivors and the comparison group also differed on some socio-demographic issues. A considerably lower percentage of survivors than peers in the comparison group were married or living together, and/or employed. Their educational level, on the other hand, was as high as that of their peers. Copyright 2004 John Wiley & Sons, Ltd.

Suicide and violent deaths in survivors of cancer in childhood, adolescence and young adulthood-A national cohort study.

PubMed

Gunnes, Maria W; Lie, Rolv T; Bjørge, Tone; Ghaderi, Sara; Syse, Astri; Ruud, Ellen; Wesenberg, Finn; Moster, Dag

2017-02-01

Suicide risk in adult cancer patients is found to be elevated, but limited information exists regarding risks of suicide and non-suicidal violent deaths when diagnosed with cancer in young age. We investigate suicide and violent deaths in a national cohort including individuals diagnosed with cancer before age 25. Through the linkage of different national registries (Cancer Registry of Norway, Norwegian Causes of Death Registry and the National Registry) a cohort of all live births in Norway during 1965-1985 was defined and followed up through 2008. Individuals diagnosed with cancer before age 25 and the cancer-free references were compared using an extended Cox proportional hazard regression model. The cohort comprised 1,218,013 individuals, including 5,440 diagnosed with cancer before age 25. We identified 24 suicides and 14 non-suicidal violent deaths in the cancer group. The hazard ratio (HR) of suicide in the cancer group was 2.5 (95% confidence interval (CI) 1.7-3.8), and was increased both when diagnosed with cancer in childhood (0-14 years of age); HR = 2.3 (95% CI: 1.2-4.6), and during adolescence/young adulthood (15-24 years); HR = 2.6 (95% CI: 1.5-4.2). Survivors of bone/soft tissue sarcomas, CNS tumors and testicular cancer were at particular risk. The risk of non-suicidal violent death was not increased in the cancer survivors (HR = 1.0; 95% CI: 0.6-1.7). Although based on small numbers and the absolute risk of suicide being low, these are novel findings with important implications for establishing adequate follow-up including suicide prevention strategies for young cancer survivors. © 2016 UICC.

Design and Rationale for a Parent-Led Intervention to Increase Fruit and Vegetable Intake in Young Childhood Cancer Survivors (Reboot): Protocol for a Pilot Study.

PubMed

Touyz, Lauren; Cohen, Jennifer; Wakefield, Claire; Grech, Allison; Garnett, Sarah; Gohil, Paayal; Cohn, Richard

2018-05-16

Poor dietary habits are common among childhood cancer survivors, despite increasing their risk of cardio metabolic complications after cancer treatment. Here, we describe the design and rationale for a pilot telephone-based, parent-led intervention aimed at increasing fruit and vegetable intake in young cancer survivors (Reboot). This pilot study aims to assess the feasibility and acceptability of delivering evidence-based telephone support to parents of childhood cancer survivors. A secondary aim includes assessing the effect of Reboot on improving childhood cancer survivors' dietary quality by increasing child fruit and vegetable intake and variety and its contribution to overall nutrient intake. We aim to recruit parents of 15 young cancer survivors aged 2 to 12 years who have completed cancer treatment less than five years ago. The intervention comprises of 4 weekly 45-minute telephone sessions led by a health professional and one booster session 6 weeks later. Sessions address the effects of cancer treatment on children's diets, recommended fruit and vegetable intake for children, and evidence-based strategies to promote the consumption of fruit and vegetables as well as to manage fussy eating. Reboot is based on an existing, evidence-based parent nutrition intervention and modified for childhood cancer survivors following extensive collaboration with experts in the field. Primary outcomes of feasibility and acceptability will be measured by the number of participants who complete all five sessions, average session length (minutes), length between sessions (days) and parent Likert ratings of the usefulness and impact of the intervention collected after the booster session. Of the 15 participants we aim to recruit, 3 have completed the intervention, 1 declined to participate, 11 are actively completing the intervention and 2 participants are providing written consent. The remaining 3 participants will be recruited via telephone follow-up calls. The intervention

Social Outcomes in the Childhood Cancer Survivor Study Cohort

PubMed Central

Gurney, James G.; Krull, Kevin R.; Kadan-Lottick, Nina; Nicholson, H. Stacy; Nathan, Paul C.; Zebrack, Brad; Tersak, Jean M.; Ness, Kirsten K.

2009-01-01

Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects. PMID:19224833

Social outcomes in the Childhood Cancer Survivor Study cohort.

PubMed

Gurney, James G; Krull, Kevin R; Kadan-Lottick, Nina; Nicholson, H Stacy; Nathan, Paul C; Zebrack, Brad; Tersak, Jean M; Ness, Kirsten K

2009-05-10

Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects.

Development and Validation of the Health Competence Beliefs Inventory in Young Adults With and Without a History of Childhood Cancer

PubMed Central

DeRosa, Branlyn Werba; Doshi, Kinjal; Schwartz, Lisa A.; Ginsberg, Jill; Mao, Jun J.; Straton, Joseph; Hobbie, Wendy; Rourke, Mary T.; Carlson, Claire; Ittenbach, Richard F.

2012-01-01

Background Adolescent and young adult survivors of childhood cancer are a vulnerable population. Health beliefs may be related to necessary follow-up care. Purpose This study seeks to develop a measure of health beliefs for adolescents and young adults with and without a history of cancer. Methods Inductive and deductive methods and focus groups were used to develop the Health Competence Beliefs Inventory. Cancer survivors (n=138) and comparison participants (n=130) completed the Health Competence Beliefs Inventory and other measures. Healthcare providers reported current medical problems. Results A series of iterative exploratory factor analyses generated a 21-item four-factor solution: (1) Health Perceptions; (2) Satisfaction with Healthcare; (3) Cognitive Competence; and (4) Autonomy. Survivors reported significantly different Health Competence Beliefs Inventory scale scores than comparisons (p<.05). The Health Competence Beliefs Inventory was associated with beliefs, affect, quality of life, posttraumatic stress symptoms, and medical problems. Conclusions The Health Competence Beliefs Inventory is a promising measure of adolescent and young adult perceptions of health and well-being. PMID:20936390

Young adult survivors of childhood acute lymphoblastic leukemia show evidence of chronic inflammation and cellular aging.

PubMed

Ariffin, Hany; Azanan, Mohamad Shafiq; Abd Ghafar, Sayyidatul Syahirah; Oh, Lixian; Lau, Kee Hie; Thirunavakarasu, Tharshanadhevasheri; Sedan, Atiqah; Ibrahim, Kamariah; Chan, Adelyne; Chin, Tong Foh; Liew, Fong Fong; Jeyamogan, Shareni; Rosli, Erda Syerena; Baharudin, Rashidah; Yap, Tsiao Yi; Skinner, Roderick; Lum, Su Han; Hainaut, Pierre

2017-11-01

Large epidemiologic studies have reported the premature onset of age-related conditions, such as ischemic heart disease and diabetes mellitus, in childhood cancer survivors, decades earlier than in their peers. The authors investigated whether young adult survivors of childhood acute lymphoblastic leukemia (ALL) have a biologic phenotype of cellular ageing and chronic inflammation. Plasma inflammatory cytokines were measured using a cytometric bead array in 87 asymptomatic young adult survivors of childhood ALL (median age, 25 years; age range, 18-35 years) who attended annual follow-up clinic and compared with healthy, age-matched and sex-matched controls. Leukocyte telomere length (LTL) was measured using Southern blot analysis. Survivors had significant elevation of plasma interleukin-2 (IL-2), IL-10, IL-17a, and high-sensitivity C-reactive protein levels (all P < .05). A raised high-sensitivity C-reactive protein level (>0.8 mg/dL) was related to increased odds of having metabolic syndrome (odds ratio, 7.256; 95% confidence interval, 1.501-35.074). Survivors also had significantly shorter LTL compared with controls (median, 9866 vs 10,392 base pairs; P = .021). Compared with published data, LTL in survivors was similar to that in healthy individuals aged 20 years older. Survivors who received cranial irradiation had shorter LTL compared with those who had not (P = .013). Asymptomatic young adult survivors of childhood ALL demonstrate a biologic profile of chronic inflammation and telomere attrition, consistent with an early onset of cellular processes that drive accelerated aging. These processes may explain the premature development of age-related chronic conditions in childhood cancer survivors. Understanding their molecular basis may facilitate targeted interventions to disrupt the accelerated aging process and its long-term impact on overall health. Cancer 2017;123:4207-4214. © 2017 American Cancer Society. © 2017 American Cancer Society.

Alcohol use assessment in young adult cancer survivors.

PubMed

Breitenbach, Katherine; Epstein-Reeves, Marc; Hacker, Eileen; Corte, Colleen; Piano, Mariann R

2014-09-01

To determine whether oncology practitioners assess for alcohol consumption rates and usage patterns among young adult cancer survivors, and to determine drinking patterns and frequency of alcoholic beverage consumption among young adult cancer survivors. Retrospective chart review. Two outpatient cancer clinics. 77 young adult survivors of childhood cancer aged 18-30 years. Charts were selected from June to December 2009 and data were extracted using a structured questionnaire. Oncology practitioner assessment of alcohol use and alcohol consumption of young adult cancer survivors. Alcohol screening was conducted for 48 participants. No significant differences were noted in most variables between those not screened for alcohol use and those screened for alcohol use. Of the 48 screened for alcohol use, 30 reported "no use." For the 18 who reported alcohol use, the terms used to describe the frequency varied and were vague. The key finding of the study was that screening and documentation of alcohol consumption was poorly and inconsistently performed in the authors' sample of young adult cancer survivors. Similar to healthy young adults aged 18-30 years, young adult cancer survivors are at a developmental age where it is likely they will engage in unhealthy drinking; therefore, they should be screened for alcohol use and binge drinking. Practitioners can incorporate simple, short questions into health assessment visits that allow them to screen for unhealthy alcohol use.

Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors.

PubMed

Lehmann, Vicky; Hagedoorn, Mariët; Gerhardt, Cynthia A; Keim, Madelaine C; Guthrie, Lory; Sanderman, Robbert; Tuinman, Marrit A

2017-03-01

Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like childhood cancer may cause survivors to be more insecurely attached than healthy peers, which could have downstream effects on survivors' romantic relationships later in life. Therefore, we examined survivors' perspectives on parent behaviors, adult attachment, and marital status among adult survivors of childhood cancer relative to controls. One hundred forty-nine young adult survivors and 149 matched controls (M age  = 28, range 20-40) indicated their relationship status (single vs. partnered) and completed standardized questionnaires assessing memories of upbringing (warmth, overprotection, rejection) and adult attachment (avoidance, anxiety). Adult survivors of childhood cancer remembered mothers and fathers as emotionally warmer (d = 0.53/0.30), and mothers as less rejecting than controls (d = 0.30). Adult attachment was overall similar between survivors and controls, but partnered survivors reported particularly low attachment-related anxiety. Childhood cancer was related to higher mother and father warmth, which were associated with lower attachment-related avoidance and in turn with a greater likelihood of being in a relationship. Adult childhood cancer survivors did not remember their parents as overprotective, but reported more positive parenting relative to controls; and similar adult attachment and relationship status. The results were unexpected, but offer novel insights for future prospective studies, which are necessary to better understand psychosocial late effects of childhood cancer.

Childhood Conduct Problems and Young Adult Outcomes Among Women with Childhood ADHD

PubMed Central

Owens, Elizabeth B.; Hinshaw, Stephen P.

2015-01-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with ADHD during childhood, in the context of three potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data emanated from 140 participants in the Berkeley Girls with ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood (F1,118 change = 9.00, p = .003, R2 change = .069) and adolescent (F1,109 change = 10.41, p = .002, R2 change = .083) conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young-adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young-adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. PMID:26854507

Childhood colon cancer in a patient with ataxia telangiectasia

PubMed Central

Jo, Kyeong Min; Park, Jong Ha; Kim, Tae Oh; Jeong, Heui Jeong; Heo, Chang Min; Jang, Ji Hoon; Hur, So Chong; Jeong, Na Ri; Jeong, Su Jin; Seol, Sang Hoon; Nam, Kyung Han

2016-01-01

Background Ataxia-telangiectasia (AT) is a rare autosomal recessive disease characterized by progressive neurologic impairment and cerebellar ataxia. In addition, patients with this disease are known to have an inherent increased susceptibility to the development of cancer, predominantly hematologic malignancies. Methods We report the case of a young boy with AT from Russia, who had abdominal pain. Laboratory tests and radiologic examinations were performed to him. Results After abdominal computed tomography (CT), colonoscopy and surgical interventions, the young boy was diagnosed with colon cancer that had signet ring cell features. Conclusions It is known that the patient with AT appeared to be predisposed to various tumors, including leukemia or lymphoma, which are more common in childhood. Even if the patient with AT could have solid tumor such as stomach cancer or breast cancer, it is less likely to have colon cancer, especially signet ring cell type. Actually, no case of colon cancer has ever been reported, especially in young patient and hence, we have focused on this point and are hereby reporting this unique case. PMID:26855947

Site of childhood cancer care in the Netherlands.

PubMed

Reedijk, A M J; van der Heiden-van der Loo, M; Visser, O; Karim-Kos, H E; Lieverst, J A; de Ridder-Sluiter, J G; Coebergh, J W W; Kremer, L C; Pieters, R

2017-12-01

Due to the complexity of diagnosis and treatment, care for children and young adolescents with cancer preferably occurs in specialised paediatric oncology centres with potentially better cure rates and minimal late effects. This study assessed where children with cancer in the Netherlands were treated since 2004. All patients aged under 18 diagnosed with cancer between 2004 and 2013 were selected from the Netherlands Cancer Registry (NCR) and linked with the Dutch Childhood Oncology Group (DCOG) database. Associations between patient and tumour characteristics and site of care were tested statistically with logistic regression analyses. This population-based study of 6021 children diagnosed with cancer showed that 82% of them were treated in a paediatric oncology centre. Ninety-four percent of the patients under 10 years of age, 85% of the patients aged 10-14 and 48% of the patients aged 15-17 were treated in a paediatric oncology centre. All International Classification of Childhood Cancers (ICCC), 3rd edition, ICCC-3 categories, except embryonal tumours, were associated with a higher risk of treatment outside a paediatric oncology centre compared to leukaemia. Multivariable analyses by ICCC-3 category revealed that specific tumour types such as chronic myelogenous leukaemia (CML), embryonal carcinomas, bone tumours other type than osteosarcoma, non-rhabdomyosarcomas, thyroid carcinomas, melanomas and skin carcinomas as well as lower-staged tumours were associated with treatment outside a paediatric oncology centre. The site of childhood cancer care in the Netherlands depends on the age of the cancer patient, type of tumour and stage at diagnosis. Collaboration between paediatric oncology centre(s), other academic units is needed to ensure most up-to-date paediatric cancer care for childhood cancer patients at the short and long term. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

PubMed

Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

2017-10-01

Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

Screening for psychological late effects in childhood, adolescent and young adult cancer survivors: a systematic review.

PubMed

Michel, Gisela; Vetsch, Janine

2015-07-01

In the past years, increasing evidence showed that many childhood cancer survivors suffer from psychological distress long after treatment ended. However, psychosocial issues are often neglected during follow-up care. Including screening for psychological distress before follow-up appointments might help addressing the topic in survivors who need support. Our aim was to systematically review the available evidence on screening for psychological distress in childhood cancer survivors. We found eight studies that investigated different screening tools for their utility in detecting psychological distress in childhood cancer survivors. The Brief Symptom Inventory-18 with an adapted cutoff score for childhood cancer survivors, and the newly developed short form of the Beck Depression Index were both shown to be of a potential benefit as brief screening tools in follow-up care. We identified promising screening tools to be used to detect psychological distress in childhood cancer survivors. However, there is still a lack of studies addressing applicability and effectiveness when screening is routinely implemented into follow-up care. To improve quality of follow-up care, and identify and treat survivors with psychological distress, screening tools should now be implemented and their adequacy further tested in day-to-day clinic life.

Associates of Engagement in Adult-Oriented Follow-Up Care for Childhood Cancer Survivors.

PubMed

Szalda, Dava; Piece, Lisa; Brumley, Lauren; Li, Yimei; Schapira, Marilyn M; Wasik, Monika; Hobbie, Wendy L; Ginsberg, Jill P; Schwartz, Lisa A

2017-02-01

Understanding how to predict appropriate uptake of adult-oriented medical care is important for adult patients with pediatric-onset chronic health conditions with continued health vulnerability. We examined associates of engagement in adult survivors of childhood cancer following transfer to adult-oriented care. Adult survivors of childhood cancer (N = 80), within 1-5 years post transfer from pediatric to adult-oriented follow-up care, completed assessments of engagement with recommended adult-oriented follow-up care and psychosocial and transition readiness measures. Measures were validated with adolescent and young adults and/or intended to measure readiness to transition to adult care. Earlier age at diagnosis, parental involvement in health care decision-making, higher motivation, and increased comfort speaking to providers about health concerns were significantly associated with attendance at adult-oriented follow-up care visits. Associates of engagement in adult care are complex, representing social-ecological variables. Current measures of transition readiness or adolescent and young adult health-related measures may not adequately capture the associates of engagement in care or identify targets of intervention to promote successful transfer of care. Identifying patients at risk for loss to follow-up will be useful to design interventions for young adult survivors of childhood cancer and other young adults with pediatric-onset chronic conditions who require ongoing adult-oriented care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

How childhood cancers are different from adult cancers

MedlinePlus

... medlineplus.gov/ency/patientinstructions/000845.htm How childhood cancers are different from adult cancers To use the sharing features on this page, ... with cancer can be cured. Types of Childhood Cancers Cancer in children is rare, but some types ...

Lifestyle behavior interventions delivered using technology in childhood, adolescent, and young adult cancer survivors: A systematic review.

PubMed

Kopp, Lisa M; Gastelum, Zachary; Guerrero, Christian H; Howe, Carol L; Hingorani, Pooja; Hingle, Melanie

2017-01-01

Childhood, adolescent, and young adult cancer survivors demonstrate increased cardio-metabolic risk factors, which are amenable to lifestyle changes. The use of technology to impact lifestyle change expands previously limited intervention access, yet little is known about its use. We summarized lifestyle interventions for survivors delivered using technology, finding six studies, primarily targeting physical activity. Study samples were small and durations ranged from 5 to 16 weeks and outcomes modest. Participants were older, white, survivors of leukemia or brain tumors, and the majority received Web-based interventions. Study quality was moderate. Few technology-based interventions have been developed, suggesting an area of opportunity for survivors. © 2016 Wiley Periodicals, Inc.

Survivors of childhood cancer and comparison peers: the influence of early family factors on distress in emerging adulthood.

PubMed

Robinson, Kristen E; Gerhardt, Cynthia A; Vannatta, Kathryn; Noll, Robert B

2009-02-01

This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. Copyright 2009 APA, all rights reserved.

Management and Prevention of Breast Cancer After Radiation to the Chest for Childhood, Adolescent, and Young Adulthood Malignancy.

PubMed

Koo, Eva; Henderson, Michael A; Dwyer, Mary; Skandarajah, Anita R

2015-12-01

Women treated with chest irradiation for childhood, adolescent, and young adulthood (CAYA) malignancies, in particular Hodgkin's lymphoma, have an increased risk of developing second cancers of the breast (SCB). However, there are few uniform guidelines regarding surveillance and prevention for this high-risk group. A systematic search using PUBMED and OVID MEDLINE was performed. Publications listed under the terms "breast neoplasm", "neoplasm, radiation-induced", "therapeutic radiation-induced breast cancer", "screening", "surveillance", "prevention", and "prophylaxis" between January 1992 and January 2015 were assessed. A total of 138 publications were reviewed. Factors associated with increased SCB risk include young age at irradiation, prolong duration since irradiation (peak relative risk 13.87 at 15-19 years postradiation), and increased radiation dose and field. Early menopause reduces SCB risk. Annual screening mammography and breast MRI is recommended from age 25 or 8 years posttreatment for women treated with ≥20 Gy chest radiation before age 30 years. Compared with sporadic primary breast cancers (PBC), SCB more often are bilateral (6-34 %), managed with mastectomy (56-100 %), hormone receptor-negative (27-49 %), and high-grade (35 %). Women with SCB have a similar breast cancer event-free survival and breast cancer-specific survival compared to women with PBC. However, their overall survival is worse due to comorbid conditions. There is paucity of information regarding secondary prevention of SCB. Survivors of CAYA malignancy are at risk of many late effects, including iatrogenic breast cancer from chest irradiation. They are best managed in a multidisciplinary late-effects setting where tailored risk management can be provided.

Stages of Childhood Liver Cancer

MedlinePlus

... Liver Cancer Prevention Liver Cancer Screening Research Childhood Liver Cancer Treatment (PDQ®)–Patient Version Treatment Option Overview Go ... different types of treatment for patients with childhood liver cancer. Different types of treatments are available for children ...

Developing a new instrument to assess the impact of cancer in young adult survivors of childhood cancer.

PubMed

Zebrack, Brad

2009-09-01

Thirty years of psychosocial oncology research have detailed issues having significant impact in both pediatric and adult populations; yet, few studies have captured the subtle and unique ways in which cancer impacts, disrupts and in some instances promotes the growth and development of adolescents and young adults with a cancer history. This paper reports the initiation of an effort to assess the impact of cancer in this young survivor population through the development of a new Impact of Cancer (IOC) instrument. 64 young adults aged 18-39 years and treated for a pediatric malignancy participated in face-to-face interviews and responded to questions prompting them to describe the impact of cancer on their physical, psychological, social and spiritual/existential well-being. Intent of analysis was to organize data into meaningful sub-categories from which to develop a set of candidate survey items that assess a range of problems, issues and changes that long-term survivors ascribe to their cancer experience. A total of 82 candidate survey items represented content across 11 topical domains including Body, Health and Body image, Treatment and Health Care, Having Children, Identity, Talking and Thinking About Cancer, Meaning of Cancer, Memory and Thinking, Finances, Family and Relationships, Socializing, and Life Goals. Assessing the instrument's psychometric properties in a large representative group of young cancer survivors is the next step for further development of such a measure. Once established, a valid and reliable Impact of Cancer instrument has the potential for identifying salient survivorship issues in a clinical setting.

Breast Cancer After Chest Radiation Therapy for Childhood Cancer

PubMed Central

Moskowitz, Chaya S.; Chou, Joanne F.; Wolden, Suzanne L.; Bernstein, Jonine L.; Malhotra, Jyoti; Friedman, Danielle Novetsky; Mubdi, Nidha Z.; Leisenring, Wendy M.; Stovall, Marilyn; Hammond, Sue; Smith, Susan A.; Henderson, Tara O.; Boice, John D.; Hudson, Melissa M.; Diller, Lisa R.; Bhatia, Smita; Kenney, Lisa B.; Neglia, Joseph P.; Begg, Colin B.; Robison, Leslie L.; Oeffinger, Kevin C.

2014-01-01

Purpose The risk of breast cancer is high in women treated for a childhood cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. Patients and Methods We evaluated cumulative breast cancer risk in 1,230 female childhood cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). Results Childhood cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast cancer–specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. Conclusion Among women treated for childhood cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast cancer after childhood cancer is substantial. PMID:24752044

Gonadal and Sexual Dysfunction in Childhood Cancer Survivors.

PubMed

Yoon, Ju Young; Park, Hyeon Jin; Ju, Hee Young; Yoon, Jong Hyung; Chung, Jin Soo; Hwang, Sang Hyun; Lee, Dong Ock; Shim, Hye Young; Park, Byung-Kiu

2017-10-01

Few studies have addressed gonadal and sexual dysfunctions in childhood cancer survivors. We evaluated the prevalence rates and risk factors for gonadal failure among adolescent/young adult childhood cancer survivors and their sexual function. Subjects were childhood cancer survivors aged 15-29 years who had completed therapy more than 2 years ago. Demographic and medical characteristics were obtained from the patients' medical records. In addition, hormonal evaluation and semen analysis were performed and sexual function was evaluated via questionnaire. The study included 105 survivors (57 males, 48 females), of which 61 were adults (age > 19 years) and 44 were adolescents. In both males and females, the proportion of survivors with low sex hormone levels did not differ among age groups or follow-up period. Thirteen female subjects (27.1%) needed sex hormone replacement, while five males subjects (8.8%) were suspected of having hypogonadism, but none were receiving sex hormone replacement. Of 27 semen samples, 14 showed azospermia or oligospermia. The proportion of normospermia was lower in the high cyclophosphamide equivalent dose (CED) group (CED ≥ 8,000 mg/m2) than the low CED group (27.3% vs. 62.5%, p=0.047). Among adults, none were married and only 10 men (35.7%) and eight women (34.3%) were in a romantic relationship. Though a significant proportion (12.0% of males and 5.3% of females) of adolescent survivors had experienced sexual activity, 13.6% had not experienced sex education. The childhood cancer survivors in this study showed a high prevalence of gonadal/sexual dysfunction; accordingly, proper strategies are needed to manage these complications.

Mapping brain development during childhood, adolescence and young adulthood

NASA Astrophysics Data System (ADS)

Guo, Xiaojuan; Jin, Zhen; Chen, Kewei; Peng, Danling; Li, Yao

2009-02-01

Using optimized voxel-based morphometry (VBM), this study systematically investigated the differences and similarities of brain structural changes during the early three developmental periods of human lives: childhood, adolescence and young adulthood. These brain changes were discussed in relationship to the corresponding cognitive function development during these three periods. Magnetic Resonance Imaging (MRI) data from 158 Chinese healthy children, adolescents and young adults, aged 7.26 to 22.80 years old, were included in this study. Using the customized brain template together with the gray matter/white matter/cerebrospinal fluid prior probability maps, we found that there were more age-related positive changes in the frontal lobe, less in hippocampus and amygdala during childhood, but more in bilateral hippocampus and amygdala and left fusiform gyrus during adolescence and young adulthood. There were more age-related negative changes near to central sulcus during childhood, but these changes extended to the frontal and parietal lobes, mainly in the parietal lobe, during adolescence and young adulthood, and more in the prefrontal lobe during young adulthood. So gray matter volume in the parietal lobe significantly decreased from childhood and continued to decrease till young adulthood. These findings may aid in understanding the age-related differences in cognitive function.

Childhood cancer survivorship research in minority populations: A position paper from the Childhood Cancer Survivor Study.

PubMed

Bhatia, Smita; Gibson, Todd M; Ness, Kirsten K; Liu, Qi; Oeffinger, Kevin C; Krull, Kevin R; Nathan, Paul C; Neglia, Joseph P; Leisenring, Wendy; Yasui, Yutaka; Robison, Leslie L; Armstrong, Gregory T

2016-08-01

By the middle of this century, racial/ethnic minority populations will collectively constitute 50% of the US population. This temporal shift in the racial/ethnic composition of the US population demands a close look at the race/ethnicity-specific burden of morbidity and premature mortality among survivors of childhood cancer. To optimize targeted long-term follow-up care, it is essential to understand whether the burden of morbidity borne by survivors of childhood cancer differs by race/ethnicity. This is challenging because the number of minority participants is often limited in current childhood cancer survivorship research, resulting in a paucity of race/ethnicity-specific recommendations and/or interventions. Although the overall childhood cancer incidence increased between 1973 and 2003, the mortality rate declined; however, these changes did not differ appreciably by race/ethnicity. The authors speculated that any racial/ethnic differences in outcome are likely to be multifactorial, and drew on data from the Childhood Cancer Survivor Study to illustrate the various contributors (socioeconomic characteristics, health behaviors, and comorbidities) that could explain any observed differences in key treatment-related complications. Finally, the authors outlined challenges in conducting race/ethnicity-specific childhood cancer survivorship research, demonstrating that there are limited absolute numbers of children who are diagnosed and survive cancer in any one racial/ethnic minority population, thereby precluding a rigorous evaluation of adverse events among specific primary cancer diagnoses and treatment exposure groups. Cancer 2016;122:2426-2439. © 2016 American Cancer Society. © 2016 American Cancer Society.

Childhood Cancer Survivors Are Living Longer

Cancer.gov

New data from the Childhood Cancer Survivor Study suggest that refinements in pediatric cancer treatment over the last few decades have helped to extend the lifespans of many survivors of childhood cancer.

Siblings of Childhood Cancer Survivors.

ERIC Educational Resources Information Center

Gogan, Janis L.

This paper reports on a long term follow up study of siblings of childhood cancer survivors. Seventy siblings of childhood cancer survivors in 37 families were interviewed using a semi-structured format which included both forced choice and open ended questions. The children discussed their memories of the sibling's cancer diagnosis and treatment…

Good News About Childhood Cancer

MedlinePlus

... years, five-year survival rates have increased and death rates have decreased for most childhood cancers. Both improvements ... of U.S. and international trends in incidence and death rates for childhood cancers Studies to better understand the ...

Height and Body Size in Childhood, Adolescence and Young Adulthood and Breast Cancer Risk According to Molecular Subtype in the Nurses’ Health Studies

PubMed Central

Warner, Erica T.; Hu, Rong; Collins, Laura C.; Beck, Andrew H.; Schnitt, Stuart; Rosner, Bernard; Eliassen, A. Heather; Michels, Karin B.; Willett, Walter C.; Tamimi, Rulla M.

2016-01-01

Height and body size in childhood and young adulthood have been consistently associated with breast cancer risk; whether associations differ across molecular subtypes is unclear. In a pooled analysis of the Nurses’ Health Studies we prospectively examined the association of four exposures: height, body mass index (BMI) at age 18, childhood and adolescent somatotypes, with breast cancer risk according to molecular subtypes defined by immunohistochemical markers. We used multivariable-adjusted Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI).We identified 2983 luminal A, 1281 luminal B, 318 HER2-enriched, 408 basal-like and 128 unclassified tumors. Height was positively associated with all subtypes (p-heterogeneity=0.78). BMI at age 18 (p-heterogeneity=0.001), childhood (p-heterogeneity=0.51) and adolescent somatotype (p-heterogeneity=0.046) were inversely associated, but with differences in magnitude of association. BMI at age 18 of ≥25 kg/m2 (compared to 20-21.9 kg/m2) was associated with a 52% decreased risk of HER2-enriched (HR: 0.48, 95%CI: 0.26-0.91; p-trend <0.0001) and 39% reduced risk of basal-like tumors (HR: 0.61, 95% CI: 0.36-1.02; p-trend=0.008). Compared to the lowest category, women in the highest adolescent body size category were 71% less likely to develop HER2-enriched (HR: 0.29, 95%CI: 0.10-0.85; p-trend=0.0005) and 60% less likely to develop basal-like (HR: 0.40, 95%CI: 0.17-0.95; p-trend=0.0008). Height was positively associated with risk of all breast cancer molecular subtypes. BMI at age 18 and childhood and adolescent were inversely associated with risk of most breast cancer molecular subtypes with somewhat stronger associations with HER2-enriched and basal-like subtypes. PMID:27590596

Mental health among young adult survivors of childhood cancer and their siblings including posttraumatic growth.

PubMed

Kamibeppu, Kiyoko; Sato, Iori; Honda, Misato; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Okamura, Jun; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Horibe, Keizo; Ishida, Yasushi

2010-12-01

Few studies have addressed the mental health status of young adult childhood cancer survivors (CCSs) and their siblings (SIBs). This paper focuses on depression, anxiety, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG) among Japanese CCSs and their SIBs. Adolescent and young adult CCSs (n=185), in remission for more than 1 year, their SIBs (n=72), and general controls (CONTs) (n=1,000) completed anonymous self-report questionnaires for depression, anxiety, PTSS, and PTG. The physicians in charge also completed an anonymous disease/treatment data sheet. CCSs were approximately 8 years old at diagnosis and approximately 23 years old at the time of the survey. Their diagnoses included leukemia (57%), lymphoma (12%), and solid tumors (30%). Thirty-eight percent underwent surgery and 25% received stem cell transplantation. No significant differences were found between CCSs and CONTs in terms of depression and anxiety. CCSs had significantly more PTSS and had remarkably greater PTG compared to CONTs. Although no significant differences were found between SIBs and CONTs regarding depression, anxiety, or PTSS, female SIBs exhibited greater PTG compared to female CONTs. To empower CCSs, they should be evaluated periodically regarding PTSS and PTG and should be provided appropriate care and feedback. The fact that the mental health status of young adult SIBs was similar to CONTs at 15 years after their siblings' diagnoses may help reassure parents who worry about mental health among the siblings of an affected child during and after his/her treatment.

Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

PubMed

Nipp, Ryan D; Kirchhoff, Anne C; Fair, Douglas; Rabin, Julia; Hyland, Kelly A; Kuhlthau, Karen; Perez, Giselle K; Robison, Leslie L; Armstrong, Gregory T; Nathan, Paul C; Oeffinger, Kevin C; Leisenring, Wendy M; Park, Elyse R

2017-10-20

Purpose Survivors of childhood cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of childhood cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of childhood cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of childhood cancer and 173 siblings, survivors of childhood cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P < .001). Characteristics of the survivors of childhood cancer that were associated with a higher percentage of income spent on out-of-pocket costs included hospitalization in the past year (odds ratio [OR], 2.3; 95% CI, 1.1 to 4.9) and household income < $50,000 (OR, 5.5; 95% CI, 2.4 to 12.8). Among survivors of childhood cancer, a higher percentage of income spent on out-of-pocket medical costs was significantly associated with problems paying medical bills (OR, 8.9; 95% CI, 4.4 to 18.0); deferring care for a medical problem (OR, 3.0; 95% CI, 1.6 to 5.9); skipping a test, treatment, or follow-up (OR, 2.1; 95% CI, 1.1 to 4.0); and thoughts of filing for bankruptcy (OR, 6.6; 95% CI, 3.0 to

Hospital contact for mental disorders in survivors of childhood cancer and their siblings in Denmark: a population-based cohort study.

PubMed

Lund, Lasse Wegener; Winther, Jeanette F; Dalton, Susanne O; Cederkvist, Luise; Jeppesen, Pia; Deltour, Isabelle; Hargreave, Marie; Kjær, Susanne K; Jensen, Allan; Rechnitzer, Catherine; Andersen, Klaus K; Schmiegelow, Kjeld; Johansen, Christoffer

2013-09-01

Survivors of childhood cancer are known to be at risk for long-term physical and mental effects. However, little is known about how cancers can affect mental health in the siblings of these patients. We aimed to assess the long-term risks of mental disorders in survivors of childhood cancer and their siblings. Hospital contact for mental disorders was assessed in a population-based cohort of 7085 Danish children treated for cancer by contemporary protocols between 1975 and 2010 and in their 13 105 siblings by use of data from the Danish Psychiatric Central Research Registry. Hazard ratios (HRs) for first hospital contact were calculated using a Cox proportional hazards model. We compared these sibling and survivor cohorts with two population-based cohorts who were not childhood cancer survivors or siblings of survivors. Survivors of childhood cancer were at increased risk of hospital contact for mental disorders, with HRs of 1·50 (95% CI 1·32-1·69) for males and 1·26 (1·10-1·44) for females. Children younger than 10 years at diagnosis had the highest risk, and increased risks were seen in survivors of CNS tumours, haematological malignancies, and solid tumours. Survivors had higher risk of neurodevelopmental, emotional, and behavioural disorders than population-based comparisons and siblings, and male survivors had higher risk for unipolar depression. Overall, siblings had no excess risk for mental disorders. However, our data suggest that siblings who were young at the time of cancer diagnosis of the survivor were at increased risk for mental disorders, whereas those older than 15 years at diagnosis were at a lower risk than the general population. Childhood cancer survivors should be followed up for mental late effects, especially those diagnosed in young age. Further, clinicians should also be aware that siblings who were young at the time of cancer diagnosis might be at increased risk for mental health disorders. Copyright © 2013 Elsevier Ltd. All

Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD).

PubMed

Owens, Elizabeth B; Hinshaw, Stephen P

2016-02-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with attention-deficit/hyperactivity disorder (ADHD) during childhood, in the context of 3 potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data came from 140 participants in the Berkeley Girls With ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood, F(1, 118) change = 9.00, p = .003, R2 change = .069, and adolescent, F(1, 109) change = 10.41, p = .002, R2 change = .083, conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. (c) 2016 APA, all rights reserved).

[Educational and social outcome after childhood cancer].

PubMed

Bonneau, Jacinthe; Dugas, Karyn; Louis, Aurélien; Morel, Laëtitia; Toughza, Jihane; Frappaz, Didier

2015-01-01

The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Dental complications of rickets in early childhood: case report on 2 young girls.

PubMed

Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

2014-04-01

Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

The effects of individual- and network-level factors on discussion of cancer experiences: Survivors of childhood cancer in Korea.

PubMed

Kim, Min Ah; Yi, Jaehee; Prince, Kort C; Nagelhout, Elizabeth; Wu, Yelena P

2018-01-01

This study aimed to identify young adult Korean cancer survivors' individual- (psychological distress, stigma, sociodemographic variables, and cancer-related variables) and network-level factors (relationship type, social support type) that influence discussion of their cancer experiences. Sixty-eight survivors of childhood cancer who were recruited using snowball sampling nominated 245 individuals from their networks, including family and intimate partners (40%) and friends and acquaintances (60%), as people with whom they most frequently interacted. Results of multilevel modeling analysis indicated that higher levels of internalized shame were a prominent individual-level factor associated with a lack of discussion of cancer experiences. Relationship type and support type at the network-level were also significant correlates of discussion of cancer experiences. Programs for reducing the survivors' shame, improving illness identity, and providing professional training for building social relationships that are intimate and in which they could exchange reciprocal support may help Korean childhood cancer survivors to openly share their cancer experiences with others in their social network and to be successful in the journey of cancer survivorship.

Second Neoplasms in Survivors of Childhood Cancer: Findings From the Childhood Cancer Survivor Study Cohort

PubMed Central

Meadows, Anna T.; Friedman, Debra L.; Neglia, Joseph P.; Mertens, Ann C.; Donaldson, Sarah S.; Stovall, Marilyn; Hammond, Sue; Yasui, Yutaka; Inskip, Peter D.

2009-01-01

Purpose To review the reports of subsequent neoplasms (SNs) in the Childhood Cancer Survivor Study (CCSS) cohort that were made through January 1, 2006, and published before July 31, 2008, and to discuss the host-, disease-, and therapy-related risk factors associated with SNs. Patients and Methods SNs were ascertained by survivor self-reports and subsequently confirmed by pathology findings or medical record review. Cumulative incidence of SNs and standardized incidence ratios for second malignant neoplasms (SMNs) were calculated. The impact of host-, disease-, and therapy-related risk factors was evaluated by Poisson regression. Results Among 14,358 cohort members, 730 reported 802 SMNs (excluding nonmelanoma skin cancers). This represents a 2.3-fold increase in the number of SMNs over that reported in the first comprehensive analysis of SMNs in the CCSS cohort, which was done 7 years ago. In addition, 66 cases of meningioma and 1,007 cases of nonmelanoma skin cancer were diagnosed. The 30-year cumulative incidence of SMNs was 9.3% and that of nonmelanoma skin cancer was 6.9%. Risk of SNs remains elevated for more than 20 years of follow-up for all primary childhood cancer diagnoses. In multivariate analyses, risks differ by SN subtype, but include radiotherapy, age at diagnosis, sex, family history of cancer, and primary childhood cancer diagnosis. Female survivors whose primary childhood cancer diagnosis was Hodgkin's lymphoma or sarcoma and who received radiotherapy are at particularly increased risk. Analyses of risk associated with radiotherapy demonstrated different dose-response curves for specific SNs. Conclusion Childhood cancer survivors are at a substantial and increasing risk for SNs, including nonmelanoma skin cancer and meningiomas. Health care professionals should understand the magnitude of these risks to provide individuals with appropriate counseling and follow-up. PMID:19255307

Childhood attention-deficit/hyperactivity disorder predicts intimate partner victimization in young women

PubMed Central

Guendelman, Maya D.; Ahmad, Shaikh; Meza, Jocelyn I.; Owens, Elizabeth B.; Hinshaw, Stephen P.

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) is associated with interpersonal dysfunction during childhood and adolescence, yet little is known about the romantic relationships of young women with childhood ADHD. In the present study, we draw from a longitudinal sample of girls followed prospectively into young adulthood, comparing those with (n = 114) and without (n = 79; comparisons) childhood ADHD in terms of their risk for physical victimization by an intimate partner (physical IPV; e.g., slapping, punching) by 17–24 years of age. We examined ADHD both diagnostically and dimensionally, at the same time establishing reliable indicators of young adult physical IPV. Externalizing and internalizing problems, and academic achievement during adolescence, were tested as potential mediators. Overall, participants with a childhood diagnosis of ADHD experienced more physical IPV than did comparisons (30.7% vs. 6.3%). In parallel, IPV was associated with higher levels of childhood ADHD symptomatology (d = .73). Young women with persistent ADHD stood the highest risk of experiencing IPV (37.3%), followed by those with transient ADHD (19.0%) and those never-diagnosed (5.9%). Academic achievement measured during adolescence was a significant partial mediator of the childhood ADHD symptomatology-young adult IPV relationship, even with control of sociodemographic, psychiatric, and cognitive factors, including childhood reading and math disorders. Findings indicate that in young women, childhood ADHD is a specific and important predictor of physically violent victimization in their intimate relationships. This vulnerable population requires IPV prevention and intervention, with academic empowerment as a key target. PMID:25663589

The influence of family management style on psychosocial problems of childhood cancer survivors in Korea.

PubMed

Kim, Dong Hee; Im, Yeo Jin

2015-04-01

To examine the psychosocial problems of childhood cancer survivors in Korea and investigate whether such problems are influenced by family management style. Family members of 158 childhood cancer survivors answered a questionnaire on demographic and illness characteristics, described psychosocial problems in their children using the Pediatric Symptom Checklist (PSC), and completed the Family Management Measure (FaMM). Perceived economic status and all six subscales of the FaMM were significantly correlated with children's psychosocial problems. In a multiple regression model, the Family Life Difficulty and Parental Mutuality scales of the FaMM were each independent predictors of psychosocial problems in young cancer survivors. A detailed care plan designed to (1) promote balance between the management of a child's condition and normal family life and (2) encourage parents to share their feelings with one another and provide mutual support should be required to improve psychosocial outcomes for childhood cancer survivors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Family social environment in childhood and self-rated health in young adulthood

PubMed Central

2011-01-01

Background Family social support, as a form of social capital, contributes to social health disparities at different age of life. In a life-course epidemiological perspective, the aims of our study were to examine the association between self-reported family social environment during childhood and self-reported health in young adulthood and to assess the role of family functioning during childhood as a potential mediating factor in explaining the association between family breakup in childhood and self-reported health in young adulthood. Methods We analyzed data from the first wave of the Health, Inequalities and Social Ruptures Survey (SIRS), a longitudinal health and socio-epidemiological survey of a random sample of 3000 households initiated in the Paris metropolitan area in 2005. Sample-weighted logistic regression analyses were performed to determine the association between the quality of family social environment in childhood and self-rated health (overall health, physical health and psychological well-being) in young adults (n = 1006). We used structural equation model to explore the mediating role of the quality of family functioning in childhood in the association between family breakup in childhood and self-rated health in young adulthood. Results The multivariate results support an association between a negative family social environment in childhood and poor self-perceived health in adulthood. The association found between parental separation or divorce in childhood and poor self-perceived health in adulthood was mediated by parent-child relationships and by having witnessed interparental violence during childhood. Conclusion These results argue for interventions that enhance family cohesion, particularly after family disruptions during childhood, to promote health in young adulthood. PMID:22192716

Risk of Salivary Gland Cancer After Childhood Cancer: A Report From the Childhood Cancer Survivor Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boukheris, Houda; Stovall, Marilyn; Gilbert, Ethel S.

Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 casesmore » of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.« less

Health status of the oldest adult survivors of cancer during childhood.

PubMed

Kenney, Lisa B; Nancarrow, Cheryl Medeiros; Najita, Julie; Vrooman, Lynda M; Rothwell, Monica; Recklitis, Christopher; Li, Frederick P; Diller, Lisa

2010-01-15

Young adult survivors of childhood cancer have an increased risk for treatment-related morbidity and mortality. In this study, the authors assessed how treatment for childhood cancer affects older-adult health and health practices. One hundred seven adults treated for childhood cancer between 1947 and 1968, known to have survived past age 50 years, were identified from a single-institution cohort established in 1975. Updated vital status on eligible cases was obtained from public records. Survivors and a control group of their age-matched siblings and cousins completed a mailed survey to assess physical and social function, healthcare practices, and the prevalence of common adult illnesses. Of the 107 survivors known to be alive at age 50 years, 16 were deceased at follow-up; 7 deaths could be associated with prior treatment (second malignancy in radiation field [3], small bowel obstruction after abdominal radiation [2], and cardiac disease after chest irradiation [2]). The 55 survivors (median age, 56 years; range, 51-71 years), and 32 family controls (median age, 58 years; range, 48-70 years), reported similar health practices, health-related quality of life, and social function. However, survivors reported more frequent visits to healthcare providers (P < .05), more physical impairments (P < .05), fatigue (P = .02), hypertension (P = .001), and coronary artery disease (P = .01). An increased risk of hypertension was associated with nephrectomy during childhood (odds ratio, 18.9; 95% confidence interval, 3.0-118.8). The oldest adult survivors of childhood cancer continue to be at risk for treatment-related complications that potentially decrease their life expectancy and compromise their quality of life.

Cancer of childhood in sub-Saharan Africa

PubMed Central

Stefan, Cristina; Bray, Freddie; Ferlay, Jacques; Liu, Biying; Maxwell Parkin, D

2017-01-01

Measurement of incidence rates of childhood cancer in Africa is difficult. The study ‘Cancer of Childhood in sub Saharan Africa’ brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA. It is clear that, in many centres, lack of adequate diagnostic and treatment facilities leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high-income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers - retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents). The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have—potentially—an excellent prognosis. PMID:28900468

Psychological, social, and behavioral issues for young adults with cancer.

PubMed

Zebrack, Brad J

2011-05-15

Theories of human development suggest that, although all cancer patients experience a common set of life disruptions, they experience them differently, focus on different issues, and attach different levels of importance to different aspects of the experience depending on the time in life at which they were diagnosed. During the critical developmental transition from childhood to adulthood, older adolescents and young adults in particular have typical concerns with establishing identity, developing a positive body image and sexual identity, separating from parents, increasing involvement with peers and dating, and beginning to make decisions about careers or employment, higher education, and/or family. Accordingly, cancer-related issues such as premature confrontation with mortality, changes in physical appearance, increased dependence on parents, disruptions in social life and school/employment because of treatment, loss of reproductive capacity, and health-related concerns about the future may be particularly distressing for adolescents and young adults. Psychosocial and behavioral interventions for young adult cancer patients and survivors often involve assisting these individuals in retaining or returning to function in significant social roles, such as spouse, parent, student, worker, or friend. Successful interventions will enable these young people to overcome the detrimental impact of a health crisis and strengthen the internal and external coping resources available to them. © 2011 American Cancer Society

Financial Dependence of Young Adults with Childhood ADHD.

PubMed

Altszuler, Amy R; Page, Timothy F; Gnagy, Elizabeth M; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S G; Pelham, William E

2016-08-01

This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N = 517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p < 0.05) and the welfare system (p < 0.01) and had lower earnings (p < 0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000-$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood.

Financial Dependence of Young Adults with Childhood ADHD

PubMed Central

Altszuler, Amy R.; Page, Timothy F.; Gnagy, Elizabeth M.; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S. G.; Pelham, William E.

2016-01-01

This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N=517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p<0.05) and the welfare system (p<0.01) and had lower earnings (p<0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000–$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood. PMID:26542688

The mediating roles of cancer-related rumination in the relationship between dispositional hope and psychological outcomes among childhood cancer survivors.

PubMed

Yuen, Ada N Y; Ho, Samuel M Y; Chan, Calais K Y

2014-04-01

This study aimed to examine the effects of dispositional hope on psychopathology as well as self-perceived positive change in childhood cancer survivors through the potential mediation of cancer-related ruminations. A cross-sectional design was used, and a group of childhood cancer survivors (N = 89; mean age = 23.2 years; age range = 17.2-31.3 years) were studied. Dispositional hope level was measured by the Hope Scale; positive and negative cancer-related ruminations were assessed by the Chinese Cancer-related Rumination Scale; depression symptoms were measured by Beck Depression Inventory; and anxiety symptoms were measured by Beck Anxiety Inventory. Positive adjustment outcome of posttraumatic growth (PTG) was assessed by the Chinese Post-traumatic Growth Inventory. Multiple regressions were used to analyze the relationship between dispositional hope and the outcome variables of PTG, anxiety and depression and the potential mediators of positive and negative cancer-related rumination. Dispositional hope was positively related to PTG, and the correlation was specifically mediated by positive cancer-related rumination. Dispositional hope also correlated with lower levels of depression and anxiety, specifically mediated by negative cancer-related rumination. The present finding supported hope as a significant positive factor for childhood cancer survivors, which was associated with PTG and better psychological adjustment. The findings may inform development of therapeutic intervention programs aimed at increasing childhood cancer patients' hope levels, which may be correlated with more positive cancer-related thoughts and better adjustment. The present study, which examined survivors diagnosed at young age, may enrich existing studies on the effect of onset age and adjustment outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

Using Social Media to Target Cancer Prevention in Young Adults: Viewpoint.

PubMed

Sarkar, Urmimala; Le, Gem M; Lyles, Courtney R; Ramo, Danielle; Linos, Eleni; Bibbins-Domingo, Kirsten

2018-06-05

Focusing on primary cancer prevention can reduce its incidence. Changing health behaviors is critical to cancer prevention. Modifiable cancer risk factors include lifestyle behaviors related to vaccination, physical activity, weight control and maintenance, alcohol consumption, and tobacco use. These health habits are often formed in young adulthood, a life stage which currently intersects with the growing population of digital natives whose childhood occurred in the internet era. Social media is a critical communication medium to reach this population of digital natives. Using a life course perspective, the purpose of this viewpoint paper is to describe the current landscape of nascent research using social media to target cancer prevention efforts in young adults and propose future directions to strengthen the scientific knowledge supporting social media strategies to promote cancer prevention behaviors. Leveraging social media as a health promotion tool is a promising strategy to impact modifiable behavioral risk factors for cancer and warrants further research on developing effective communication strategies in young adults to prevent cancer in the future generations. ©Urmimala Sarkar, Gem M Le, Courtney R Lyles, Danielle Ramo, Eleni Linos, Kirsten Bibbins-Domingo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.06.2018.

Medical and sociodemographic factors associated with human papillomavirus (HPV) vaccination adherence among female survivors of childhood cancer.

PubMed

Klosky, James L; Russell, Kathryn M; Simmons, Jessica L; Foster, Rebecca H; Peck, Kelly; Green, Daniel M; Hudson, Melissa M

2015-09-01

Among those 9-26 years of age, vaccination can prevent specific types of genital human papillomavirus (HPV), the most common sexually transmitted infection and cause of cervical and other cancers. The objective of this study was to estimate the prevalence of and factors associated with HPV vaccine initiation and completion among females surviving childhood cancer. One-hundred fourteen young adults and 230 mothers with daughters surviving childhood cancer completed surveys querying HPV vaccination history along with medical and sociodemographic factors potentially associated with vaccination outcomes. Vaccination rate differences by age necessitated analysis of outcomes by age group: 9-13 years (preadolescents), 14-17 years (adolescents), and 18-26 years (young adults). Multivariable logistic regression was utilized to identify factors associated with HPV vaccination outcomes. Overall, 34.6% (119/344) of survivors initiated and 20.9% (72/344) completed HPV vaccination. Preadolescents were least likely to have initiated vaccination (P < 0.001). Physician recommendation was associated with initiation across age groups (OR = 6.81-11.96, Ps < 0.001-.01), whereas older age at diagnosis (≥12 years of age) was associated with lower vaccination initiation among young adults only (OR = 0.28; 95%CI, 0.10-0.76, P = 0.012). Physician recommendation (OR = 7.54; 95%CI, 1.19-47.69, P = 0.032; adolescent group) and greater treatment intensity (OR = 5.25; 95%CI, 1.00-27.61, P = 0.050; young adult group) were associated with vaccine completion, whereas being non-White was associated with decreased vaccination completion (OR = 0.17; 95%CI, 0.05-0.66, P = 0.010; adolescent group). A minority of youths surviving childhood cancer have initiated or completed HPV vaccination. Strategies to increase vaccination among survivors are discussed. © 2015 Wiley Periodicals, Inc.

Long-Term Effects of Radiation Exposure among Adult Survivors of Childhood Cancer: Results from the Childhood Cancer Survivor Study

PubMed Central

Armstrong, Gregory T.; Stovall, Marilyn; Robison, Leslie L.

2010-01-01

In the last four decades, advances in therapies for primary cancers have improved overall survival for childhood cancer. Currently, almost 80% of children will survive beyond 5 years from diagnosis of their primary malignancy. These improved outcomes have resulted in a growing population of childhood cancer survivors. Radiation therapy, while an essential component of primary treatment for many childhood malignancies, has been associated with risk of long-term adverse outcomes. The Childhood Cancer Survivor Study (CCSS), a retrospective cohort of over 14,000 survivors of childhood cancer diagnosed between 1970 and 1986, has been an important resource to quantify associations between radiation therapy and risk of long-term adverse health and quality of life outcomes. Radiation therapy has been associated with increased risk for late mortality, development of second neoplasms, obesity, and pulmonary, cardiac and thyroid dysfunction as well as an increased overall risk for chronic health conditions. Importantly, the CCSS has provided more precise estimates for a number of dose–response relationships, including those for radiation therapy and development of subsequent malignant neoplasms of the central nervous system, thyroid and breast. Ongoing study of childhood cancer survivors is needed to establish long-term risks and to evaluate the impact of newer techniques such as conformal radiation therapy or proton-beam therapy. PMID:21128808

Life after cancer: how does public stigma increase psychological distress of childhood cancer survivors?

PubMed

Kim, Min Ah; Yi, Jaehee

2014-12-01

Public stigma is a major source of stress for cancer survivors. However, factors that buffer or exacerbate the negative effects of public stigma on psychological distress have not been elucidated. This study examined how perceived public stigma affects psychological distress as mediated by cancer disclosure, internalized reactions to stigma, and social support availability. Cross-sectional study. The study was conducted in South Korea. The study sample was 223 adolescent and young adult survivors of childhood cancer diagnosed before the age of 19 and currently between 15 and 39 years old. Psychological distress was assessed using the Brief Symptom Inventory-18. Structural equation modeling was used with 1000 bootstrap samples. The goodness of model fit was acceptable. Public stigma perceived by cancer survivors influenced psychological distress via cancer disclosure, internalized shame, and social support availability. Higher levels of perceived public stigma predicted higher levels of internalized shame and self-blame and lower levels of social support availability, which subsequently increased psychological distress. Higher levels of perceived public stigma predicted lower levels of disclosure about cancer history and experiences. Cancer disclosure indirectly ameliorated psychological distress by reducing internalized shame. This study offers evidence that cognitive and social factors play important roles in mediating the effects of perceived public stigma on psychological distress in Korean cancer survivors. A greater understanding of factors that influence psychological distress may help psychosocial oncology service providers to identify childhood cancer survivors in need of psychosocial services and provide them with appropriate resources and interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prevalence and Predictors of Risky and Heavy Alcohol Consumption Among Adult Siblings of Childhood Cancer Survivors

PubMed Central

Lown, E. Anne; Mertens, Ann C.; Korcha, Rachael A.; Leisenring, Wendy; Hudson, Melissa M.; Greenfield, Thomas K.; Robison, Leslie L.; Zeltzer, Lonnie K.

2013-01-01

Objective To describe alcohol consumption patterns and risk factors for heavy alcohol use among siblings of childhood cancer survivors compared to survivors and national controls. Methods Secondary analysis of prospectively collected data from two national surveys was performed including a cohort of 3,034 adult siblings of childhood cancer survivors (age 18-56 years) and 10,398 adult childhood cancer survivors both from the Childhood Cancer Survivor Study, plus 5,712 adult participants from the population-based National Alcohol Survey. Cancer-related experiences, self-reported current health and mental health were examined in relation to alcohol consumption patterns including heavy and risky drinking. Results Adult siblings of childhood cancer survivors were more likely to be heavy drinkers (ORadj=1.3; 1.0-1.6) and risky drinkers (ORadj=1.3; 1.1-1.6) compared to controls from a national sample. Siblings were also more likely to drink at these two levels compared to survivors. Factors associated with heavy drinking among siblings include being 18-21 years old (ORadj=2.9; 2.0-4.4), male (ORadj=2.3; 1.7-3.0), having a high school education or less (ORadj=2.4; 1.7-3.5), and drinking initiation at a young age (ORadj=5.1; 2.5-10.3). Symptoms of depression, (ORadj=2.1; 1.3-3.2), anxiety (ORadj=1.9; 1.1-3.3) and global psychiatric distress (ORadj=2.5; 1.5-4.3) were significantly associated with heavy alcohol use. Conclusions Siblings of children with cancer are more likely to be heavy drinkers as adults compared to childhood cancer survivors or national controls. Early initiation of drinking and symptoms of psychological distress should be identified during early adolescence and effective sibling-specific interventions should be developed and made available for siblings of children with cancer. PMID:22736595

Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report

PubMed Central

Migliorati, Cesar A.; Hudson, Melissa M.; McMullen, Kevin P.; Kaste, Sue C.; Ruble, Kathy; Guilcher, Gregory M. T.; Shah, Ami J.; Castellino, Sharon M.

2014-01-01

Purpose Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children’s Oncology Group. Methods An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network “Categories of Consensus” system. Results The Children’s Oncology Group oral-dental pan el selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Addition ally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent ma lignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Conclusions Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life. PMID:24781353

Genetic predispositions and childhood cancer.

PubMed Central

Shannon, K

1998-01-01

This article provides an overview of the problem of genetic susceptibility to childhood cancer with a particular emphasis on problems with ascertaining inherited cancer risk and the role of tumor-suppressor gene mutations in cancer predispositions. The association between neurofibromatosis type 1 and childhood leukemia is used to illustrate some of the issues faced by molecular biologists and genetic epidemiologists in identifying and analyzing at-risk individuals. The problem of incomplete penetrance in cancer susceptibility is presented and potential models are discussed. The article concludes with a number of tentative conclusions from existing data and speculations for future studies. Images Figure 1 PMID:9646040

General Information about Unusual Cancers of Childhood

MedlinePlus

... Cancers of Childhood Treatment (PDQ®)–Patient Version General Information About Unusual Cancers of Childhood Go to Health ... the PDQ Pediatric Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

[Life style and occupational factors and prevention of second primary cancers after childhood and adolescent cancer: Current state of knowledge].

PubMed

Duval, Sarah; Carretier, Julien; Boyle, Helen; Philip, Thierry; Berger, Claire; Marec-Bérard, Perrine; Fervers, Béatrice

2015-01-01

Survival of children, adolescents and young adults treated for cancer increased with improved treatments. But there is still an increased risk of second primary cancer (SPC) in the long term compared to the population of the same age, especially related to treatments. A reflection on the follow-up of this population and the prevention of SPC is an important issue. To perform a synthesis of the available literature on SCP risk factors, related risk behaviors, occupational exposures and prevention strategies. Literature search on PubMed from the following equation: "cancer [Tiab] AND young adult [Tiab] or teen [Tiab] or childhood [Tiab] AND prevention [Tiab] AND survivors [Mesh term]". Twenty-seven articles were included in this synthesis. Children, adolescents and young adults have similar risk behaviors than those of their peers regarding tobacco, diet and sun exposure; however, they have lower physical activity. There are few studies on prevention strategies focused on this population. Results of available studies remain inconclusive. No publication was found in relation to occupational exposure and risk of second cancer. Children, adolescents and young adults treated for cancer are a population at risk and require long-term follow-up and the implementation of effective prevention strategies tailored to this population. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Fatigue in young survivors of extracranial childhood cancer: a Finnish nationwide survey.

PubMed

Mört, Susanna; Lähteenmäki, Päivi M; Matomäki, Jaakko; Salmi, Toivo T; Salanterä, Sanna

2011-11-01

To evaluate self-reports of fatigue by young cancer survivors (aged 11-18 years), to compare young survivors' fatigue scores with the scores of a healthy control group and of the parent proxy evaluation, and to analyze whether demographic or disease-related factors are associated with young survivors' fatigue. Cross-sectional quantitative study. An urban hospital in southwestern Finland. 384 survivors diagnosed with an extracranial malignancy at age 16 or younger, who have survived four or more years postdiagnosis, and who are free of cancer. General matched population controls were randomly selected from the Finnish Population Registry. Demographic data and a self-report written fatigue questionnaire. Total fatigue (TF), general fatigue (GF), sleep or rest fatigue (SF), and cognitive fatigue. The control populations reported significantly more issues with TF, GF, and SF than did the survivor population. In survivors, older age, the need for remedial education at school, and a sarcoma diagnosis were associated with increasing fatigue, whereas female gender, better school grades, and greater health-related quality-of-life (HRQOL) scores were associated with lower fatigue. The study variables explained 49%-65% of the variation in fatigue scores. Although survivors and their matched controls seem to have similar fatigue, subgroups of survivors do experience excessive fatigue, which may have an impact on their HRQOL. This study increases the knowledge about fatigue levels of young survivors of extracranial malignancies and identifies the need for instruments specifically designed to assess fatigue in this population. The healthcare team should pay attention to the fatigue level of young survivors, particularly SF.

Long-term pulmonary disease among Swiss childhood cancer survivors.

PubMed

Kasteler, Rahel; Weiss, Annette; Schindler, Matthias; Sommer, Grit; Latzin, Philipp; von der Weid, Nicolas X; Ammann, Roland A; Kuehni, Claudia E

2018-01-01

Pulmonary diseases are potentially severe late complications of childhood cancer treatment that increase mortality risk among survivors. This nationwide study assesses the prevalence and incidence of pulmonary diseases in long-term childhood cancer survivors (CCS) and their siblings, and quantifies treatment-related risks. As part of the Swiss Childhood Cancer Survivor Study, we studied CCS who were diagnosed between 1976 and 2005 and alive at least 5 years after diagnosis. We compared prevalence of self-reported pulmonary diseases (pneumonia, chest wall abnormalities, lung fibrosis, emphysema) between CCS and their siblings, calculated cumulative incidence of pulmonary diseases using the Kaplan-Meier method, and determined risk factors using multivariable logistic regression. CCS reported more pneumonias (10% vs. 7%, P = 0.020) and chest wall abnormalities (2% vs. 0.4%, P = 0.003) than siblings. Treatment with busulfan was associated with prevalence of pneumonia (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.1-14.9), and thoracic surgery was associated with chest wall abnormalities and lung fibrosis (OR 4.1, 95% CI 1.6-10.7 and OR 6.3, 95% CI 1.7-26.6). Cumulative incidence of any pulmonary disease after 35 years of follow-up was 21%. For pneumonia, the highest cumulative incidence was seen in CCS treated with both pulmotoxic chemotherapy and radiotherapy to the thorax (23%). This nationwide study in CCS found an increased risk for pulmonary diseases, especially pneumonia, while still young, which indicates that CCS need long-term pulmonary follow-up. © 2017 Wiley Periodicals, Inc.

Adult life after childhood cancer in Scandinavia: diabetes mellitus following treatment for cancer in childhood.

PubMed

Holmqvist, Anna Sällfors; Olsen, Jørgen H; Andersen, Klaus Kaae; de Fine Licht, Sofie; Hjorth, Lars; Garwicz, Stanislaw; Moëll, Christian; Anderson, Harald; Wesenberg, Finn; Tryggvadottir, Laufey; Malila, Nea; Boice, John D; Hasle, Henrik; Winther, Jeanette Falck

2014-04-01

An increased risk for diabetes mellitus (DM) adds significantly to the burden of late complications in childhood cancer survivors. Complications of DM may be prevented by using appropriate screening. It is, therefore, important to better characterise the reported increased risk for DM in a large population-based setting. From the national cancer registries of the five Nordic countries, a cohort of 32,903 1-year survivors of cancer diagnosed before the age of 20 between start of cancer registration in the 1940s and 1950s through 2008 was identified; 212,393 comparison subjects of the same age, gender and country were selected from national population registers. Study subjects were linked to the national hospital registers. Absolute excess risks (AERs) and standardised hospitalisation rate ratios (SHRRs) were calculated. DM was diagnosed in 496 childhood cancer survivors, yielding an overall SHRR of 1.6 (95% confidence interval (CI), 1.5-1.8) and an AER of 43 per 100,000 person-years, increasing from approximately 20 extra cases of DM in ages 0-19 to more than 100 extra cases per 100,000 person-years in ages > or =50. The relative risks for DM were significantly increased after Wilms' tumour (SHRR, 2.9), leukaemia (2.0), CNS neoplasms (1.8), germ-cell neoplasms (1.7), malignant bone tumours (1.7) and Hodgkin's lymphoma (1.6). The risk for DM type 2 was slightly higher than that for type 1. Childhood cancer survivors are at increased risk for DM, with absolute risks increasing throughout life. These findings underscore the need for preventive interventions and prolonged follow-up of childhood cancer survivors. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Risk of Cataract among Survivors of Childhood and Adolescent Cancer: A Report from the Childhood Cancer Survivor Study

PubMed Central

Chodick, Gabriel; Sigurdson, Alice J.; Kleinerman, Ruth A.; Sklar, Charles A.; Leisenring, Wendy; Mertens, Ann C.; Stovall, Marilyn; Smith, Susan A.; Weathers, Rita E.; Veiga, Lene H. S.; Robison, Leslie L.; Inskip, Peter D.

2016-01-01

With therapeutic successes and improved survival after a cancer diagnosis in childhood, increasing numbers of cancer survivors are at risk of subsequent treatment-related morbidities, including cataracts. While it is well known that the lens of the eye is one of the most radiosensitive tissues in the human body, the risks associated with radiation doses less than 2 Gy are less understood, as are the long- and short-term cataract risks from exposure to ionizing radiation at a young age. In this study, we followed 13,902 five-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort an average of 21.4 years from the date of first cancer diagnosis. For patients receiving radiotherapy, lens dose (mean: 2.2 Gy; range: 0–66 Gy) was estimated based on radiotherapy records. We used unconditional multivariable logistic regression models to evaluate prevalence of self-reported cataract in relationship to cumulative radiation dose both at five years after the initial cancer diagnosis and at the end of follow-up. We modeled the radiation effect in terms of the excess odds ratio (EOR) per Gy. We also analyzed cataract incidence starting from five years after initial cancer diagnosis to the end of follow-up using Cox regression. A total of 483 (3.5%) cataract cases were identified, including 200 (1.4%) diagnosed during the first five years of follow-up. In a multivariable logistic regression model, cataract prevalence at the end of follow-up was positively associated with lens dose in a manner consistent with a linear dose-response relationship (EOR per Gy = 0.92; 95% CI: 0.65–1.20). The odds ratio for doses between 0.5 and 1.5 Gy was elevated significantly relative to doses <0.5 Gy (OR = 2.2; 95% CI: 1.3–3.7). The results from this study indicate a strong association between ocular exposure to ionizing radiation and long-term risk of pre-senile cataract. The risk of cataract increased with increasing exposure, beginning at lens doses as low as 0

Surviving a childhood cancer: impact on education and employment.

PubMed

Maule, Milena; Zugna, Daniela; Migliore, Enrica; Alessi, Daniela; Merletti, Franco; Onorati, Roberta; Zengarini, Nicolás; Costa, Giuseppe; Spadea, Teresa

2017-07-01

Long-term consequences of childhood cancer encompass adverse psychosocial effects that may severely limit the opportunity to live a satisfying and productive life. We assessed the social integration of adults cured of a cancer in their first 14 years of life by record linkage between the population-based Childhood Cancer Registry of Piedmont and the Turin Longitudinal Study. We compared education and employment outcomes within the cohort of survivors and between the cohort of survivors and their peers in the general population through logistic regression. Individuals cured of a childhood tumour have a higher risk of not obtaining educational qualifications [odds ratio (OR) 0.67 (95% confidence interval 0.40-1.11) for compulsory school, OR 0.81 (0.61-1.07) for higher education] or employment, OR 0.66 (0.45-0.98), than the general population. This problem is particularly severe for individuals cured of a central nervous system neoplasm: OR 0.56 (0.31-1.01) for higher education and OR 0.28 (0.13-0.58) for employment. Within-cohort comparisons show that men are less likely to obtain educational goals than women, OR 0.72 (0.40-1.29), but more likely to be employed, OR 2.18 (0.90-5.28); parental education (university qualifications) is positively associated with the success of the child's education, OR 9.54 (2.60-35.02), but not with their employment status, OR 1.02 (0.21-4.85). Strategies should be put in place to mitigate the risk of adverse psychosocial effects from the beginning of treatment to cure and beyond to offer those suffering a cancer at a young age the possibility of full integration into society.

Talking About Cancer Among Adolescent and Young Adult Cancer Patients and Survivors: A Systematic Review.

PubMed

Janin, Madeleine Marie Hortense; Ellis, Sarah Jane; Wakefield, Claire Elizabeth; Fardell, Joanna Elizabeth

2018-05-31

Communication plays an essential role in social relationships. Yet it is unclear how young cancer patients and survivors communicate with peers, and whether this contributes to increased rates of social difficulties. We aimed to analyze how childhood cancer patients and survivors communicate about their cancer with family and peers. We systematically searched Medline, Embase and PsycINFO for peer-reviewed studies on cancer-related communication among patients and survivors (any cancer, <25 years at diagnosis). We screened 309 articles, and included 6 qualitative studies. Studies were assessed using a standardized quality assessment tool. Participants were adolescents and young adults, 16-34 years of age at the time of study. Included studies related to different forms of cancer-related communication, benefits, and challenges. We found that cancer-related communication was an individual, complex process, addressing medical, existential, and emotional aspects of cancer. Communication occurred on a spectrum with variation in who information was shared with, as well as differences in the frequency at which information was shared, and the amount and type of information shared. Communication often occurred at uncertain or significant times for participants, or was initiated by others. Communicating about cancer yielded benefits as a coping strategy, prompted social support, and appeared central to significant relationships. Barriers to communication, including fear of stigma and poor peer reactions, hindered willingness to disclose. The number of studies analyzing this topic was limited. Communicating about cancer is a significant yet complex process for young patients and survivors. Further research is needed to complement the existing literature and to establish the evidence base for the development of future effective interventions promoting social and communication skills.

An overview of disparities in childhood cancer: Report on the Inaugural Symposium on Childhood Cancer Health Disparities, Houston, Texas, 2016.

PubMed

Scheurer, Michael E; Lupo, Philip J; Schüz, Joachim; Spector, Logan G; Wiemels, Joseph L; Aplenc, Richard; Gramatges, M Monica; Schiffman, Joshua D; Pombo-de-Oliveira, Maria S; Yang, Jun J; Heck, Julia E; Metayer, Catherine; Orjuela-Grimm, Manuela A; Bona, Kira; Aristizabal, Paula; Austin, Mary T; Rabin, Karen R; Russell, Heidi V; Poplack, David G

2018-05-08

The Inaugural Symposium on Childhood Cancer Health Disparities was held in Houston, Texas, on November 2, 2016. The symposium was attended by 109 scientists and clinicians from diverse disciplinary backgrounds with interests in pediatric cancer disparities and focused on reviewing our current knowledge of disparities in cancer risk and outcomes for select childhood cancers. Following a full day of topical sessions, everyone participated in a brainstorming session to develop a working strategy for the continued expansion of research in this area. This meeting was designed to serve as a springboard for examination of childhood cancer disparities from a more unified and systematic approach and to enhance awareness of this area of need.

Domestic radon and childhood cancer in Denmark.

PubMed

Raaschou-Nielsen, Ole; Andersen, Claus E; Andersen, Helle P; Gravesen, Peter; Lind, Morten; Schüz, Joachim; Ulbak, Kaare

2008-07-01

Higher incidence rates of childhood cancer and particularly leukemia have been observed in regions with higher radon levels, but case-control studies have given inconsistent results. We tested the hypothesis that domestic radon exposure increases the risk for childhood cancer. We identified 2400 incident cases of leukemia, central nervous system tumor, and malignant lymphoma diagnosed in children between 1968 and 1994 in the Danish Cancer Registry. Control children (n = 6697) were selected from the Danish Central Population Registry. Radon levels in residences of children and the cumulated exposure of each child were calculated as the product of exposure level and time, for each address occupied during childhood. Cumulative radon exposure was associated with risk for acute lymphoblastic leukemia (ALL), with rate ratios of 1.21 (95% confidence interval = 0.98-1.49) for levels of 0.26 to 0.89 x 10(3) Bq/m3-years and 1.63 (1.05-2.53) for exposure to >0.89 x 10(3) Bq/m3-years, when compared with <0.26 x 10(3) Bq/m3-years. A linear dose-response analysis showed a 56% increase in the rate of ALL per 10(3) Bq/m3-years increase in exposure. The association with ALL persisted in sensitivity analyses and after adjustment for potential confounders. No association was found with the other types of childhood cancer. This study suggests that domestic radon exposure increases the risk for ALL during childhood but not for other childhood cancers.

Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium

PubMed Central

van Dorp, Wendy; Mulder, Renée L.; Kremer, Leontien C.M.; Hudson, Melissa M.; van den Heuvel-Eibrink, Marry M.; van den Berg, Marleen H.; Levine, Jennifer M.; van Dulmen-den Broeder, Eline; di Iorgi, Natascia; Albanese, Assunta; Armenian, Saro H.; Bhatia, Smita; Constine, Louis S.; Corrias, Andreas; Deans, Rebecca; Dirksen, Uta; Gracia, Clarisa R.; Hjorth, Lars; Kroon, Leah; Lambalk, Cornelis B.; Landier, Wendy; Levitt, Gill; Leiper, Alison; Meacham, Lillian; Mussa, Alesandro; Neggers, Sebastian J.; Oeffinger, Kevin C.; Revelli, Alberto; van Santen, Hanneke M.; Skinner, Roderick; Toogood, Andrew; Haupt, Riccardo

2016-01-01

Purpose Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors’ access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening. Patients and Methods The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer. Results and Conclusion The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. PMID:27458300

Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium.

PubMed

van Dorp, Wendy; Mulder, Renée L; Kremer, Leontien C M; Hudson, Melissa M; van den Heuvel-Eibrink, Marry M; van den Berg, Marleen H; Levine, Jennifer M; van Dulmen-den Broeder, Eline; di Iorgi, Natascia; Albanese, Assunta; Armenian, Saro H; Bhatia, Smita; Constine, Louis S; Corrias, Andreas; Deans, Rebecca; Dirksen, Uta; Gracia, Clarisa R; Hjorth, Lars; Kroon, Leah; Lambalk, Cornelis B; Landier, Wendy; Levitt, Gill; Leiper, Alison; Meacham, Lillian; Mussa, Alesandro; Neggers, Sebastian J; Oeffinger, Kevin C; Revelli, Alberto; van Santen, Hanneke M; Skinner, Roderick; Toogood, Andrew; Wallace, William H; Haupt, Riccardo

2016-10-01

Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors' access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening. The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer. The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. © 2016 by American Society of Clinical Oncology.

Childhood growth and breast cancer.

PubMed

De Stavola, B L; dos Santos Silva, I; McCormack, V; Hardy, R J; Kuh, D J; Wadsworth, M E J

2004-04-01

Adult height is known to be positively associated with breast cancer risk. The mechanism underlying this association is complex, since adult height is positively correlated with age at menarche, which in turn is negatively associated with breast cancer risk. The authors used prospective data from a British cohort of 2,547 girls followed from birth in 1946 to the end of 1999 to examine breast cancer risk in relation to childhood growth. As expected, adult height was positively associated with age at menarche and breast cancer. In childhood, cases were taller and leaner, on average, than noncases. Significant predictors of breast cancer risk in models containing all components of growth were height velocity at age 4-7 years (for a one-standard-deviation increase, odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.13, 2.09) and age 11-15 years (OR = 1.29, 95% CI: 0.97, 1.71) and body mass index velocity (weight (kg)/height (m)(2)/year) at age 2-4 years (OR = 0.63, 95% CI: 0.48, 0.83). The effects of these variables were particularly marked in women with early menarche (age <12.5 years). These findings suggest that women who grow faster in childhood and reach an adult height above the average for their menarche category are at particularly increased risk of breast cancer.

Prevalence and predictors of risky and heavy alcohol consumption among adult siblings of childhood cancer survivors.

PubMed

Lown, E Anne; Mertens, Ann C; Korcha, Rachael A; Leisenring, Wendy; Hudson, Melissa M; Greenfield, Thomas K; Robison, Leslie L; Zeltzer, Lonnie K

2013-05-01

To describe alcohol consumption patterns and risk factors for risky and heavy alcohol use among siblings of childhood cancer survivors compared with survivors and national controls. Secondary analysis of prospectively collected data from two national surveys was performed including a cohort of 3034 adult siblings of childhood cancer survivors (age 18-56 years) and 10,398 adult childhood cancer survivors, both from the Childhood Cancer Survivor Study, plus 5712 adult participants from the population-based National Alcohol Survey. Cancer-related experiences, self-reported current health, and mental health were examined in relation to alcohol consumption patterns including heavy and risky drinking. Adult siblings of childhood cancer survivors were more likely to be heavy drinkers (OR adj = 1.3; 1.0-1.6) and risky drinkers (OR adj = 1.3; 1.1-1.6) compared with controls from a national sample. Siblings were also more likely to drink at these two levels compared with survivors. Factors associated with heavy drinking among siblings included being 18-21 years old (OR adj = 2.9; 2.0-4.4), male (OR adj = 2.3; 1.7-3.0), having a high school education or less (OR adj = 2.4; 1.7-3.5), and drinking initiation at a young age (OR adj = 5.1; 2.5-10.3). Symptoms of depression, (OR adj = 2.1; 1.3-3.2), anxiety (OR adj = 1.9; 1.1-3.3), and global psychiatric distress (OR adj = 2.5; 1.5-4.3) were significantly associated with heavy alcohol use. Siblings of children with cancer are more likely to be risky and heavy drinkers as adults compared with childhood cancer survivors or national controls. Early initiation of drinking and symptoms of psychological distress should be identified during early adolescence and effective sibling-specific interventions should be developed and made available for siblings of children with cancer. Copyright © 2012 John Wiley & Sons, Ltd.

Childhood Cancer Genomics Gaps and Opportunities - Workshop Summary

Cancer.gov

NCI convened a workshop of representative research teams that have been leaders in defining the genomic landscape of childhood cancers to discuss the influence of genomic discoveries on the future of childhood cancer research.

Young female cancer survivors' use of fertility care after completing cancer treatment

PubMed Central

Kim, Jayeon; Mersereau, Jennifer E.; Su, H. Irene; Whitcomb, Brian W.; Malcarne, Vanessa L.; Gorman, Jessica R.

2016-01-01

Purpose To investigate factors associated with female young adult cancer survivors’ (YCS) use of fertility care (FC), including consultation or fertility treatment, after completing their cancer treatment. Methods In this cross-sectional study, females between that ages of 18 and 35 years who had been diagnosed with childhood, adolescent, or young adult cancers completed a 20-min web-based survey that included demographics, reproductive history, use of FC, fertility-related informational needs, and reproductive concerns. Results A total of 204 participants completed the survey. Participants’ mean age was 28.3±4.5 years. Thirty (15%) participants reported using FC after cancer treatment. The majority of participants recalled not receiving enough information about FP options at the time of cancer diagnosis (73%). In multivariable analysis, those with higher concerns about having children because of perceived risk to their personal health (P=0.003) were less likely to report use of FC after cancer treatment. Those who had used FC before cancer treatment (P=0.003) and who felt less fertile than age-matched women (P=0.02) were more likely to use FC after their cancer treatment. Conclusions While most YCS in this cohort believed that they did not receive enough information about fertility and most wanted to have children, the vast majority did not seek FC. The findings of this study offer further evidence of the need for improved education and emotional support regarding reproductive options after cancer treatment is completed. Targeted discussions with YCS about appropriate post-treatment FC options may improve providers’ capacity to help YCS meet their parenthood goals. PMID:26939923

Childhood cancers in families with and without Lynch syndrome.

PubMed

Heath, John A; Reece, Jeanette C; Buchanan, Daniel D; Casey, Graham; Durno, Carol A; Gallinger, Steven; Haile, Robert W; Newcomb, Polly A; Potter, John D; Thibodeau, Stephen N; Le Marchand, Loïc; Lindor, Noralane M; Hopper, John L; Jenkins, Mark A; Win, Aung Ko

2015-12-01

Inheritance of a germline mutation in one of the DNA mismatch repair (MMR) genes or the EPCAM gene is associated with an increased risk of colorectal cancer, endometrial cancer, and other adult malignancies (Lynch syndrome). The risk of childhood cancers in Lynch syndrome families, however, is not well studied. Using data from the Colon Cancer Family Registry, we compared the proportion of childhood cancers (diagnosed before 18 years of age) in the first-, second-, and third-degree relatives of 781 probands with a pathogenic mutation in one of the MMR genes; MLH1 (n = 275), MSH2 (n = 342), MSH6 (n = 99), or PMS2 (n = 55) or in EPCAM (n = 10) (Lynch syndrome families), with that of 5073 probands with MMR-deficient colorectal cancer (non-Lynch syndrome families). There was no evidence of a difference in the proportion of relatives with a childhood cancer between Lynch syndrome families (41/17,230; 0.24%) and non-Lynch syndrome families (179/94,302; 0.19%; p = 0.19). Incidence rate of all childhood cancers was estimated to be 147 (95% CI 107-206) per million population per year in Lynch syndrome families and 115 (95% CI 99.1-134) per million population per year in non-Lynch syndrome families. There was no evidence for a significant increase in the risk of all childhood cancers, hematologic cancers, brain and central nervous system cancers, Lynch syndrome-associated cancers, or other cancers in Lynch syndrome families compared with non-Lynch syndrome families. Larger studies, however, are required to more accurately define the risk of specific individual childhood cancers in Lynch syndrome families.

Young Adults with Gambling Problems: The Impact of Childhood Maltreatment

ERIC Educational Resources Information Center

Felsher, Jennifer R.; Derevensky, Jeffrey L.; Gupta, Rina

2010-01-01

Childhood maltreatment has been thought to be a significant risk factor in the development of gambling problems. Incorporating a developmental psychopathology perspective, 1,324 adolescents and young adults, age 17-22 years completed self-report measures on gambling behaviors, gambling severity, and childhood maltreatment. Problem gamblers…

Physical exercise training interventions for children and young adults during and after treatment for childhood cancer.

PubMed

Braam, Katja I; van der Torre, Patrick; Takken, Tim; Veening, Margreet A; van Dulmen-den Broeder, Eline; Kaspers, Gertjan J L

2013-04-30

A decreased physical fitness and impaired social functioning has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of disease and treatment of childhood cancer and by behavioural and social elements. Exercise training for adults during or after cancer therapy has frequently been reported to improve physical fitness and social functioning. More recently, literature on this subject became available for children and young adults with cancer, both during and after treatment. This review aimed to evaluate the effect of a physical exercise training intervention (at home, at a physical therapy centre, or hospital based) on the physical fitness of children with cancer, in comparison with the physical fitness in a care as usual control group. The intervention needed to be offered within the first five years from diagnosis.The second aim was to assess the effects of a physical exercise training intervention in this population on fatigue, anxiety, depression, self efficacy, and health-related quality of life and to assess the adverse effects of the intervention. For this review the electronic databases of CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, and ongoing trial registries were searched on 6 September 2011. In addition, a handsearch of reference lists and conference proceedings was performed in that same month. The review included randomised controlled trials (RCTs) and clinical controlled trials (CCTs) that compared the effects of physical exercise training with no training, in people who were within the first five years of their diagnosis of childhood cancer. By the use of standardised forms two review authors independently identified studies meeting the inclusion criteria, performed the data extraction, and assessed the risk of bias. Quality of the studies was rated by using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. Five articles were included in this review: four RCTs (14

Childhood Thyroid Cancer Treatment (PDQ®)—Patient Version

Cancer.gov

Childhood thyroid cancer treatment usually includes surgery and may include radioactive iodine therapy, targeted therapy, and hormone replacement therapy. Learn more about the diagnosis and treatment of childhood thyroid cancer in this expert-reviewed summary.

Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study.

PubMed

Ritenour, Chad W M; Seidel, Kristy D; Leisenring, Wendy; Mertens, Ann C; Wasilewski-Masker, Karen; Shnorhavorian, Margarett; Sklar, Charles A; Whitton, John A; Stovall, Marilyn; Constine, Louis S; Armstrong, Gregory T; Robison, Leslie L; Meacham, Lillian R

2016-06-01

With survival rates higher than 80%, the number of survivors from pediatric cancer continues to increase. Late effects resulting from cancer and cancer therapy are being characterized, but little information exists on sexual health for men who have survived childhood cancer. To assess erectile dysfunction (ED) in men who survived childhood and adolescent cancers and to identify potential risk factors for ED. In total, 1,622 men and 271 eligible brothers in the Childhood Cancer Survivor Study cohort completed the Male Health Questionnaire, which provided information on sexual practices and sexual function. Combined with demographic, cancer, and treatment information from medical record abstraction, results of the Male Health Questionnaire were analyzed using multivariable modeling. The International Index of Erectile Function was used to identify ED in subjects. International Index of Erectile Function. Survivors (mean age = 37.4 years, SD = 7.3 years) reported significantly lower sexual activity in the year before the survey than the brothers (mean age = 38.8 years, SD = 8.5 years) without cancer. ED was reported by 12.3% (95% CI = 10.4-14.3) of survivors and 4.2% (95% CI = 2.0-7.9) of brothers. Survivors showed significantly higher relative risk (RR) for ED (RR = 2.63, 95% CI = 1.40-4.97). In addition to older age, survivors who were exposed to higher-dose (≥10 Gy) testicular radiation (RR = 3.55, 95% CI = 1.53-8.24), had surgery on the spinal cord or nerves (RR = 2.87, 95% CI = 1.36-6.05), prostate surgery (RR = 6.56, 95% CI = 3.84-11.20), or pelvic surgery (RR = 2.28, 95% CI = 1.04-4.98) were at higher risk for ED. Men who have survived childhood cancer have a greater than 2.6-fold increased risk for ED and certain cancer-specific treatments are associated with increased risk. Attention to sexual health, with its physical and emotional implications, and opportunities for early detection and intervention in these individuals could be important

Fertility-related knowledge and reproductive goals in childhood cancer survivors: short communication.

PubMed

Lehmann, V; Keim, M C; Nahata, L; Shultz, E L; Klosky, J L; Tuinman, M A; Gerhardt, C A

2017-11-01

Do young adult survivors of childhood cancer know their fertility status, in the context of their parenthood goals and screening for gonadal functioning? While 80% of survivors (who were without children) wanted children in the future, most did not know their fertility status, and screening for gonadal functioning was underutilized. Survivors of childhood cancer are at risk for infertility, but fertility counseling and assessment are underutilized. Separate studies indicated that survivors' fertility-related knowledge is poor and that they often wanted to have children. Yet, studies have not investigated the intersection of both issues, as well as potential distress if parenthood goals are not met. Young adult male and female survivors of childhood cancer (N = 149) completed cross-sectional surveys, and data for those without children (n = 105, 70.5%) are presented here. Participants were 20-40 years old (M = 26.5), diagnosed 5-33 years prior to study participation, and completed questionnaires online. Knowledge of fertility status, parenthood goals, and potential distress if survivors were unable to have children were assessed. Medical records were reviewed for hormone levels as indicators of screening for gonadal functioning. Most survivors (n = 81; 77.1%) did not know their fertility status, while over 80% (n = 89) wanted children (neither aspect varied by socio-demographic/cancer-specific factors). Two-thirds of survivors indicated they would be distressed if parenthood goals remained unfulfilled; especially female (versus male, t = 2.64; P = 0.01) or partnered (versus single, t = -3.45; P < 0.001) survivors. Forty survivors (38.1%) had documented assessments of gonadal functioning, of which 33 (82.5%) reported not knowing their fertility status. Relevant risk factors may have not been identified owing to limited sample size and missing treatment information. The underutilization of screening for gonadal functioning needs further exploration in other pediatric

Childhood Nasopharyngeal Cancer Treatment (PDQ®)—Patient Version

Cancer.gov

Childhood nasopharyngeal cancer treatment options include chemotherapy, external and internal radiation therapy, surgery, and immunotherapy (interferon). Learn more about the risk factors, symptoms, tests to diagnose, and treatment of childhood nasopharyngeal cancer in this expert-reviewed summary.

Which Childhood and Adolescent Psychiatric Disorders predict which Young Adult Disorders?

PubMed Central

Copeland, William E.; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

2009-01-01

Context Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. Objective To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. Design/Setting/Patients Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used, covering children in the community ages 9−16, 19, and 21 years old. Outcome Common psychiatric disorders were assessed in childhood (ages 9 to 12) and adolescence (ages 13 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Results Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder) and anxiety disorders, although this effect was primary accounted for by DSM-III-R overanxious disorder. Conclusions Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult

Transitions for Young Children: Creating Connections across Early Childhood Systems

ERIC Educational Resources Information Center

Kagan, Sharon Lynn, Ed.; Tarrant, Kate, Ed.

2010-01-01

Smooth early childhood transitions are key to ensuring positive outcomes for young children the world over--but in today's fragmented early education systems, it's difficult to ensure continuity among programs and services. Early childhood professionals will help change that with this book, the first to propose a comprehensive, practical framework…

Cognitive, behaviour, and academic functioning in adolescent and young adult survivors of childhood acute lymphoblastic leukaemia: a report from the Childhood Cancer Survivor Study.

PubMed

Jacola, Lisa M; Edelstein, Kim; Liu, Wei; Pui, Ching-Hon; Hayashi, Robert; Kadan-Lottick, Nina S; Srivastava, Deokumar; Henderson, Tara; Leisenring, Wendy; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

2016-10-01

Survivors of childhood acute lymphoblastic leukaemia (ALL) are at risk for neurocognitive deficits that affect development in adolescence and young adulthood, and influence educational attainment and future independence. We examined a large and diverse cohort of survivors to identify risk predictors and modifiers of these outcomes. In this cohort study, cognitive and behaviour symptoms were assessed via a standardised parent questionnaire for 1560 adolescent survivors of ALL diagnosed between 1970 and 1999. Clinically significant symptoms (≥90th percentile) and learning problems were compared between survivors and a sibling cohort. Multivariable regression models were used to examine associations with demographic and treatment characteristics. Models were adjusted for inverse probability of sampling weights to reflect undersampling of ALL survivors in the expansion cohort. In a subset of survivors with longitudinal data (n=925), we examined associations between adolescent symptoms or problems and adult educational attainment. Compared with siblings, survivors treated with chemotherapy only were more likely to demonstrate headstrong behaviour (155 [19%] of 752 survivors vs 88 [14%] of 610 siblings, p=0·010), inattention-hyperactivity (15 [19%] vs 86 [14%], p<0·0001), social withdrawal (142 [18%] vs 75 [12%], p=0·002), and had higher rates of learning problems (191 [28%] vs 76 [14%], p<0·0001). In multivariable models among survivors, increased cumulative dose of intravenous methotrexate (ie, >4·3 g/m 2 ) conferred increased risk of inattention-hyperactivity (relative risk [RR] 1·53, 95% CI 1·13-2·08). Adolescent survivors with cognitive or behaviour problems and those with learning problems were less likely to graduate from college as young adults than adolescent survivors without cognitive or behaviour problems. Although modern therapy for childhood ALL has eliminated the use of cranial radiation therapy, adolescent survivors treated with chemotherapy

Assessment of Fundamental Movement Skills in Childhood Cancer Patients.

PubMed

Naumann, Fiona L; Hunt, Mitchell; Hunt, Mitchel; Ali, Dulfikar; Wakefield, Claire E; Moultrie, Kevin; Cohn, Richard J

2015-12-01

The improved treatment protocols and subsequent improved survival rates among childhood cancer patients have shifted the focus toward the long-term consequences arising from cancer treatment. Children who have completed cancer treatment are at a greater risk of delayed development, diminished functioning, disability, compromised fundamental movement skill (FMS) attainment, and long-term chronic health conditions. The aim of the study was to compare FMS of childhood cancer patients with an aged matched healthy reference group. Pediatric cancer patients aged 5-8 years (n = 26; median age 6.91 years), who completed cancer treatment (<5 years) at the Sydney Children's Hospital, were assessed performing seven key FMS: sprint, side gallop, vertical jump, catch, over-arm throw, kick, and leap. Results were compared to the reference group (n = 430; 6.56 years). Childhood cancer patients scored significantly lower on three out of seven FMS tests when compared to the reference group. These results equated to a significantly lower overall score for FMS. This study highlighted the significant deficits in FMS within pediatric patients having completed cancer treatment. In order to reduce the occurrence of significant FMS deficits in this population, FMS interventions may be warranted to assist in recovery from childhood cancer, prevent late effects, and improve the quality of life in survivors of childhood cancer. © 2015 Wiley Periodicals, Inc.

Why did I get cancer? Perceptions of childhood cancer survivors in Korea.

PubMed

Yi, Jaehee; Kim, Min Ah; Parsons, Bridget G; Wu, Yelena P

2018-04-01

This study explored whether and how childhood cancer survivors in Korea ask and resolve the question of what may have caused their cancer. Thirty-one childhood cancer survivors participated in in-depth interviews about their self-questioning process in this regard. The findings indicate that Korean childhood cancer survivors pondered this question alone due to the stigma attached to cancer in the family and society. Their answers included internal factors (doing "bad things," having unhealthy eating habits, engaging in magical thinking, having a stress-prone personality, or having a biological susceptibility) or external factors (stressors, random events, the environment, or medical conditions). How they perceived the cause of cancer had an impact on aspects of their current lives. Psychosocial care standards or guidelines are needed in regard to the provision of a safe environment in which Korean cancer survivors and their parents can share their perceptions and process their thoughts.

Development and Content Validation of the Transition Readiness Inventory Item Pool for Adolescent and Young Adult Survivors of Childhood Cancer.

PubMed

Schwartz, Lisa A; Hamilton, Jessica L; Brumley, Lauren D; Barakat, Lamia P; Deatrick, Janet A; Szalda, Dava E; Bevans, Katherine B; Tucker, Carole A; Daniel, Lauren C; Butler, Eliana; Kazak, Anne E; Hobbie, Wendy L; Ginsberg, Jill P; Psihogios, Alexandra M; Ver Hoeve, Elizabeth; Tuchman, Lisa K

2017-10-01

The development of the Transition Readiness Inventory (TRI) item pool for adolescent and young adult childhood cancer survivors is described, aiming to both advance transition research and provide an example of the application of NIH Patient Reported Outcomes Information System methods. Using rigorous measurement development methods including mixed methods, patient and parent versions of the TRI item pool were created based on the Social-ecological Model of Adolescent and young adult Readiness for Transition (SMART). Each stage informed development and refinement of the item pool. Content validity ratings and cognitive interviews resulted in 81 content valid items for the patient version and 85 items for the parent version. TRI represents the first multi-informant, rigorously developed transition readiness item pool that comprehensively measures the social-ecological components of transition readiness. Discussion includes clinical implications, the application of TRI and the methods to develop the item pool to other populations, and next steps for further validation and refinement. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Psychosexual Functioning Among Adult Female Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Ford, Jennifer S.; Kawashima, Toana; Whitton, John; Leisenring, Wendy; Laverdière, Caroline; Stovall, Marilyn; Zeltzer, Lonnie; Robison, Leslie L.; Sklar, Charles A.

2014-01-01

Purpose Childhood cancer survivors may be at risk for impaired psychosexual functioning as a direct result of their cancer or its treatments, psychosocial difficulties, and/or diminished quality of life. Patients and Methods Two thousand one hundred seventy-eight female adult survivors of childhood cancer and 408 female siblings from the Childhood Cancer Survivor Study (CCSS) completed a self-report questionnaire about their psychosexual functioning and quality of life. On average, participants were age 29 years (range, 18 to 51 years) at the time of the survey, had been diagnosed with cancer at a median age of 8.5 years (range, 0 to 20) and were most commonly diagnosed with leukemia (33.2%) and Hodgkin lymphoma (15.4%). Results Multivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], −0.2; P = .01), lower sexual interest (MnD, −0.2; P < .01), lower sexual desire (MnD, −0.3; P < .01), lower sexual arousal (MnD, −0.3; P < .01), lower sexual satisfaction (MnD, −0.2; P = .01), and lower sexual activity (MnD, −0.1; P = .02) compared with siblings. Risk factors for poorer psychosexual functioning among survivors included older age at assessment, ovarian failure at a younger age, treatment with cranial radiation, and cancer diagnosis during adolescence. Conclusion Decreased sexual functioning among female survivors of childhood cancers seems to be unrelated to emotional factors and is likely to be an underaddressed issue. Several risk factors among survivors have been identified that assist in defining high-risk subgroups who may benefit from targeted screening and interventions. PMID:25113763

Accumulation of childhood poverty on young adult overweight or obese status: race/ethnicity and gender disparities.

PubMed

Hernandez, Daphne C; Pressler, Emily

2014-05-01

Childhood poverty is positively correlated with overweight status during childhood, adolescence and adulthood. Repeated exposure of childhood poverty could contribute to race/ethnicity and gender disparities in young adult overweight/obese (OV/OB) weight status. Young adults born between 1980 and 1990 who participated in the Young Adult file of the 1979 National Longitudinal Study of Youth were examined (N=3901). The accumulation of childhood poverty is captured via poverty exposure from each survey year from the prenatal year through age 18 years. Body mass index was calculated and categorised into the reference criteria for adults outlined by the Center for Disease Control. Logistic regression models were stratified by race/ethnicity and included a term interacting poverty and gender, along with a number of covariates, including various longitudinal socioeconomic status measures and indicators for the intergenerational transmission of economic disadvantage and body weight. Reoccurring exposure to childhood poverty was positively related to OV/OB for white, black and Hispanic young adult women and inversely related for white young adult men. A direct relationship between the accumulation of childhood poverty and OV/OB was not found for black and Hispanic young adult men. Helping families move out of poverty may improve the long-term health status of white, black and Hispanic female children as young adults. Community area interventions designed to change impoverished community environments and assist low-income families reduce family level correlates of poverty may help to reduce the weight disparities observed in young adulthood.

Remembering Childhood: Do Our Memories and Experiences Influence Our Understanding of Early Childhood and Our Practice with Young Children?

ERIC Educational Resources Information Center

Horsley, Karen; Penn, Helen

2014-01-01

Students on the Early Childhood Studies degree programme at the University of East London were asked to reflect on their childhood memories and how these have shaped their understandings of early childhood and practices with young children. Students' rich and varied accounts reflect the diversity of largely non-traditional students from countries…

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

PubMed Central

Hammen, Constance L.; Brennan, Patricia A; Najman, Jake M.

2016-01-01

Objective Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health. Design The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384). Main Outcome Measures The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood. Results The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood. Conclusions Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood. PMID:27329508

Hypothyroidism after Radiation Therapy for Childhood Cancer: A Report from the Childhood Cancer Survivor Study.

PubMed

Inskip, Peter D; Veiga, Lene H S; Brenner, Alina V; Sigurdson, Alice J; Ostroumova, Evgenia; Chow, Eric J; Stovall, Marilyn; Smith, Susan A; Weathers, Rita E; Leisenring, Wendy; Robison, Leslie L; Armstrong, Gregory T; Sklar, Charles A; Lubin, Jay H

2018-05-15

While thyroid cancer risks from exposure to ionizing radiation early in life are well characterized quantitatively, the association of radiation with nonmalignant, functional thyroid disorders has been less studied. Here, we report on a risk analysis study of hypothyroidism with radiation dose to the thyroid gland and the hypothalamic-pituitary axis among survivors of childhood cancer. Utilizing data from the Childhood Cancer Survivor Study, a cohort of 14,364 five-year survivors of childhood cancer diagnosed at 26 hospitals in the U.S. and Canada between 1970 and 1986 and followed through 2009, the occurrence of hypothyroidism was ascertained among 12,015 survivors through serial questionnaires. Radiation doses to the thyroid gland and pituitary gland were estimated from radiotherapy records. Binary outcome regression was used to estimate prevalence odds ratios for hypothyroidism at five years from diagnosis of childhood cancer and Poisson regression to model incidence rate ratios (RR) after the first five years. A total of 1,193 cases of hypothyroidism were observed, 777 (65%) of which occurred five or more years after cancer diagnosis. The cumulative proportion affected with hypothyroidism (prevalence at five years after cancer diagnosis plus incidence through 30 years after cancer diagnosis) was highest among five-year survivors of Hodgkin lymphoma (32.3%; 95% CI: 29.5-34.9) and cancers of the central nervous system (17.7%; 95% CI: 15.2-20.4). The incidence rate was significantly associated with radiation dose to the thyroid and pituitary. The joint association of hypothyroidism with thyroid and pituitary dose was sub-additive for pituitary doses greater than 16 Gy. In particular, a very strong thyroid radiation dose dependence at low-to-moderate pituitary/hypothalamic doses was diminished at high pituitary doses. Radiation-related risks were higher in males than females and inversely associated with age at exposure and time since exposure but remained elevated

A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study.

PubMed

Mendoza, Jason A; Baker, K Scott; Moreno, Megan A; Whitlock, Kathryn; Abbey-Lambertz, Mark; Waite, Alan; Colburn, Trina; Chow, Eric J

2017-12-01

Physical activity (PA) may be important for preventing chronic diseases for adolescent and young adult (AYA) childhood cancer survivors. Randomized controlled trials (RCTs) of PA interventions for AYA survivors are sparse, but necessary to determine effective programs for increasing PA among this population. Thus, we conducted a pilot RCT, testing the feasibility of a mobile health (mHealth) intervention to promote PA among AYA survivors. We recruited 14- to 18-year-olds who were ≥1-year post cancer therapy from Seattle Children's Hospital. The 10-week intervention consisted of a wearable PA-tracking device (Fitbit Flex) and a peer-based virtual support group (Facebook group). Research staff helped set step goals and awarded badges weekly. Controls received usual care. Baseline assessments occurred before randomization and follow-up assessments occurred during weeks 8-10 of the intervention period. Feasibility criteria are defined below. Qualitative interviews assessed acceptability. Exploratory outcomes included PA, quality of life, and motivation for PA. All feasibility criteria were met: we recruited 60 survivors, intervention participants wore the Fitbit on the majority (71.5%) of intervention days, and ≥90% of all participants completed questionnaires. Qualitative data confirmed intervention acceptability. Exploratory analyses found no significant adjusted group differences for change in moderate-to-vigorous PA (4.4 vs. 5.0 min/day; P = 0.92) or sedentary time (-4.5 vs. 1.0 min/day; P = 0.73), comparing intervention subjects to controls. Some modest differences were found for select subscales of quality of life and motivation for PA. This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT. © 2017 Wiley Periodicals, Inc.

Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors.

PubMed

Sukhu, Troy; Ross, Sherry; Coward, R Matthew

2018-01-27

Urological survivorship issues encompass an area that may potentially be overlooked after treatment of childhood cancer in adolescent boys and young men. Side effects of cancer therapy may include subsequent development of erectile dysfunction (ED), hypogonadism, and infertility in adulthood. The purpose of this review is to focus on the etiology and prevalence of the range of sexual and gonadal dysfunction in adolescent boys and young men who are cancer survivors, while discussing current recommendations for evaluation and treatment. We performed a literature review of articles evaluating hypogonadism, sexual dysfunction, ED, and infertility in young men cancer survivors. There is compelling evidence that significant survivorship issues are faced by boys entering adulthood after completing cancer therapy. Overall, young men cancer survivors are much more likely to report symptoms of sexual dysfunction than the general population of men. These patients can develop ED due to physiologic and psychological changes that take place with diagnosis of a malignancy and subsequent treatment. Primary hypogonadism can arise due to pelvic radiation or chemotherapy, and central hypogonadism may arise from pituitary insufficiency after brain radiation or surgery. Infertility develops from direct damage to the Sertoli cells and germinal epithelium from radiotherapy or chemotherapy. Cancer survivors who are men should therefore be screened for these important urological survivorship issues, although exact surveillance strategies remain unclear. Urological survivorship issues including ED, hypogonadism, and infertility are common among cancer survivors and result in significant morbidity. Due to the medical complexity of cancer survivorship, the population of adolescent and young adult survivors would benefit from a network of multidisciplinary survivorship experts to aid the transition into adulthood. Improved research efforts may help to clarify risk factors and to develop

Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study.

PubMed

Nathan, Paul Craig; Ness, Kirsten Kimberlie; Mahoney, Martin Christopher; Li, Zhenghong; Hudson, Melissa Maria; Ford, Jennifer Sylene; Landier, Wendy; Stovall, Marilyn; Armstrong, Gregory Thomas; Henderson, Tara Olive; Robison, Leslie L; Oeffinger, Kevin Charles

2010-10-05

Survivors of childhood cancer may develop a second malignant neoplasm during adulthood and therefore require regular surveillance. To examine adherence to population cancer screening guidelines by survivors at average risk for a second malignant neoplasm and adherence to cancer surveillance guidelines by survivors at high risk for a second malignant neoplasm. Retrospective cohort study. The Childhood Cancer Survivor Study (CCSS), a 26-center study of long-term survivors of childhood cancer that was diagnosed between 1970 and 1986. 4329 male and 4018 female survivors of childhood cancer who completed a CCSS questionnaire assessing screening and surveillance for new cases of cancer. Patient-reported receipt and timing of mammography, Papanicolaou smear, colonoscopy, or skin examination was categorized as adherent to the U.S. Preventive Services Task Force guidelines for survivors at average risk for breast or cervical cancer or the Children's Oncology Group guidelines for survivors at high risk for breast, colorectal, or skin cancer as a result of cancer therapy. In average-risk female survivors, 2743 of 3392 (80.9%) reported having a Papanicolaou smear within the recommended period, and 140 of 209 (67.0%) reported mammography within the recommended period. In high-risk survivors, rates of recommended mammography among women were only 241 of 522 (46.2%) and the rates of colonoscopy and complete skin examinations among both sexes were 91 of 794 (11.5%) and 1290 of 4850 (26.6%), respectively. Data were self-reported. Participants in the CCSS are a selected group of survivors, and their adherence may not be representative of all survivors of childhood cancer. Female survivors at average risk for a second malignant neoplasm show reasonable rates of screening for cervical and breast cancer. However, surveillance for new cases of cancer is very low in survivors at the highest risk for colon, breast, or skin cancer, suggesting that survivors and their physicians need

Childhood friendships and psychological difficulties in young adulthood: an 18 year follow-up study

PubMed Central

Sakyi, Kwame S.; Surkan, Pamela J.; Fombonne, Eric; Chollet; Melchior, Maria

2014-01-01

Childhood friendships have been shown to impact mental health over the short-term, however, it is unclear whether these effects are sustained into young adulthood. We studied the prospective association between childhood friendships and psychological difficulties in young adulthood. Data come from 1103 French 22–35 year olds participating in the TEMPO study. Childhood friendships were ascertained in 1991 when participants were 4–16 years old. Psychological difficulties were measured in 2009 using the Adult Self-Report. Logistic regression models controlled for participants’ age, sex, childhood psychological difficulties and parental characteristics. Young adults who had no childhood friends had higher odds of psychological difficulties than those with at least one friend: (adjusted ORs: 2.45; 95% CI: 1.32–4.66, p=0.01 for high internalizing symptoms; 1.81; 95% CI: 0.94–3.54, p=0.08 for high externalizing symptoms). Social relations early in life may have consequences for adult psychological well-being. PMID:25316094

From Adjustment to Thriving: Exploring Well-Being in Young Adult Survivors of Childhood Cancer and Their Siblings.

PubMed

Scrignaro, Marta; Nichelli, Francesca; Cattaneo, Laura; Spinelli, Marco; Magrin, Maria Elena; Fraschini, Donatella; Biondi, Andrea; Jankovic, Momcilo

2016-12-01

Few studies have addressed the adaptive mental health status of young adult (YA) survivors of childhood cancer (SCCs) and the siblings (SIBs) of the same families. This article explores the existence of different psychological well-being (PWB) profiles and verifies their relationship with life satisfaction, resilience, and mental adjustment among Italian YA survivors of childhood leukemia or lymphoma and their own SIBs. YA SCCs (n = 35) who had been off primary treatment for at least 5 years and their SIBs (n = 47) completed anonymous self-report questionnaires for PWB, life satisfaction, resilience, and mental adjustment. The survivors at the time of the survey had an average age of 27 years (SD 3.37) and they were an average age of 12 years (SD 1.93) at diagnosis. Their own SIBs had an average age of 29 years (SD ±5.25). No significant differences were found between SCCs and their SIBs in all considered dimensions. Only 12% of the sample showed evidence of clinically significant mental health disorders, 51% manifested medium levels of resilience, and 49% fit a functional PWB profile. By means of cluster analysis, three PWB statuses could be derived: self-devaluing (25.5%), fatalist (25.5%), and eudaimonic (49%). Each of these PWB statuses exhibited a significant distinct profile in terms of life satisfaction, resilience, and mental adjustment. There is a need to establish psychosocial services that offer follow-up examinations aimed to not only prevent mental disorders but also to promote PWB.

Childhood Cancer in the Classroom: Information for the School Nurse.

ERIC Educational Resources Information Center

VanDenburgh, Kari

2003-01-01

The school nurse is a resource and support to students, school personnel, and communities with respect to students with cancer. This article discusses: general cancer information and statistics; childhood cancer versus adult cancer; treatments for childhood cancer; and information for school nurses (e.g., central venous catheters in school,…

Childhood Predictors of Young Adult Social Functioning in 22q11.2 Deletion Syndrome

ERIC Educational Resources Information Center

Wagner, Kayla E.; Kates, Wendy R.; Fremont, Wanda; Antshel, Kevin M.

2017-01-01

The primary objectives of the current prospective longitudinal study were to (a) describe social functioning outcomes and (b) identify childhood predictors of social functioning in young adults with (22q11.2DS). Childhood predictors of young adult social functioning were examined. Family environment and parental stress in adolescence were…

Childhood Executive Function Continues to Predict Outcomes in Young Adult Females with and without Childhood-Diagnosed ADHD

ERIC Educational Resources Information Center

Miller, Meghan; Nevado-Montenegro, Adriana J.; Hinshaw, Stephen P.

2012-01-01

We prospectively followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 10 years, from middle childhood through late adolescence/young adulthood. Our aim was to examine the ability of childhood measures of executive function (EF) to predict…

Importance of updating family cancer history in childhood cancer survivors.

PubMed

Russo, Selena; Warby, Meera; Tucker, Katherine M; Wakefield, Claire E; Cohn, Richard J

2017-10-01

Estimates of the number of childhood cancers with a genetic basis range from 5-8.5% found in germline samples to 29% based on clinical criteria. Family history-taking practice is a fundamental first step in detecting at risk individuals and families. This study focused on Li-Fraumeni Syndrome (LFS), a highly penetrant cancer syndrome. Reported family history in a cohort of 648 of cancer survivor cohort (CCS) was examined. Eligible CCS were: (i) aged up to 14 years at diagnosis; (ii) more than 5 years postdiagnosis; (iii) treated for a childhood cancer at the study hospitals in NSW, Australia; (iv) in remission for more than 3 years. CCS completed self-administered questionnaires. Medical records confirmed diagnosis and treatment-related information. Our findings reveal an increased cancer risk among sibling and relatives of CCS. 91% of siblings diagnosed with cancer were diagnosed under the age of 40 and about 30% diagnosed under the aged of 15 revealing a 5- (RR = 5.1; 95% CI, 3.3-7.9) and 44-fold (RR = 44.6; 95% CI, 18.4-108.3) increased risked of cancer compared with the Australian population, respectively. About 2% of CCS reported that they had been diagnosed with a genetic cancer syndrome. However, 11% of survivors described a family history pattern which met Chompret criteria for screening for TP53 mutations associated with LFS. Our data suggests that familial cancer predispositions may be initially overlooked. Aperiodic and accurate ascertainment of family cancer history of childhood cancer patients and survivors is therefore recommended.

Distinct health behavior and psychosocial profiles of young adult survivors of childhood cancers: a mixed methods study.

PubMed

Lowe, Kincaid; Escoffery, Cam; Mertens, Ann C; Berg, Carla J

2016-08-01

We used a mixed-methods approach to examine health behavior profiles of young adult cancer survivors and characterize related sociodemographic and psychosocial factors. We conducted a mail-based survey assessing sociodemographics, cancer treatment, health behaviors (e.g., tobacco use, physical activity), healthcare provider interactions, and psychosocial factors (e.g., Profile of Moods States [POMS]) among 106 young adult survivors from a southeastern cancer center and semi-structured interviews among a subset of 26. A k-means cluster analysis using eight health behaviors yielded three distinct health behavior profiles: high risk (n = 25), moderate risk (n = 39), and low risk (n = 40). High risks had the highest current alcohol, tobacco, and marijuana use; physical activity; and number of sexual partners (p's < 0.001). They had higher symptoms of POMS tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p's < 0.05). Moderate risks had lowest physical activity (p < 0.05) but otherwise had moderate health behaviors. Low risks had the lowest alcohol, tobacco, and marijuana use and fewest sexual partners (p's < 0.05). They had the lowest levels of tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p's < 0.05). Qualitative interviews showed that cancer had a range of effects on health behaviors and variable experiences regarding how healthcare providers address these behaviors. Assessing health behavior profiles, rather than individual health behaviors, is informative in characterizing young adult cancer survivors and targeting survivorship care. Young adult cancer survivors demonstrate distinct health behavior profiles and are differentially impacted by the experience of cancer. Healthcare providers should be consistently intervening to ensure that survivors understand their specific health risks.

Am I a 6 or a 10? Mate Value Among Young Adult Survivors of Childhood Cancer and Healthy Peers.

PubMed

Lehmann, Vicky; Tuinman, Marrit A; Keim, Madelaine C; Hagedoorn, Mariët; Gerhardt, Cynthia A

2018-02-01

This study focused on self-perceived mate value of young adult survivors of childhood cancer relative to healthy peers. Qualitative studies indicate potential problems surrounding romantic relationships among survivors, but systematic studies are missing. One-hundred forty-nine childhood cancer survivors and 149 matched controls completed online questionnaires about their mate value, social comparison strategies (i.e., upward/downward identifying/contrasting strategies), and marital status. Survivors and controls were aged 20-40 (M = 27.8), 55% were female, and survivors had been treated for brain tumors (n = 52; 35%), leukemia (n = 42; 28%), lymphoma (n = 31; 21%), or other solid tumors (n = 24; 16%) at 5-33 years before study participation. Survivors and controls did not differ on overall mate value, but on individual characteristics: Survivors thought they had a better sense of humor (d = 0.36), were more loyal (d = 0.32), had higher social status (d = 0.26), and were more ambitious (d = 0.19), while also considering themselves less sexually adventurous (d = 0.31), less healthy (d = 0.26), having less desire to have children (d = 0.21), and a less attractive face (d = 0.20). Higher mate value was related to being partnered, more upward-identifying, less upward-contrasting, and less downward-identifying strategies. Moreover, less downward-identifying was associated with higher mate value in survivors, but not controls; whereas greater downward-contrasting was associated with higher mate value among controls only (R 2  = 30.8%). Survivors do not generally view themselves as less valuable (potential) romantic partners, but they evaluate different characteristics either more positively or more negatively. Social comparison strategies offer targetable points of interventions to intervene on negative self-evaluations, potentially enhancing well-being.

Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

ERIC Educational Resources Information Center

Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

2012-01-01

The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

The impact of childhood gender expression on childhood sexual abuse and psychopathology among young men who have sex with men.

PubMed

Hidalgo, Marco A; Kuhns, Lisa M; Kwon, Soyang; Mustanski, Brian; Garofalo, Robert

2015-08-01

Young men who have sex with men (MSM) are a risk group highly vulnerable to HIV infection and psychiatric symptoms are direct predictors of sexual risk behavior in MSM. Childhood sexual abuse (CSA) is associated with psychiatric symptomology in adolescence, and MSM are disproportionately impacted by CSA compared to heterosexuals. Some evidence suggests that childhood gender nonconformity, a natural variation of human gender expression, is more common in MSM than heterosexual males and places MSM at greater risk for CSA. This study examined whether or not childhood gender expression moderated the association between incidents of unwanted, early sexual experiences occurring before age 13 (ESE) and current psychiatric symptomology in a community-based sample of 449 young MSM aged 16-20. Analyses revealed significant bivariate associations between ESE and psychological symptoms, and significant multivariable associations between ESE, gender nonconformity and psychiatric outcomes. Young MSM with childhood gender nonconformity may be disproportionately victimized by CSA thereby increasing their likelihood of developing psychiatric symptoms in adolescence. Early intervention addressing these factors may help reduce lifetime negative sequelae. Copyright © 2015 Elsevier Ltd. All rights reserved.

The impact of childhood gender expression on childhood sexual abuse and psychopathology among young men who have sex with men

PubMed Central

Hidalgo, Marco A.; Kuhns, Lisa M.; Kwon, Soyang; Mustanski, Brian; Garofalo, Robert

2015-01-01

Young men who have sex with men (MSM) are a risk group highly vulnerable to HIV infection and psychiatric symptoms are direct predictors of sexual risk behavior in MSM. Childhood sexual abuse (CSA) is associated with psychiatric symptomology in adolescence, and MSM are disproportionately impacted by CSA compared to heterosexuals. Some evidence suggests that childhood gender nonconformity, a natural variation of human gender expression, is more common in MSM than heterosexual males and places MSM at greater risk for CSA. This study examined whether or not childhood gender expression moderated the association between incidents of unwanted, early sexual experiences occurring before age 13 (ESE) and current psychiatric symptomology in a community-based sample of 449 young MSM aged 16–20. Analyses revealed significant bivariate associations between ESE and psychological symptoms, and significant multivariable associations between ESE, gender nonconformity and psychiatric outcomes. Young MSM with childhood gender nonconformity may be disproportionately victimized by CSA thereby increasing their likelihood of developing psychiatric symptoms in adolescence. Early intervention addressing these factors may help reduce lifetime negative sequelae. PMID:26002599

Predictors of inactive lifestyle among adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

PubMed

Ness, Kirsten K; Leisenring, Wendy M; Huang, Sujuan; Hudson, Melissa M; Gurney, James G; Whelan, Kimberly; Hobbie, Wendy L; Armstrong, Gregory T; Robison, Leslie L; Oeffinger, Kevin C

2009-05-01

: Participation in physical activity is important for childhood cancer survivors, because inactivity may compound cancer/treatment-related late effects. However, some survivors may have difficulty participating in physical activity, and these individuals need to be identified so that risk-based guidelines for physical activity, tailored to specific needs, can be developed and implemented. The objectives of the current study were to document physical activity patterns in the Childhood Cancer Survivor Study (CCSS) cohort, to compare the physical activity patterns with siblings in the CCSS and with a population-based sample from the Behavioral Risk Factor Surveillance System, and to evaluate associations between diagnosis, treatment, and personal factors in terms of the risk for an inactive lifestyle. : Percentages of participation in recommended physical activity were compared among survivors, siblings, and population norms. Generalized linear models were used to evaluate the associations between cancer diagnosis and therapy, sociodemographics, and the risk for an inactive lifestyle. : Participants included 9301 adult survivors of childhood cancer and 2886 siblings. Survivors were less likely than siblings (46% vs 52%) to meet physical activity guidelines and were more likely than siblings to report an inactive lifestyle (23% vs 14%). Medulloblastoma (35%) and osteosarcoma (27%) survivors reported the highest levels of inactive lifestyle. Treatments with cranial radiation or amputation were associated with an inactive lifestyle as were being a woman, black race, older age, lower educational attainment, underweight or obese status, smoking, and depression. : Childhood cancer survivors were less active than a sibling comparison group or an age- and sex-matched population sample. Survivors who are at risk for an inactive lifestyle should be considered high priority for developing and testing of intervention approaches. Cancer 2009. (c) 2009 American Cancer Society.

Childhood Cancer Survivor Study: An Overview

Cancer.gov

Health problems that develop years later as a result of a cancer treatment are known as late effects. The Childhood Cancer Survivor Study (CCSS) was started in 1994 to better understand these late effects.

Unusual Cancers of Childhood Treatment (PDQ®)—Health Professional Version

Cancer.gov

The Unusual Cancers of Childhood Treatment summary addresses the treatment options for many uncommon childhood cancers. Get information about the diagnosis and treatment of cancers of the head and neck, chest, genitourinary system, and others in this summary for clinicians.

Annual Economic Burden of Productivity Losses Among Adult Survivors of Childhood Cancers.

PubMed

Guy, Gery P; Berkowitz, Zahava; Ekwueme, Donatus U; Rim, Sun Hee; Yabroff, K Robin

2016-11-01

Although adult survivors of childhood cancers have poorer health and greater health limitations than other adults, substantial gaps remain in understanding the economic consequences of surviving childhood cancer. Therefore, we estimated the economic burden of productivity losses among adult survivors of childhood cancers. We examined health status, functional limitations, and productivity loss among adult survivors of childhood cancers (n = 239) diagnosed at ≤14 years of age compared with adults without a history of cancer (n = 304 265) by using the 2004-2014 National Health Interview Survey. We estimated economic burden using the productivity loss from health-related unemployment, missed work days, missed household productivity, and multivariable regression models controlling for age, sex, race/ethnicity, education, comorbidities, and survey year. Childhood cancer survivorship is associated with a substantial economic burden. Adult survivors of childhood cancers are more likely to be in poorer health, need assistance with personal care and routine needs, have work limitations, be unable to work because of health, miss more days of work, and have greater household productivity loss compared with adults without a history of cancer (all P < .05). The annual productivity loss for adult survivors of childhood cancer is $8169 per person compared with $3083 per person for individuals without a history of cancer. These findings underscore the importance of efforts to reduce the health and economic burden among adult survivors of childhood cancer. In addition, this study highlights the potential productivity losses that could be avoided during adulthood from the prevention of childhood cancer in the United States. Copyright © 2016 by the American Academy of Pediatrics.

Physical exercise training interventions for children and young adults during and after treatment for childhood cancer.

PubMed

Braam, Katja I; van der Torre, Patrick; Takken, Tim; Veening, Margreet A; van Dulmen-den Broeder, Eline; Kaspers, Gertjan J L

2016-03-31

A decreased physical fitness has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of the disease and the treatment of childhood cancer. Exercise training for adult cancer patients has frequently been reported to improve physical fitness. In recent years, literature on this subject has also become available for children and young adults with cancer, both during and after treatment. This is an update of the original review that was performed in 2011. To evaluate the effect of a physical exercise training intervention on the physical fitness (i.e. aerobic capacity, muscle strength, or functional performance) of children with cancer within the first five years from their diagnosis (performed either during or after cancer treatment), compared to a control group of children with cancer who did not receive an exercise intervention.To determine whether physical exercise within the first five years of diagnosis has an effect on fatigue, anxiety, depression, self efficacy, and HRQoL and to determine whether there are any adverse effects of the intervention. We searched the electronic databases of Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and PEDro; ongoing trial registries and conference proceedings on 6 September 2011 and 11 November 2014. In addition, we performed a handsearch of reference lists. The review included randomized controlled trials (RCTs) and clinical controlled trials (CCTs) that compared the effects of physical exercise training with no training, in people who were within the first five years of their diagnosis of childhood cancer. Two review authors independently identified studies meeting the inclusion criteria, performed the data extraction, and assessed the risk of bias using standardized forms. Study quality was rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. Apart from the five studies in the original review, this

Missing content from health-related quality of life instruments: interviews with young adult survivors of childhood cancer.

PubMed

Quinn, Gwendolyn P; Huang, I-Chan; Murphy, Devin; Zidonik-Eddelton, Katie; Krull, Kevin R

2013-02-01

Young adult survivors of childhood cancer (YASCC) are an ever-growing cohort of survivors due to increasing advances in technology. Today, there is a shift of focus to not just ensuring survivorship but also the quality of survivorship, which can be assessed with standardized instruments. The majority of standardized health related quality of life (HRQoL) instruments, however, are non-specific to this age group and the unique late effects within YASCC populations. The purpose of this study was to investigate the relevance and accuracy of standardized HRQoL instruments used with YASCC. In a previous study, HRQoL items from several instruments (SF-36, QLACS, QLS-CS) were examined for relevance with a population of YASCC. Participants (n = 30) from this study were recruited for a follow-up qualitative interview to expand on their perceptions of missing content from existing instruments. Respondents reported missing, relevant content among all three of the HRQoL instruments. Results identified three content areas of missing information: (1) Perceived sense of self, (2) Relationships, and (3) Parenthood. Existing HRQoL instruments do not take into account the progression and interdependence of emotional development impacted by a cancer diagnosis. The themes derived from our qualitative interviews may serve as a foundation for the generation of new items in future HRQoL instruments for YASCC populations. Further testing is required to examine the prevalence, frequency, and breadth of these items in a larger sample.

Using the area under the curve to reduce measurement error in predicting young adult blood pressure from childhood measures.

PubMed

Cook, Nancy R; Rosner, Bernard A; Chen, Wei; Srinivasan, Sathanur R; Berenson, Gerald S

2004-11-30

Tracking correlations of blood pressure, particularly childhood measures, may be attenuated by within-person variability. Combining multiple measurements can reduce this error substantially. The area under the curve (AUC) computed from longitudinal growth curve models can be used to improve the prediction of young adult blood pressure from childhood measures. Quadratic random-effects models over unequally spaced repeated measures were used to compute the area under the curve separately within the age periods 5-14 and 20-34 years in the Bogalusa Heart Study. This method adjusts for the uneven age distribution and captures the underlying or average blood pressure, leading to improved estimates of correlation and risk prediction. Tracking correlations were computed by race and gender, and were approximately 0.6 for systolic, 0.5-0.6 for K4 diastolic, and 0.4-0.6 for K5 diastolic blood pressure. The AUC can also be used to regress young adult blood pressure on childhood blood pressure and childhood and young adult body mass index (BMI). In these data, while childhood blood pressure and young adult BMI were generally directly predictive of young adult blood pressure, childhood BMI was negatively correlated with young adult blood pressure when childhood blood pressure was in the model. In addition, racial differences in young adult blood pressure were reduced, but not eliminated, after controlling for childhood blood pressure, childhood BMI, and young adult BMI, suggesting that other genetic or lifestyle factors contribute to this difference. 2004 John Wiley & Sons, Ltd.

Young Children's Enactments of Human Rights in Early Childhood Education

ERIC Educational Resources Information Center

Quennerstedt, Ann

2016-01-01

This paper explores ways in which human rights become part of and affect young children's everyday practices in early childhood education and, more particularly, how very young children enact human rights in the preschool setting. The study is conducted in a Swedish preschool through observations of the everyday practices of a group of children…

Pregnancy and Labor Complications in Female Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

PubMed Central

Bright, Chloe J.; Winter, David L.; Fidler, Miranda M.; Wong, Kwok; Guha, Joyeeta; Kelly, Julie S.; Frobisher, Clare; Edgar, Angela B.; Skinner, Roderick; Wallace, W. Hamish B.; Hawkins, Mike M.

2017-01-01

Abstract Background: Female survivors of childhood cancer treated with abdominal radiotherapy who manage to conceive are at risk of delivering premature and low-birthweight offspring, but little is known about whether abdominal radiotherapy may also be associated with additional complications during pregnancy and labor. We investigated the risk of developing pregnancy and labor complications among female survivors of childhood cancer in the British Childhood Cancer Survivor Study (BCCSS). Methods: Pregnancy and labor complications were identified by linking the BCCSS cohort (n = 17 980) to the Hospital Episode Statistics (HES) for England. Relative risks (RRs) of pregnancy and labor complications were calculated by site of radiotherapy treatment (none/abdominal/cranial/other) and other cancer-related factors using log-binomial regression. All statistical tests were two-sided. Results: A total of 2783 singleton pregnancies among 1712 female survivors of childhood cancer were identified in HES. Wilms tumor survivors treated with abdominal radiotherapy were at threefold risk of hypertension complicating pregnancy (relative risk = 3.29, 95% confidence interval [CI] = 2.29 to 4.71), while all survivors treated with abdominal radiotherapy were at risk of gestational diabetes mellitus (RR = 3.35, 95% CI = 1.41 to 7.93) and anemia complicating pregnancy (RR = 2.10, 95% CI = 1.27 to 3.46) compared with survivors treated without radiotherapy. Survivors treated without radiotherapy had similar risks of pregnancy and labor complications as the general population, except survivors were more likely to opt for an elective cesarean section (RR = 1.39, 95% CI = 1.16 to 1.70). Conclusions: Treatment with abdominal radiotherapy increases the risk of developing hypertension complicating pregnancy in Wilms tumor survivors, and diabetes mellitus and anemia complicating pregnancy in all survivors. These patients may require extra vigilance during pregnancy

Cancer in working-age is not associated with childhood adversities.

PubMed

Korpimäki, Sonja K; Sumanen, Markku P T; Sillanmäki, Lauri H; Mattila, Kari J

2010-05-01

Early life events are studied as potential causes of cancer. The objective here was to study childhood adversities in the etiology of cancer. The material comprised a population based random sample of 25 898 individuals among the Finnish working-aged population. In 1998 they were requested through six questions in a postal questionnaire to recall their childhood adversities. The cases consisted of people with cancer diagnosed 2000-2006 and registered in the Finnish Cancer Registry (n = 384). The rest of the sample consisted of cancer-free controls. The most common adversities were prolonged financial difficulties, serious conflicts in the family and someone in the family having been seriously or chronically ill. The cancer patients reported more prolonged financial difficulties and someone seriously or chronically ill in the family. They reported less parental divorce than the controls. The associations were not statistically significant after adjusting for age, sex, education, and health behaviour. Nor was there a significant difference in the total number of childhood adversities between the study group and the controls. On the whole, these cancer patients had not experienced more childhood adversities than the controls. According to our findings, there is no cause to attribute development of cancer in working age to childhood adversities. This information may also give relief to other family members.

Understanding Childhood Cancer. [CD-ROM].

ERIC Educational Resources Information Center

2001

This interactive multimedia CD-ROM presentation is intended for the parents and families of children who have recently been diagnosed with cancer. It begins with an introduction by a pediatric oncologist. It features menus that include over 200 questions commonly asked about childhood cancer, with answers in a slide presentation format. Menus…

Impact of Childhood Family Disruption on Young Adults' Relationships with Parents.

ERIC Educational Resources Information Center

Aquilino, William S.

1994-01-01

Explored implications of childhood family disruption for parent-adult child relations in sample of 4,516 young adults. Among young adults raised in single-parent families, relationships with custodial mothers and custodial fathers remained quite positive into early adulthood. Becoming noncustodial parent resulted in severe deterioration of…

Mental health trajectories from childhood to young adulthood affect the educational and employment status of young adults: results from the TRAILS study.

PubMed

Veldman, Karin; Reijneveld, Sijmen A; Ortiz, Josue Almansa; Verhulst, Frank C; Bültmann, Ute

2015-06-01

Young adults at work without basic educational level (BEL), and young adults in Neither Employment, Education nor Training (NEET) are at high risk of adverse employment outcomes. Evidence lacks on the impact of mental health problems during childhood, adolescence and young adulthood on employment outcomes of young adults. Therefore, the aims of this study were to (1) identify trajectories of mental health problems from childhood to young adulthood and (2) investigate the relation between these trajectories and the educational or employment status of young adults. Data were used from the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9-year follow-up. Trajectories of mental health problems measured at ages 11, 13.5, 16 and 19 years were identified in 1711 young adults with latent class growth models. Young adults with high-stable trajectories of total problems, from childhood to young adulthood, were more likely to work without BEL or be in NEET at age 19, than to be at school or to work with BEL (28.0% vs 16.0%, p=0.01). The same was found for externalising problems (35.3% vs 23.2%, p=0.02). For internalising and attention problems, no statistically significant differences were found. Young adults with high-stable trajectories of mental health problems from age 11 to 19, were at risk of adverse employment outcomes. Interventions reducing mental health problems in childhood may improve the educational or employment status of young adults and their chances for successfully entering the labour market. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Factor Structure of the Brief Symptom Inventory--18 in Adult Survivors of Childhood Cancer: Results from the Childhood Cancer Survivor Study

ERIC Educational Resources Information Center

Recklitis, Christopher J.; Parsons, Susan K.; Shih, Mei-Chiung; Mertens, Ann; Robison, Leslie L.; Zeltzer, Lonnie

2006-01-01

The factor structure of the Brief Symptom Inventory--18 (BSI-18; L. R. Derogatis, 2000) was investigated in a sample of adult survivors of childhood cancer enrolled in the Childhood Cancer Survivor Study (CCSS; N = 8,945). An exploratory factor analysis with a randomly chosen subsample supported a 3-factor structure closely corresponding to the 3…

Patterns of adverse childhood experiences and substance use among young adults: A latent class analysis.

PubMed

Shin, Sunny H; McDonald, Shelby Elaine; Conley, David

2018-03-01

Adverse childhood experiences (ACEs) have been strongly linked with subsequent substance use. The aim of this study was to investigate how different patterns of ACEs influence substance use in young adulthood. Using a community sample of young individuals (N=336; ages 18-25), we performed latent class analyses (LCA) to identify homogenous groups of young people with similar patterns of ACEs. Exposure to ACEs incorporates 13 childhood adversities including childhood maltreatment, household dysfunction, and community violence. Multiple linear and logistic regression models were used in an effort to examine the associations between ACEs classes and four young adult outcomes such as alcohol-related problems, current tobacco use, drug dependence symptoms, and psychological distress. LCA identified four heterogeneous classes of young people distinguished by different patterns of ACEs exposure: Low ACEs (56%), Household Dysfunction/Community Violence (14%), Emotional ACEs (14%), and High/Multiple ACEs (16%). Multiple regression analyses found that compared to those in the Low ACEs class, young adults in the High/Multiple ACEs class reported more alcohol-related problems, current tobacco use, and psychological symptoms, controlling for sociodemographic characteristics and common risk factors for substance use such as peer substance use. Our findings confirm that for many young people, ACEs occur as multiple rather than single experiences. The results of this research suggest that exposure to poly-victimization during childhood is particularly related to substance use during young adulthood. Copyright © 2017 Elsevier Ltd. All rights reserved.

Strontium-90 in deciduous teeth as a factor in early childhood cancer.

PubMed

Gould, J M; Sternglass, E J; Sherman, J D; Brown, J; McDonnell, W; Mangano, J J

2000-01-01

Strontium-90 concentrations in deciduous (baby) teeth of 515 children born mainly after the end of worldwide atmospheric nuclear bomb tests in 1980 are found to equal the concentrations in children born during atmospheric tests in the late 1950s. Recent Sr-90 concentrations in the New York-New Jersey-Long Island metropolitan area have exceeded the expected downward trend seen in both baby teeth and adult bone after the 1963 ban on atmospheric testing. Sharp rises and declines are also seen in Miami, Florida. In Suffolk County, Long Island, Sr-90 concentrations in baby teeth were significantly correlated with cancer incidence for children 0 to 4 years of age. A similar correlation of childhood malignancies with the rise and decline of Sr-90 in deciduous teeth occurred during the peak years of fallout in the 1950s and 1960s. Independent support for the relation between nuclear releases and childhood cancer is provided by a significant correlation with total alpha and beta activities in local surface water in Suffolk County. These results strongly support a major role of nuclear reactor releases in the increase of cancer and other immune-system-related disorders in young American children since the early 1980s.

SECONDARY GASTROINTESTINAL MALIGNANCIES IN CHILDHOOD CANCER SURVIVORS: A COHORT STUDY

PubMed Central

Henderson, Tara O.; Oeffinger, Kevin C.; Whitton, John; Leisenring, Wendy; Neglia, Joseph; Meadows, Anna; Crotty, Catherine; Rubin, David T.; Diller, Lisa; Inskip, Peter; Smith, Susan A.; Stovall, Marilyn; Constine, Louis S.; Hammond, Sue; Armstrong, Greg T.; Robison, Leslie L.; Nathan, Paul C.

2012-01-01

Background Childhood cancer survivors develop gastrointestinal malignancies more frequently and at a younger age than the general population, but risk factors for their development have not been well characterized. Objective To determine the risk and associated risk factors for gastrointestinal subsequent malignant neoplasms (SMN) in childhood cancer survivors. Design Retrospective cohort study. Setting The Childhood Cancer Survivor Study, a multi-center study of childhood cancer survivors diagnosed between 1970 and 1986. Patients 14,358 survivors of a malignancy diagnosed at < 21 years who had survived for 5 or more years from initial diagnosis. Measurements Standardized incidence ratios (SIR) for gastrointestinal SMN were calculated using age-specific population data. Multivariate Cox regression models identified associations between risk factors and gastrointestinal SMN development. Results At median follow-up of 22.8 years (range: 5.5-30.2), 45 gastrointestinal malignancies were identified. Gastrointestinal SMN risk was 4.6-fold higher in childhood cancer survivors than the general population (95% confidence interval [CI]: 3.5-6.1). Colorectal cancer SIR was 4.2 (95% CI: 2.8-6.3). The highest gastrointestinal SMN risk was associated with abdominal radiation (SIR=11.2, 95% CI: 7.6-16.4). However, survivors not exposed to radiation had a significantly increased risk (SIR=2.4, 95% CI-1.4-3.9). In addition to abdominal radiation, high dose procarbazine (RR=3.2, 95% CI 1.1-9.4) and platinum drugs (RR 7.6, 95% CI: 2.3-25.5) independently increased the gastrointestinal SMN risk. Limitations This cohort has not yet attained an age at which gastrointestinal malignancy risk is greatest. Conclusions Childhood cancer survivors, particularly those exposed to abdominal radiation, are at increased risk for gastrointestinal SMN. These findings suggest that surveillance of at-risk childhood cancer survivors should commence at a younger age than recommended for the general

Understanding the Pathways between Mothers' Childhood Maltreatment Experiences and Patterns of Insecure Attachment with Young Children via Symptoms of Depression.

PubMed

Khan, Maria; Renk, Kimberly

2018-05-11

Although research has suggested that mothers who experienced childhood maltreatment tend to exhibit heightened risk for attachment difficulties with their young children, less is known about the mechanisms underlying this association. Thus, this study examined mothers' symptoms of depression as a mediator in the relationship between mothers' childhood maltreatment experiences and patterns of insecure (i.e., anxious, avoidant, and disorganized) mother-young child attachment. Mothers (N = 146) with children aged 1½-to 5-years provided ratings of their childhood maltreatment experiences, attachment with their young children, and symptoms of depression. Mothers' symptoms of depression mediated significantly the relationship between mothers' childhood maltreatment experiences and patterns of insecure mother-young child attachment. These findings suggested that symptoms of depression in the context of mothers' childhood maltreatment may be related more directly to mother-young child attachment than childhood maltreatment experiences alone. These results demonstrated the importance of promoting trauma-informed parenting interventions for facilitating secure emotional connections between mothers and their young children.

Childhood cancer: overview of incidence trends and environmental carcinogens.

PubMed Central

Zahm, S H; Devesa, S S

1995-01-01

An estimated 8000 children 0 to 14 years of age are diagnosed annually with cancer in the United States. Leukemia and brain tumors are the most common childhood malignancies, accounting for 30 and 20% of newly diagnosed cases, respectively. From 1975 to 1978 to 1987 to 1990, cancer among white children increased slightly from 12.8 to 14.1/100,000. Increases are suggested for leukemia, gliomas, and, to a much lesser extent, Wilms' tumor. There are a few well-established environmental causes of childhood cancer such as radiation, chemotherapeutic agents, and diethylstilbestrol. Many other agents such as electromagnetic fields, pesticides, and some parental occupational exposures are suspected of playing roles, but the evidence is not conclusive at this time. Some childhood exposures such as secondhand cigarette smoke may contribute to cancers that develop many years after childhood. For some exposures such as radiation and pesticides data suggest that children may be more susceptible to the carcinogenic effects than similarly exposed adults. PMID:8549470

Childhood Adversities and Educational Attainment in Young Adulthood: The Role of Mental Health Problems in Adolescence.

PubMed

Veldman, Karin; Bültmann, Ute; Almansa, Josue; Reijneveld, Sijmen A

2015-11-01

The aims of this study were to examine whether the association between childhood adversities and educational attainment in young adulthood can be explained by mental health problems in adolescence and whether associations and pathways differ for boys and girls. Data were used of 2,230 participants from the Tracking Adolescents' Individual Lives Survey, a Dutch prospective cohort study with a 9-year follow-up. Childhood adversities were measured at age 11 years, mental health problems (i.e., externalizing, internalizing and attention problems with Youth Self-Report) at age 16 years, and educational attainment at age 19 years. Structural equation modeling was performed to analyze the data, overall and stratified by gender. Only among boys, childhood adversities were associated with low educational attainment in young adulthood. Externalizing problems in adolescence explained 5% of the association between childhood adversities and educational attainment. Furthermore, for both boys and girls, externalizing problems in adolescence had a direct effect on educational attainment in young adulthood. Among boys, childhood adversities are associated with poorer educational outcomes of young adults. A part of this association runs via adolescent externalizing problems. The results suggest that boys, compared with girls, are less capable to cope with childhood adversities. Monitoring of exposed boys to childhood adversities is of utmost importance. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Childhood Liver Cancer Treatment (PDQ®)—Patient Version

Cancer.gov

Treatment for pediatric liver cancer depends on many factors, including the type of cancer and whether it has spread. When possible, liver cancer is removed by surgery. Learn about the types of treatment options for childhood liver cancers.

Childhood Liver Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Childhood liver cancer has two major histologic subgroups: hepatoblastoma and hepatocellular carcinoma. Less common histologies are undifferentiated embryonal sarcoma of the liver, infantile choriocarcinoma, and vascular liver tumors. Get detailed information about newly diagnosed and recurrent childhood liver cancers including tumor biology, presentation, prognosis, staging, and treatment in this summary for clinicians.

Late Effects of Treatment for Childhood Cancer (PDQ®)—Patient Version

Cancer.gov

The treatment of cancer may cause health problems (late effects) for childhood cancer survivors months or years after successful treatment has ended. Get information about the long-term physical, psychological and social effects of treatment for childhood cancer in this expert-reviewed summary.

Cancer Prevention and Screening Practices of Siblings of Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

PubMed Central

Buchbinder, David; Mertens, Ann C.; Zeltzer, Lonnie K.; Leisenring, Wendy; Goodman, Pam; Lown, E. Anne; Alderfer, Melissa A.; Recklitis, Christopher; Oeffinger, Kevin; Armstrong, Gregory T.; Hudson, Melissa; Robison, Leslie L.; Casillas, Jacqueline

2012-01-01

Objective To compare the skin and breast/cervical cancer prevention/screening practices of adult siblings of childhood cancer survivors with controls and to identify modifying factors for these practices. Methods Cross-sectional, self-report data from 2,588 adult siblings of 5+ year survivors of childhood cancer were analyzed to assess cancer prevention/screening practices. Two age, sex and race/ethnicity-matched samples (n=5,915 and n=37,789) of the Behavioral Risk Factor Surveillance System participants served as the comparison populations. Sociodemographic and cancer-related data were explored as modifying factors for sibling cancer prevention/screening practices through multivariable logistic regression. Results Compared to controls, siblings were more likely to practice skin cancer prevention behaviors: use of protective clothing (OR 2.85, 95% 2.39-3.39), use of shade (OR 2. 11, 95% 1.88-2.36), use of sunscreen (OR 1.27, 95% 1.14-1.40), and wearing a hat (OR 1.77, 95% 1.58-1.98). No differences were noted for breast/cervical cancer screening including mammography and Pap testing. Having less than a high school education and lack of health insurance were associated with diminished cancer prevention/screening behaviors. Survivor diagnosis, treatment intensity, adverse health, chronic health conditions, and second cancers were not associated with sibling cancer prevention/screening behaviors. Conclusions Siblings of cancer survivors report greater skin cancer prevention practices when compared with controls; however, no differences were noted for breast/cervical cancer screening practices. Access to care and lack of education may be associated with decreased cancer prevention/screening behaviors. Interventions are needed to address these barriers. Impact Research should be directed at understanding the impact of the cancer experience on sibling health behaviors. PMID:22576363

Childhood Social Inequalities Influences Neural Processes in Young Adult Caregiving

PubMed Central

Kim, Pilyoung; Ho, S. Shaun; Evans, Gary W.; Liberzon, Israel; Swain, James E.

2016-01-01

Childhood poverty is associated with harsh parenting with a risk of transmission to the next generation. This prospective study examined the relations between childhood poverty and non-parent adults’ neural responses to infant cry sounds. While no main effects of poverty were revealed in contrasts of infant cry vs. acoustically matched white noise, a gender by childhood poverty interaction emerged. In females, childhood poverty was associated with increased neural activations in the posterior insula, striatum, calcarine sulcus, hippocampus and fusiform gyrus, while, in males, childhood poverty was associated with reduced levels of neural responses to infant cry in the same regions. Irrespective of gender, neural activation in these regions was associated with higher levels of annoyance with the cry sound and reduced desire to approach the crying infant. The findings suggest gender differences in neural and emotional responses to infant cry sounds among young adults growing up in poverty. PMID:25981334

Prenatal exposure to traffic-related air pollution and risk of early childhood cancers.

PubMed

Ghosh, Jo Kay C; Heck, Julia E; Cockburn, Myles; Su, Jason; Jerrett, Michael; Ritz, Beate

2013-10-15

Exposure to air pollution during pregnancy has been linked to the risk of childhood cancer, but the evidence remains inconclusive. In the present study, we used land use regression modeling to estimate prenatal exposures to traffic exhaust and evaluate the associations with cancer risk in very young children. Participants in the Air Pollution and Childhood Cancers Study who were 5 years of age or younger and diagnosed with cancer between 1988 and 2008 were had their records linked to California birth certificates, and controls were selected from birth certificates. Land use regression-based estimates of exposures to nitric oxide, nitrogen dioxide, and nitrogen oxides were assigned based on birthplace residence and temporally adjusted using routine monitoring station data to evaluate air pollution exposures during specific pregnancy periods. Logistic regression models were adjusted for maternal age, race/ethnicity, educational level, parity, insurance type, and Census-based socioeconomic status, as well as child's sex and birth year. The odds of acute lymphoblastic leukemia increased by 9%, 23%, and 8% for each 25-ppb increase in average nitric oxide, nitrogen dioxide, and nitrogen oxide levels, respectively, over the entire pregnancy. Second- and third-trimester exposures increased the odds of bilateral retinoblastoma. No associations were found for annual average exposures without temporal components or for any other cancer type. These results lend support to a link between prenatal exposure to traffic exhaust and the risk of acute lymphoblastic leukemia and bilateral retinoblastoma.

The relationship between types of childhood victimisation and young adulthood criminality.

PubMed

Howell, Kathryn H; Cater, Åsa K; Miller-Graff, Laura E; Schwartz, Laura E; Graham-Bermann, Sandra A

2017-10-01

Previous research suggests that some types of childhood abuse and neglect are related to an increased likelihood of perpetrating criminal behaviour in adulthood. Little research, however, has examined associations between multiple different types of childhood victimisation and adult criminal behaviour. We sought to examine the contribution of multiple and diverse childhood victimisations on adult criminal behaviour. Our central hypothesis was that, after controlling for gender, substance use and psychopathy, each type of childhood victimisation - specifically experience of property offences, physical violence, verbal abuse, sexual abuse, neglect and witnessed violence - would be positively and independently related to criminal behaviour in young adults. We examined data from a large, nationally representative sample of 2244 young Swedish adults who reported at least one form of victimisation, using hierarchical regression analysis to also account for gender, substance use and psychopathy. Experiences of physical assaults, neglect and witnessing violence as a child were significantly associated with adult criminal behaviour, but not experiences of property, verbal or sexual victimizations. Our findings help to identify those forms of harm to children that are most likely to be associated with later criminality. Even after accounting for gender, substance misuse and psychopathology, childhood experience of violence - directly or as a witness - carries risk for adulthood criminal behaviour, so such children need targeted support and treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Teaching Students with Childhood Cancer: It's More than Just the Disease

ERIC Educational Resources Information Center

Losinski, Mickey; Ennis, Robin Parks

2018-01-01

Childhood cancers are the second leading cause of death among children. Common childhood cancers include leukemia (34%), brain tumors (23%), and lymphomas (12%; Kaatsch, 2010). Fortunately, survival rates related to these diseases have been increasing (Phillips et al., 2015). There are approximately 388,500 survivors of childhood cancers, with…

Sustaining innovation and improvement in the treatment of childhood cancer: lessons from high-income countries.

PubMed

Pritchard-Jones, Kathy; Pieters, Rob; Reaman, Gregory H; Hjorth, Lars; Downie, Peter; Calaminus, Gabriele; Naafs-Wilstra, Marianne C; Steliarova-Foucher, Eva

2013-03-01

Cancer in children and adolescents is rare and biologically very different from cancer in adults. It accounts for 1·4% of all cancers worldwide, although this proportion ranges from 0·5% in Europe to 4·8% in Africa, largely because of differences in age composition and life expectancy. In high-income countries, survival from childhood cancer has reached 80% through a continuous focus on the integration of clinical research into front-line care for nearly all children affected by malignant disease. However, further improvement must entail new biology-driven approaches, since optimisation of conventional treatments has in many cases reached its limits. In many instances, such approaches can only be achieved through international collaborative research, since rare cancers are being subdivided into increasingly smaller subgroups on the basis of their molecular characteristics. The long-term effect of anticancer treatment on quality of life must also be taken into account because more than one in 1000 adults in high-income countries are thought to be survivors of cancer in childhood or adolescence. The introduction of drugs that are less toxic and more targeted than those currently used necessitates a partnership between clinical and translational researchers, the pharmaceutical industry, drug regulators, and patients and their families. This therapeutic alliance will ensure that efforts are focused on the unmet clinical needs of young people with cancer. Most children with cancer live in low-income and middle-income countries, and these countries account for 94% of all deaths from cancer in people aged 0-14 years. The immediate priority for these children is to improve access to an affordable, best standard of care in each country. Every country should have a national cancer plan that recognises the unique demographic characteristics and care needs of young people with cancer. Centralisation of the complex components of treatment of these rare diseases is essential

Childhood cancer and residential proximity to power lines. UK Childhood Cancer Study Investigators.

PubMed

2000-12-01

In the United Kingdom Childhood Cancer Study, a population-based case-control study covering the whole of England, Scotland and Wales, measured power-frequency magnetic fields were not found to be associated with risk for any malignancy. To examine further the risk associated with residential proximity to electricity supply equipment, distances to high-voltage lines, underground cables, substations and distribution circuits were collected for 3380 cases and 3390 controls. Magnetic field exposure from this equipment was calculated using distance, load and other circuit information. There was no evidence that either proximity to electrical installations or the magnetic field levels they produce in the UK is associated with increased risk of childhood leukaemia or any other cancer. Odds ratios of 0.73 (95% CI = 0.42-1.26) for acute lymphoblastic leukaemia, 0.75 (95% CI = 0.45-1.25) for all leukaemias, 1.08 (95% CI = 0.56-2.09) for central nervous system cancers and 0.92 (95% CI = 0.64-1.34) for all malignancies were obtained for residence within 50 m of an overhead line. When individuals with a calculated magnetic field exposure > or = 0.2 microT were compared to those in a reference category of exposure <0.1 microT, odds ratios of 0.51 (95% CI = 0.11-2.33) for acute lymphoblastic leukaemia, 0.41 (95% CI = 0. 09-1.87) for total leukaemia, 0.48 (95% CI =0.06-3.76) for central nervous system cancers and 0.62 (95% CI = 0.24-1.61) for all malignancies were obtained. Copyright 2000 Cancer Research Campaign.

Poverty and childhood cancer incidence in the United States.

PubMed

Pan, I-Jen; Daniels, Julie L; Zhu, Kangmin

2010-07-01

This study examined socioeconomic differentials in cancer incidence rates during 2000-2005 among children aged 0-19 in the United States. The data on childhood cancers, which were classified by the International Classification of Childhood Cancer, Third Edition (ICCC-3), were obtained from the Surveillance, Epidemiology, and End Results program. The socioeconomic status of residential area at diagnosis was estimated by county-level poverty rate in Census 2000, i.e., percentage of persons in the county living below the national poverty thresholds. Counties were categorized as low-, medium-, and high-poverty areas when the poverty rates were <10, 10-19.99, and 20% or higher, respectively. The results showed that medium- and high-poverty counties had lower age-adjusted incidence rates than low-poverty counties for total childhood cancers combined, central nervous system neoplasms (ICCC group III), neuroblastoma (group IV), renal tumors (group VI), and other malignant epithelial neoplasms and malignant melanomas (group XI). When the data were stratified by race, these associations were observed among whites, but not blacks. For leukemia (group I), poor counties had higher incidence rates than affluent counties for whites, but lower rates for blacks. This ecologic study provides perspective on area socioeconomic variations in childhood cancer incidence that warrants further research.

Vocational identity, positive affect, and career thoughts in a group of young adult central nervous system cancer survivors.

PubMed

Lange, Dustin D; Wong, Alex W K; Strauser, David R; Wagner, Stacia

2014-12-01

The aims of this study were as follows: (a) to compare levels of career thoughts and vocational identity between young adult childhood central nervous system (CNS) cancer survivors and noncancer peers and (b) to investigate the contribution of vocational identity and affect on career thoughts among cancer survivors. Participants included 45 young adult CNS cancer survivors and a comparison sample of 60 college students. Participants completed Career Thoughts Inventory, My Vocational Situation, and the Positive and Negative Affect Schedule. Multivariate analysis of variance and multiple regression analysis were used to analyze the data in this study. CNS cancer survivors had a higher level of decision-making confusion than the college students. Multiple regression analysis indicated that vocational identity and positive affect significantly predicted the career thoughts of CNS survivors. The differences in decision-making confusion suggest that young adult CNS survivors would benefit from interventions that focus on providing knowledge of how to make decisions, while increasing vocational identity and positive affect for this specific population could also be beneficial.

Links between Family Gender Socialization Experiences in Childhood and Gendered Occupational Attainment in Young Adulthood.

PubMed

Lawson, Katie M; Crouter, Ann C; McHale, Susan M

2015-10-01

Gendered occupational segregation remains prevalent across the world. Although research has examined factors contributing to the low number of women in male-typed occupations - namely science, technology, engineering, and math - little longitudinal research has examined the role of childhood experiences in both young women's and men's later gendered occupational attainment. This study addressed this gap in the literature by examining family gender socialization experiences in middle childhood - namely parents' attitudes and work and family life - as contributors to the gender typicality of occupational attainment in young adulthood. Using data collected from mothers, fathers, and children over approximately 15 years, the results revealed that the associations between childhood socialization experiences (∼10 years old) and occupational attainment (∼26 years old) depended on the sex of the child. For sons but not daughters, mothers' more traditional attitudes towards women's roles predicted attaining more gender-typed occupations. In addition, spending more time with fathers in childhood predicted daughters attaining less and sons acquiring more gender-typed occupations in young adulthood. Overall, evidence supports the idea that childhood socialization experiences help to shape individuals' career attainment and thus contribute to gender segregation in the labor market.

Psychological Symptoms, Social Outcomes, Socioeconomic Attainment, and Health Behaviors Among Survivors of Childhood Cancer: Current State of the Literature.

PubMed

Brinkman, Tara M; Recklitis, Christopher J; Michel, Gisela; Grootenhuis, Martha A; Klosky, James L

2018-06-06

The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer. Results suggest that although most survivors are psychologically well adjusted, survivors are at risk for anxiety and depression compared with siblings. Although the absolute risk of suicide ideation and post-traumatic stress symptoms is low, adult survivors are at increased risk compared with controls. Moreover, young adult survivors are at risk for delayed psychosexual development, lower rates of marriage or cohabitation, and nonindependent living. Survivors' socioeconomic attainment also is reduced, with fewer survivors graduating college and gaining full-time employment. Despite risk for late health-related complications, survivors of childhood cancer generally engage in risky health behaviors at rates similar to or only slightly lower than siblings and peers. CNS tumors and CNS-directed therapies are salient risk factors for poor psychosocial outcomes. In addition, physical health morbidities resulting from cancer-directed therapies are associated with worse psychosocial functioning. Several studies support the effectiveness of cognitive and behavioral interventions to treat psychological symptoms as well as to modify health behaviors. Additional randomized controlled trials are needed to evaluate the efficacy and long-term outcomes of intervention efforts. Future research should focus on the identification of potential genetic predispositions related to psychosocial outcomes to provide opportunities for preventive interventions among survivors of childhood cancer.

Preparing Early Childhood Teachers to Work With Young Dual Language Learners

PubMed Central

Zepeda, Marlene; Castro, Dina C.; Cronin, Sharon

2015-01-01

Teacher preparation is clearly linked to the quality of early childhood programs. In order for young dual language learners (DLLs) to be academically successful, teacher preparation should focus on those skills and abilities relevant to students’ particular needs. This article reviews the content of professional preparation for early educators working with young DLLs and briefly discusses the importance of developing the cultural and linguistic diversity of the early childhood workforce. It identifies 6 content areas: (a) understanding language development, (b) understanding the relationship between language and culture, (c) developing skills and abilities to effectively teach DLLs, (d) developing abilities to use assessment in meaningful ways for DLLs, (e) developing a sense of professionalism, and (f) understanding how to work with families. PMID:26500692

Preparing Early Childhood Teachers to Work With Young Dual Language Learners.

PubMed

Zepeda, Marlene; Castro, Dina C; Cronin, Sharon

2011-03-01

Teacher preparation is clearly linked to the quality of early childhood programs. In order for young dual language learners (DLLs) to be academically successful, teacher preparation should focus on those skills and abilities relevant to students' particular needs. This article reviews the content of professional preparation for early educators working with young DLLs and briefly discusses the importance of developing the cultural and linguistic diversity of the early childhood workforce. It identifies 6 content areas: (a) understanding language development, (b) understanding the relationship between language and culture, (c) developing skills and abilities to effectively teach DLLs, (d) developing abilities to use assessment in meaningful ways for DLLs, (e) developing a sense of professionalism, and (f) understanding how to work with families.

Health Promoting Lifestyle Among Israeli Adult Survivors of Childhood Cancer.

PubMed

Liebergall-Wischnitzer, Michal; Buyum, Moriya; DeKeyser Ganz, Freda

2016-01-01

Childhood cancer survivors are at risk for recurrence of their primary cancer as well as other secondary site cancers. The survivors are also at increased risk for long-term effects such as chronic illnesses. Health promoting lifestyles are therefore especially important for childhood cancer survivors. The purpose of the study was to describe the health promoting behaviors of childhood cancer survivors and to determine whether these behaviors are associated with demographic and clinical characteristics. This is a descriptive-comparative study that took place in an oncology follow-up clinic in Israel. Seventy-seven childhood cancer survivors. Health Promoting Lifestyle Profile 2, questionnaire (interpersonal relationships, spiritual growth, physical activity, nutrition, health responsibility, and stress management), and smoking and alcohol consumption and a demographic-clinical questionnaire. The mean item score was moderate-high. Survivors scored highest on interpersonal relationships and spiritual growth while the lowest scoring activities were physical activity and nutrition. About 30% of the survivors abstained from smoking and alcohol consumption. Women, as opposed to men, were more likely to have higher scores related to nutrition and interpersonal relationships while singles as opposed to those who were married were found to have higher scores related to spiritual growth. Health behaviors associated with interpersonal relationships and spiritual growth were more likely to be performed compared to physical activity, good nutrition, and decreased smoking and alcohol consumption. Special attention should be placed on promoting physical activity and good nutrition among survivors of childhood cancer. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Early Childhood Care & Education: Basic Indicators on Young Children.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France). Young Child and the Family Environment Unit.

This document provides information on eleven basic indicators of the well being of young children, their families, and communities worldwide. It consists of two parts: The first summarizes information on the importance of the early childhood period for children, the education system, and parents; describes the organization of efficient early…

Skin Cancer Surveillance Behaviors Among Childhood Cancer Survivors.

PubMed

Stapleton, Jerod L; Tatum, Kristina L; Devine, Katie A; Stephens, Sue; Masterson, Margaret; Baig, Amna; Hudson, Shawna V; Coups, Elliot J

2016-03-01

The risk of developing skin cancer is elevated among childhood cancer survivors (CCS), particularly among those treated with radiation. This survey study examined the skin cancer surveillance behaviors of 94 CCS. Approximately 48% of CCS had ever conducted skin self-examination (SSE) and 31% had ever received a physician skin examination. Rates of physician skin examination were 2.5 times higher among CCS treated with radiation compared to those without radiation. However, rates of SSEs did not differ based on treatment history. These findings highlight the need to promote skin cancer surveillance as an important aspect of CCS survivorship care. © 2015 Wiley Periodicals, Inc.

Childhood stature and adult cancer risk: the Boyd Orr cohort.

PubMed

Whitley, Elise; Martin, Richard M; Smith, George Davey; Holly, Jeff M P; Gunnell, David

2009-03-01

Cancer risk in adulthood may be influenced by aspects of childhood diet. In the absence of direct dietary data, indirect measures of childhood diet and nutritional status, such as anthropometric measurements, may be useful in investigating diet-cancer associations. Previous studies suggest that taller adults may have increased cancer risk. Peak growth for different anthropometric measures occurs at different times and so differential associations with cancer risk may indicate periods of development that are particularly important in determining future risk. 2,642 traced members of the Boyd Orr cohort had measures of foot length, shoulder breadth, height, and leg length made when they were aged 2-14 years; trunk length was derived from the difference between overall height and leg length. Subjects were followed-up over 59 years to determine all-cause (n = 547) and site-specific (n = 97 for lung, 69 breast, 59 colorectal, 33 prostate, 320 not related to smoking) cancer deaths and registrations. There were no strong associations between childhood anthropometric measurements and adult cancer risk. Odds ratios (ORs) were broadly consistent with a slight increase in risk with increasing childhood stature but no single measure was of particular importance. The strongest associations were seen for breast cancer (OR per standard deviation increase in foot length: 1.16 (95% CI: 0.90, 1.51), shoulder breadth: 1.16 (0.91, 1.49) and trunk: 1.26 (1.00, 1.60), and prostate cancer (OR for foot length: 1.22 (0.86, 1.75)). There was little effect of adjustment for confounding factors and very limited evidence that associations differed with measures made prior to the onset of puberty (comparing the associations in children aged <8 vs. 8+ years). There was no evidence that any of the five indicators of childhood growth was more strongly related to cancer risk than the other measures.

Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

PubMed

Dietz, Andrew C; Chen, Yan; Yasui, Yutaka; Ness, Kirsten K; Hagood, James S; Chow, Eric J; Stovall, Marilyn; Neglia, Joseph P; Oeffinger, Kevin C; Mertens, Ann C; Robison, Leslie L; Armstrong, Gregory T; Mulrooney, Daniel A

2016-12-01

Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for activity limitations with pulmonary complications. By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6% (95% CI, 29.1%-30.0%) for cancer survivors and 26.5% (95% CI, 24.9%-28.0%) for siblings. Fewer survivors reported ever smoking (23.6% vs 36.4%, P < .001), but survivors were more likely to report chronic cough (rate ratio [RR], 1.6; 95% CI, 1.4-1.9), oxygen need (RR, 1.8; 95% CI, 1.5-2.2), lung fibrosis (RR, 3.5; 95% CI, 2.3-5.4), and recurrent pneumonia (RR, 2.0; 95% CI, 1.4-3.0). The SMR for death due to pulmonary causes was 5.9 (95% CI, 4.2-8.1), and it was associated with platinum exposure and lung radiation (P < .01). The impact of chronic cough on daily activities for survivors (OR vs survivors without chronic cough, 2.7) was greater than that for siblings (OR, 2.0; P = .04). Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities. Cancer 2016;122:3687-96. © 2016 American Cancer Society. © 2016 American Cancer Society.

Tobacco Use Among Siblings of Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

PubMed Central

Buchbinder, David; Oeffinger, Kevin; Franco-Villalobos, Conrado; Yasui, Yutaka; Alderfer, Melissa A.; Armstrong, Gregory T.; Casillas, Jacqueline; Ford, Jennifer; Krull, Kevin R.; Leisenring, Wendy; Recklitis, Christopher; Robison, Leslie L.; Zeltzer, Lonnie K.; Lown, E. Anne

2015-01-01

Background Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. Procedures A retrospective cohort study was conducted using adult siblings (N=1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N=24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. Results Siblings were equally likely to have ever smoked compared to their peers, (Odds Ratio [OR] 1.02, 95% Confidence Interval [CI] 0.93–1.12). Siblings were less likely to be current smokers (OR 0.83, 95% CI 0.73–0.94), but more likely to be former smokers (OR 1.21, 95% CI 1.08–1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95% CI 1.15–2.00) and be current smokers (OR 1.67, 95% CI 1.24–2.26) compared to their peers. Among siblings, risk factors for current tobacco use included: low income <$20,000 (OR 1.66, 95% CI 1.09–2.54), low education (OR 6.68, 95% CI 4.07–10.97), psychological distress (OR 5.36, 95% CI 2.21–13.02), and heavy alcohol use (OR 3.68, 95% CI 2.50–5.41). Conclusions Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socio-economic status families facing childhood cancer. PMID:26305712

Tobacco Use Among Siblings of Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study.

PubMed

Buchbinder, David; Oeffinger, Kevin; Franco-Villalobos, Conrado; Yasui, Yutaka; Alderfer, Melissa A; Armstrong, Gregory T; Casillas, Jacqueline; Ford, Jennifer; Krull, Kevin R; Leisenring, Wendy; Recklitis, Christopher; Robison, Leslie L; Zeltzer, Lonnie K; Lown, E Anne

2016-02-01

Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. A retrospective cohort study was conducted using adult siblings (N = 1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N = 24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. Siblings were equally likely to have ever smoked compared to their peers (odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.12). Siblings were less likely to be current smokers (OR 0.83, 95%CI 0.73-0.94), but more likely to be former smokers (OR 1.21, 95%CI 1.08-1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95%CI 1.15-2.00) and be current smokers (OR 1.67, 95%CI 1.24-2.26) compared to their peers. Among siblings, risk factors for current tobacco use included the following: low income <$20,000 (OR 1.66, 95%CI 1.09-2.54), low education (OR 6.68, 95%CI 4.07-10.97), psychological distress (OR 5.36, 95%CI 2.21-13.02), and heavy alcohol use (OR 3.68, 95%CI 2.50-5.41). Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socioeconomic status families facing childhood cancer. © 2015 Wiley Periodicals, Inc.

Information model design health service childhood cancer for parents and caregivers

NASA Astrophysics Data System (ADS)

Ramli, Syazwani; Muda, Zurina

2015-05-01

Most Malaysians do not realize that they are suffer from a chronic disease until the disease is confirmed to be at a critical stage. This is because lack of awareness among Malaysians about a chronic disease especially in a childhood cancer. Based on report of the National Cancer Council (MAKNA),11 million adults and children suffered with cancer and 6 million of them die in a worldwide. Lack of public exposure to this disease leads to health problems to their children. Information model design health service childhood cancer for p arents and caregivers using an android application medium can be used by a doctor to deliver an information of cancer to the parents and caregivers. The development of this information model design health service childhood cancer for parents and caregivers are using an integration of health promotion theory, spiral model and lean model to form a new model that can be used as a model design content of health service. The method using in this study are by an interview technique and questionnaires along the study was conducted. Hopefully the production of this information model design health service childhood cancer for parents and caregivers using an android apps as a medium can help parents, caregivers and public to know more about information of childhood cancer and at the same time can gain an awareness among them and this app also can be used as a medium for doctors to deliver an information to the parents and caregivers.

Very small embryonic-like stem cells (VSELs) detected in azoospermic testicular biopsies of adult survivors of childhood cancer.

PubMed

Kurkure, Purna; Prasad, Maya; Dhamankar, Vandana; Bakshi, Ganesh

2015-11-09

Infertility is a known side-effect of oncotherapy in cancer survivors, and often compromises the quality of life. The present study was undertaken to detect very small embryonic-like stem cells (VSELs) in testicular biopsies from young adult survivors of childhood cancer who had azoospermia. VSELs have been earlier reported in human and mouse testes. They resist busulphan treatment in mice and potentially restore spermatogenesis when the somatic niche is restored by transplanting Sertoli or mesenchymal cells. VSELs also have the potential to differentiate into sperm in vitro. The study had clearance from Institutional review board (IRB). Seven azoospermic survivors of childhood cancer were included in the study after obtaining their informed consent. Semen analysis was done to confirm azoospermia prior to inclusion in the study. Testicular biopsies were performed at the Uro-oncology Unit of the hospital and then used for various studies to detect VSELs. Hematoxylin and Eosin stained tubular sections confirmed azoospermia and smears revealed the presence of very small, spherical VSELs with high nucleo-cytoplasmic ratio, in addition to the Sertoli cells. Immuno-localization studies on testicular smears showed that the VSELs were CD133+/CD45-/LIN-, expressed nuclear OCT-4, STELLA and cell surface SSEA-4. Pluripotent transcripts Oct-4A, Nanog and Sox-2 were detected in azoospermic samples whereas marked reduction was observed in germ cell markers Oct-4 and Boule. The present study demonstrates the presence of pluripotent VSELs in the testicular biopsy of azoospermic adult survivors of childhood cancer. It is likely that these persisting VSELs can restore spermatogenesis as demonstrated in mice studies. Therefore, pilot studies need to be undertaken using autologous mesenchymal cells with a hope to restore testicular function and fertility in cancer survivors. The results of this study assume a great significance in the current era, where cryopreservation of testicular

Childhood cancer incidence in relation to sunlight exposure

PubMed Central

Musselman, J R B; Spector, L G

2011-01-01

Background: There is increasing interest in the possible association between cancer incidence and vitamin D through its role as a regulator of cell growth and differentiation. Epidemiological studies in adults and one paediatric study suggest an inverse association between sunlight exposure and cancer incidence. Methods: We carried out an ecological study using childhood cancer registry data and two population-level surrogates of sunlight exposure, (1) latitude of the registry city or population centroid of the registry nation and (2) annual solar radiation. All models were adjusted for nation-level socioeconomic status using socioeconomic indicators. Results: Latitude and radiation were significantly associated with cancer incidence, and the direction of association was consistent between the surrogates. Findings were not consistent across tumour types. Conclusion: Our ecological study offers some evidence to support an association between sunlight exposure and risk of childhood cancer. PMID:21102587

Risky sexual behavior in adolescent survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

PubMed

Klosky, James L; Foster, Rebecca H; Li, Zhenghong; Peasant, Courtney; Howell, Carrie R; Mertens, Ann C; Robison, Leslie L; Ness, Kirsten K

2014-08-01

To identify correlates of risky sexual behavior among adolescents surviving childhood cancer. The Child Health and Illness Profile-Adolescent Edition (CHIP-AE) was completed by 307 survivors of childhood cancer aged 15-20 years (M age at diagnosis 1.53 years; range 0-3.76). Univariate analyses were performed using χ² and Fisher's Exact tests, and multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for risky sexual behaviors. Diagnosis of central nervous system cancer (OR = .13, 95% CI: .02-.96, p < .05), no history of beer or wine consumption (OR = .20, CI: .06-.68, p = .01), and fewer negative peer influences (OR = .28, CI: .09-.84, p = .02) associated with decreased likelihood of sexual intercourse. Good psychological health (scores ≥-1.5 SD on the CHIP-AE Emotional Discomfort scale) associated with decreased risk of early intercourse (OR = .19, CI: .05-.77, p = .02), whereas high parental education (≥ college degree) associated with decreased risk of multiple lifetime sexual partners (OR = .25, CI: .09-.72, p = .01). Increased time from diagnosis (OR = .27, CI: .10-.78, p = .02) and psychological health (OR = .09, CI: .02-.36, p < .01) associated with decreased risk of unprotected sex at last intercourse, whereas high parent education associated with increased risk (OR = 4.27, CI: 1.46-12.52, p = .01). Risky sexual behavior in adolescents surviving childhood cancer is associated with cancer type, time since diagnosis, psychological health, alcohol use, and peer influences. Consideration of these factors may provide direction for future interventions designed to reduce adolescent sexual risk-taking.

Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors

PubMed Central

Zhang, Fang Fang; Kelly, Michael J.; Must, Aviva

2017-01-01

Purpose of review Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Recent findings Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Summary Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible. PMID:28455678

Knowledge and risk perception of late effects among childhood cancer survivors and parents before and after visiting a childhood cancer survivor clinic.

PubMed

Cherven, Brooke; Mertens, Ann; Meacham, Lillian R; Williamson, Rebecca; Boring, Cathy; Wasilewski-Masker, Karen

2014-01-01

Survivors of childhood cancer are at risk for a variety of treatment-related late effects and require lifelong individualized surveillance for early detection of late effects. This study assessed knowledge and perceptions of late effects risk before and after a survivor clinic visit. Young adult survivors (≥ 16 years) and parents of child survivors (< 16 years) were recruited prior to initial visit to a cancer survivor program. Sixty-five participants completed a baseline survey and 50 completed both a baseline and follow-up survey. Participants were found to have a low perceived likelihood of developing a late effect of cancer therapy and many incorrect perceptions of risk for individual late effects. Low knowledge before clinic (odds ratio = 9.6; 95% confidence interval, 1.7-92.8; P = .02) and low perceived likelihood of developing a late effect (odds ratio = 18.7; 95% confidence interval, 2.7-242.3; P = .01) were found to predict low knowledge of late effect risk at follow-up. This suggests that perceived likelihood of developing a late effect is an important factor in the individuals' ability to learn about their risk and should be addressed before initiation of education. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Predictors of Posttraumatic Stress Symptoms Among Adolescent and Young Adult Survivors of Childhood Cancer: Importance of Monitoring Survivors' Experiences of Family Functioning.

PubMed

Kamibeppu, Kiyoko; Murayama, Shiho; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Okamura, Jun; Horibe, Keizo; Ishida, Yasushi

2015-11-01

The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. © The Author(s) 2015.

Links between Family Gender Socialization Experiences in Childhood and Gendered Occupational Attainment in Young Adulthood

PubMed Central

Lawson, Katie M.; Crouter, Ann C.; McHale, Susan M.

2015-01-01

Gendered occupational segregation remains prevalent across the world. Although research has examined factors contributing to the low number of women in male-typed occupations – namely science, technology, engineering, and math – little longitudinal research has examined the role of childhood experiences in both young women’s and men’s later gendered occupational attainment. This study addressed this gap in the literature by examining family gender socialization experiences in middle childhood – namely parents’ attitudes and work and family life – as contributors to the gender typicality of occupational attainment in young adulthood. Using data collected from mothers, fathers, and children over approximately 15 years, the results revealed that the associations between childhood socialization experiences (∼10 years old) and occupational attainment (∼26 years old) depended on the sex of the child. For sons but not daughters, mothers’ more traditional attitudes towards women’s roles predicted attaining more gender-typed occupations. In addition, spending more time with fathers in childhood predicted daughters attaining less and sons acquiring more gender-typed occupations in young adulthood. Overall, evidence supports the idea that childhood socialization experiences help to shape individuals’ career attainment and thus contribute to gender segregation in the labor market. PMID:26977112

Childhood Liver Cancer Symptoms, Tests, Prognosis, and Stages (PDQ®)—Patient Version

Cancer.gov

Liver cancer is rare in children and adolescents. There are two main types of childhood liver cancer. Hepatoblastoma usually affects children 3 years and younger, and hepatocellular carcinoma occurs in older children and teenagers. Learn about risk factors, tests to diagnose, and stages of childhood liver cancer.

Cancer risk in childhood-onset systemic lupus.

PubMed

Bernatsky, Sasha; Clarke, Ann E; Labrecque, Jeremy; von Scheven, Emily; Schanberg, Laura E; Silverman, Earl D; Brunner, Hermine I; Haines, Kathleen A; Cron, Randy Q; O'Neil, Kathleen M; Oen, Kiem; Rosenberg, Alan M; Duffy, Ciarán M; Joseph, Lawrence; Lee, Jennifer L; Kale, Mruganka; Turnbull, Elizabeth M; Ramsey-Goldman, Rosalind

2013-01-01

The aim of this study was to assess cancer incidence in childhood-onset systemic lupus erythematosus (SLE). We ascertained cancers within SLE registries at 10 pediatric centers. Subjects were linked to cancer registries for the observational interval, spanning 1974 to 2009. The ratio of observed to expected cancers represents the standardized incidence ratio (SIR) or relative cancer risk in childhood-onset SLE, versus the general population. There were 1020 patients aged <18 at cohort entry. Most (82%) were female and Caucasian; mean age at cohort entry was 12.6 years (standard deviation (SD) = 3.6). Subjects were observed for a total of 7,986 (average 7.8) patient-years. Within this interval, only three invasive cancers were expected. However, 14 invasive cancers occurred with an SIR of 4.7, 95% confidence interval (CI) 2.6 to 7.8. Three hematologic cancers were found (two non-Hodgkin’s lymphoma, one leukemia), for an SIR of 5.2 (95% CI 1.1 to 15.2). The SIRs stratified by age group and sex, were similar across these strata. There was a trend for highest cancer occurrence 10 to 19 years after SLE diagnosis. These results suggest an increased cancer risk in pediatric onset SLE versus the general population. In absolute terms, this represents relatively few events. Of note, risk may be highest only after patients have transferred to adult care.

Associations between abuse/neglect and ADHD from childhood to young adulthood: A prospective nationally-representative twin study.

PubMed

Stern, Adi; Agnew-Blais, Jessica; Danese, Andrea; Fisher, Helen L; Jaffee, Sara R; Matthews, Timothy; Polanczyk, Guilherme V; Arseneault, Louise

2018-05-15

Child maltreatment has consistently been found to be associated with attention deficit/hyperactivity disorder (ADHD). However, the robustness of this association and the direction of the link between maltreatment and ADHD remain unclear. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2232 British twins, to investigate the associations between exposure to abuse/neglect and ADHD in childhood and in young adulthood, and to test their robustness and specificity. We also aimed to test longitudinal associations between abuse/neglect and ADHD from childhood to young adulthood, controlling for confounders. Results indicated strong associations between abuse/neglect and ADHD in childhood and also in young adulthood. In childhood, the association was concentrated among children with comorbid conduct disorder. Longitudinal analyses showed that childhood ADHD predicted abuse/neglect in later years. This association was again concentrated among individuals with comorbid conduct disorder. Abuse/neglect in childhood was not associated with later ADHD in young adulthood after adjusting for childhood ADHD. Our study does not provide support of a causal link between child abuse/neglect and adult ADHD but highlights the possibility of a long-term effect of disruptive behaviors on the risk for experiencing abuse/neglect. These findings emphasize the need for clinicians treating people with ADHD, especially those with comorbid conduct disorder, to be aware of their increased risk for experiencing abuse/neglect. Interventions aimed at reducing risks of abuse/neglect should also focus on the environment of individuals with disruptive behaviors. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, Sabine, E-mail: muellers@neuropeds.ucsf.edu; Fullerton, Heather J.; Stratton, Kayla

Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292more » survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively.« less

Unusual Cancers of Childhood Treatment (PDQ®)—Patient Version

Cancer.gov

Treatment for unusual cancers of childhood depends on the specific cancer (e.g., nasopharyngeal, thyroid, oral, laryngeal, lung, esophageal, cardiac). See the full list and learn more about treatment for these cancers in this expert-reviewed summary.

Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

PubMed

Lown, E Anne; Hijiya, Nobuko; Zhang, Nan; Srivastava, Deo Kumar; Leisenring, Wendy M; Nathan, Paul C; Castellino, Sharon M; Devine, Katie A; Dilley, Kimberley; Krull, Kevin R; Oeffinger, Kevin C; Hudson, Melissa M; Armstrong, Gregory T; Robison, Leslie L; Ness, Kirsten K

2016-09-01

Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHBs co-occur. To the authors' knowledge, only limited information is available describing how RHBs cluster among survivors of childhood cancer and their siblings and the risk factors for co-occurring RHBs. Latent class analysis was used to identify RHB clusters using longitudinal survey data regarding smoking, alcohol use, and physical activity from adult survivors (4184 survivors) and siblings (1598 siblings) in the Childhood Cancer Survivor Study. Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. Three RHB clusters were identified: a low-risk cluster, an insufficiently active cluster, and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared with siblings, survivors were more likely to be in the insufficiently active cluster (adjusted odds ratio [ORadj ], 1.17; 95% confidence interval [95% CI], 1.06-1.27) and were less likely to be in the high-risk cluster (ORadj , 0.79; 95% CI, 0.69-0.88). Risk factors for membership in the high-risk cluster included psychological distress (ORadj , 2.76; 95% CI, 1.98-3.86), low educational attainment (ORadj , 7.49; 95% CI, 5.15-10.88), income <$20,000 (ORadj , 2.62; 95% CI, 1.93-3.57), being divorced/separated or widowed (ORadj , 1.36; 95% CI, 1.03-1.79), and limb amputation (ORadj , 1.52; 95% CI, 1.03-2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, nonwhite race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. RHBs co-occur in survivors of childhood cancer and their siblings. Economic and educational disadvantages and psychological distress should be considered in screening and

Defining Young in the Context of Prostate Cancer

PubMed Central

Lowe, Anthony; Hyde, Melissa K.; Zajdlewicz, Leah; Gardiner, Robert A.; Sandoe, David; Dunn, Jeff

2015-01-01

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer. PMID:24780936

Childhood and adult cancer in twins: evidence from the Utah genealogy.

PubMed

Neale, Rachel E; Mineau, Geraldine; Whiteman, David C; Brownbill, Pat A; Murphy, Michael F G

2005-05-01

Evidence suggests that the in utero environment may contribute to subsequent development of cancers in childhood and adulthood. Raised levels of estrogen during pregnancy may be the primary in utero etiologic factor. Mothers of twins have higher estrogen levels during pregnancy than mothers of singletons, therefore, assessment of cancer risk in twins may be informative. We conducted a retrospective cohort study of cancer among twin and singleton newborns selected from the Utah Population Database, matched on birth year and sex. Cancer diagnoses were determined by linkage with the Utah state cancer register. Relative rates of all cancers in childhood and in adulthood in twins compared with singletons, and for specific cancers including testicular, breast and melanoma, were calculated using Poisson regression. Twin (35,271) and singleton (74,199) births were identified, among whom there were 336 and 691 cancer diagnoses, respectively. The relative risk (RR) of childhood cancer in twins compared with singletons was 0.82 [95% confidence interval (CI) 0.55-1.24] and of adult cancer was 1.06 (0.92-1.22). We found nonsignificant increases in risk among adult twins for cancers of the breast, prostate, testis, lymphatic system, thyroid, and large bowel. The largest departures from unity were for testicular cancer (RR 1.47; 95% CI, 0.73-2.95) and melanoma (RR 0.67; 95% CI, 0.42-1.06). These results are consistent with the body of evidence suggesting that twins have a reduced risk of cancer in childhood. Although there is no overall differential in adult cancer risk, these data support the hypothesis that the in utero environment may play an important role in specific cancers.

Magnitude of Treatment Abandonment in Childhood Cancer.

PubMed

Friedrich, Paola; Lam, Catherine G; Itriago, Elena; Perez, Rafael; Ribeiro, Raul C; Arora, Ramandeep S

2015-01-01

Treatment abandonment (TxA) is recognized as a leading cause of treatment failure for children with cancer in low-and-middle-income countries (LMC). However, its global frequency and burden have remained elusive due to lack of global data. This study aimed to obtain an estimate using survey and population data. Childhood cancer clinicians (medical oncologists, surgeons, and radiation therapists), nurses, social workers, and psychologists involved in care of children with cancer were approached through an online survey February-May 2012. Incidence and population data were obtained from public sources. Descriptive, univariable, and multivariable analyses were conducted. 602 responses from 101 countries were obtained from physicians (84%), practicing pediatric hematology/oncology (83%) in general or children's hospitals (79%). Results suggested, 23,854 (15%) of 155,088 children <15 years old newly diagnosed with cancer annually in the countries analyzed, abandon therapy. Importantly, 83% of new childhood cancer cases and 99% of TxA were attributable to LMC. The annual number of cases of TxA expected in LMC worldwide (26,166) was nearly equivalent to the annual number of cancer cases in children <15 years expected in HIC (26,368). Approximately two thirds of LMC had median TxA ≥ 6%, but TxA ≥ 6% was reported in high- (9%), upper-middle- (41%), lower-middle- (80%), and low-income countries (90%, p<0.001). Most LMC centers reporting TxA > 6% were outside the capital. Lower national income category, higher reliance on out-of-pocket payments, and high prevalence of economic hardship at the center were independent contextual predictors for TxA ≥ 6% (p<0.001). Global survival data available for more developed and less developed regions suggests TxA may account for at least a third of the survival gap between HIC and LMC. Results show TxA is prevalent (compromising cancer survival for 1 in 7 children globally), confirm the suspected high burden of TxA in LMC, and

Risky Sexual Behavior in Adolescent Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study

PubMed Central

Klosky, James L.; Foster, Rebecca H.; Li, Zhenghong; Peasant, Courtney; Howell, Carrie; Mertens, Ann C.; Robison, Leslie L.; Ness, Kirsten K.

2014-01-01

Objective To identify correlates of risky sexual behavior among adolescents surviving childhood cancer. Methods The Child Health and Illness Profile - Adolescent Edition (CHIP-AE) was completed by 307 survivors of childhood cancer aged 15–20 years (M age at diagnosis 1.53 years; range 0–3.76). Univariate analyses were performed using Chi-square and Fischer’s exact tests, and multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals for risky sexual behaviors. Results Diagnosis of central nervous system cancer (OR =.13, 95% CI: .02–.96, p<.05), no history of beer/wine consumption (OR =.20, CI: .06–.68, p =.01), and fewer negative peer influences (OR =.28, CI: .09–.84, p =.02) associated with decreased likelihood of sexual intercourse. Good psychological health (scores ≥ −1.5 SD on the CHIP-AE Emotional Discomfort scale) associated with decreased risk of early intercourse (OR =.19, CI: .05–.77, p= .02), whereas high parental education (≥ college degree) associated with decreased risk of multiple lifetime sexual partners (OR =.25, CI: .09–.72, p =.01). Increased time from diagnosis (OR =.27, CI: .10–.78, p = .02) and psychological health (OR =.09, CI: .02–.36, p < .01) associated with decreased risk of unprotected sex at last intercourse, whereas high parent education associated with increased risk (OR = 4.27, CI: 1.46–12.52, p =.01). Conclusions Risky sexual behavior in adolescents surviving childhood cancer is associated with cancer type, time since diagnosis, psychological health, alcohol use, and peer influences. Consideration of these factors may provide direction for future interventions designed to reduce adolescent sexual risk-taking. PMID:24364376

Adult Survivors of Childhood Cancer Have Poor Adherence to Dietary Guidelines.

PubMed

Zhang, Fang Fang; Ojha, Rohit P; Krull, Kevin R; Gibson, Todd M; Lu, Lu; Lanctot, Jennifer; Chemaitilly, Wassim; Robison, Leslie L; Hudson, Melissa M

2016-12-01

Poor nutritional intake can exacerbate the chronic disease burden in childhood cancer survivors, whereas a healthful diet serves a protective function. Few studies have provided detailed evaluations of the diet of childhood cancer survivors. This study aimed to evaluate diet quality and dietary intakes of key food groups and nutrients in a large cohort of childhood cancer survivors and whether cancer and treatment characteristics have an impact on survivors' long-term intake. Diet was assessed in 2570 adult survivors of childhood cancer enrolled in the St. Jude Lifetime cohort (mean age = 32.3 y) by using the Block food-frequency questionnaire. The Healthy Eating Index-2010 (HEI-2010) was calculated to quantify diet quality. Cancer diagnosis and treatment exposure were abstracted from medical records. Differences in HEI-2010 by patient characteristics and treatment exposure were examined by using ANCOVA. The mean ± SD HEI-2010 in childhood cancer survivors was 57.9 ± 12.4 of a maximum score of 100. Referenced to Dietary Reference Intakes, survivors consumed inadequate amounts of vitamin D, vitamin E, potassium, fiber, magnesium, and calcium (27%, 54%, 58%, 59%, 84%, and 90% of the recommended intakes) but excessive amounts of sodium and saturated fat (155% and 115% of the recommended intakes) from foods. Survivors diagnosed when <5 y of age had a lower diet quality than did those diagnosed when ≥5 y of age (mean HEI-2010 score: 56.9 compared with 58.2; P = 0.046). Survivors who received higher radiation doses to the abdomen had a lower diet quality than those who received lower doses (mean HEI-2010 scores = 58.9, 57.2, 56.7, and 56.1 for doses of 0, 1-19.9, 20-29.9, and ≥30 Gy, respectively; P = 0.02). Long-term childhood cancer survivors have poor adherence to the 2010 Dietary Guidelines for Americans. Findings reinforce the need to incorporate nutrition into cancer care to improve diet quality and to reduce morbidities. © 2016 American Society for

Interrelated Processes toward Quality of Life in Survivors of Childhood Cancer: A Grounded Theory

ERIC Educational Resources Information Center

Tsonis, Miranda; McDougall, Janette; Mandich, Angela; Irwin, Jennifer

2012-01-01

Past research has not adequately addressed the quality of life (QOL) of survivors of childhood cancer. The purpose of this study was to understand how QOL is experienced for individuals who have survived childhood cancer. Specific research questions included: (a) How do childhood cancer survivors define the concept of QOL and (b) What processes do…

Adverse Childhood Experiences and Blood Pressure Trajectories from Childhood to Young Adulthood: The Georgia Stress and Heart Study

PubMed Central

Su, Shaoyong; Wang, Xiaoling; Pollock, Jennifer S.; Treiber, Frank A.; Xu, Xiaojing; Snieder, Harold; McCall, W. Vaughn; Stefanek, Michael; Harshfield, Gregory A.

2015-01-01

Background The purpose of this study was to assess the long-term effect of adverse childhood experiences (ACEs) on blood pressure (BP) trajectories from childhood to young adulthood and to examine whether this relation is explained by childhood socioeconomic status (SES) and/or risk behaviors that are associated with ACEs. Methods and Results Systolic and diastolic blood pressure (SBP and DBP) were measured up to 16 times (13 times on average) over a 23-year period in 213 African Americans (AAs) and 181 European Americans (EAs) aged 5 to 38 years. Retrospective data on traumatic experiences prior to age 18 were collected, including abuse, neglect and household dysfunction. Individual growth curve modeling within a multilevel framework was used to examine the relation between exposure to ACEs and BP development. No main effect of ACEs on average BP levels was found. However, a significant interaction of ACE score with age3 was observed (SBP: p=0.033; DBP: p=0.017). Subjects who experienced multiple traumatic events during childhood showed a faster rise of BP levels after age of 30 years than those without ACEs. As expected, a graded association of ACEs with childhood SES and negative health behaviors was observed (p<0.001). The ACE-SBP relation was not explained by these factors, while the ACE-DBP relation was partially mediated by illicit drug use. Conclusions In this novel longitudinal study, we observed that participants who were exposed to multiple ACEs displayed a greater increase of BP levels in young adulthood compared to their counterparts without ACEs. PMID:25858196

Adverse childhood experiences and blood pressure trajectories from childhood to young adulthood: the Georgia stress and Heart study.

PubMed

Su, Shaoyong; Wang, Xiaoling; Pollock, Jennifer S; Treiber, Frank A; Xu, Xiaojing; Snieder, Harold; McCall, W Vaughn; Stefanek, Michael; Harshfield, Gregory A

2015-05-12

The purposes of this study were to assess the long-term effect of adverse childhood experiences (ACEs) on blood pressure (BP) trajectories from childhood to young adulthood and to examine whether this relation is explained by childhood socioeconomic status (SES) or risk behaviors that are associated with ACEs. Systolic and diastolic BPs were measured up to 16 times (13 times on average) over a 23-year period in 213 African Americans and 181 European Americans 5 to 38 years of age. Retrospective data on traumatic experiences before 18 years of age were collected, including abuse, neglect, and household dysfunction. Individual growth curve modeling within a multilevel framework was used to examine the relation between exposure to ACEs and BP development. No main effect of ACEs on average BP levels was found. However, a significant interaction of ACE score with age(3) was observed (systolic BP, P=0.033; diastolic BP, P=0.017). Subjects who experienced multiple traumatic events during childhood showed a faster rise in BP levels after 30 years of age than those without ACEs. As expected, a graded association of ACEs with childhood socioeconomic status and negative health behaviors was observed (P<0.001). The ACE-systolic BP relation was not explained by these factors, whereas the ACE-diastolic BP relation was partially mediated by illicit drug use. In this novel longitudinal study, we observed that participants who were exposed to multiple ACEs displayed a greater increase in BP levels in young adulthood compared with their counterparts without ACEs. © 2015 American Heart Association, Inc.

Exploration of life experiences of positive growth in long-term childhood cancer survivors.

PubMed

Kim, Yoonjung

2017-10-01

The aim of this study was to explore experiences of positive growth in long-term childhood cancer survivors, from their perspective. Fifteen long-term survivors of childhood cancer provided descriptions of their experiences. Data were collected through face-to-face interviews and the analysis was based on Giorgi's phenomenological research method. The analysis of positive growth experienced by long-term childhood cancer survivors revealed three themes: self-directed life, normalcy in life, and inner maturity. Long-term survivors defined positive growth as a successful transition to a self-satisfactory life based on motivation acquired through their cancer experience and on subjective goal-setting, as well as becoming cancer-free and living a normal life within society. They seemed to have acquired optimistic, flexible, active attitudes toward life while demonstrating profound gratefulness and consideration of people around them, as well as prudent approaches to health. The findings of this study verified that long-term survivors of childhood cancer have grown positively due to their negative past experience. We expect these findings to contribute to the development of programs that promote positive growth in long-term childhood cancer survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors.

PubMed

Chung, O K Joyce; Li, Ho Cheung William; Chiu, Sau Ying; Ho, Ka Yan Eva; Lopez, Violeta

2014-01-01

Research indicates that regular physical activity is associated with numerous physiological and psychological health benefits for childhood cancer survivors. A review of the literature reveals that no study has so far examined the physical activity levels and behavior of Hong Kong Chinese childhood cancer survivors, and how the cancer and its treatment affect the physical activity and other behavior of these children remains unclear. The aims of this study were to assess the physical activity levels of Hong Kong Chinese childhood cancer survivors and to explore the factors that affect their adherence to and maintenance of regular physical activity. A cross-sectional study was used. A total of 128 childhood cancer survivors (9-16-year-olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. There was a significant decline in physical activity levels among childhood cancer survivors. Most of them did not take physical exercise regularly. Concern about academic performance, fatigue, and a decrease in physical strength and endurance after remission prevented them from engaging in regular physical activity. This study indicates that many childhood cancer survivors did not engage in regular physical activity and that they overlooked or underestimated its importance. It is essential for nurses to correct misconceptions about physical activity among childhood cancer survivors and their parents and, most importantly, to advocate the principle of regular physical activity for these children, with the aim of enhancing their physical and psychological well-being.

Thyroid Adenomas After Solid Cancer in Childhood

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine

Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose receivedmore » at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.« less

Impact of chronic disease on emotional distress in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

PubMed

Vuotto, Stefanie C; Krull, Kevin R; Li, Chenghong; Oeffinger, Kevin C; Green, Daniel M; Patel, Sunita K; Srivastava, Deokumar; Stovall, Marilyn; Ness, Kirsten K; Armstrong, Gregory T; Robison, Leslie L; Brinkman, Tara M

2017-02-01

The current study was performed to examine associations between childhood cancer therapies, chronic health conditions, and symptoms of emotional distress in adult survivors of childhood cancer. Participants included 5021 adult survivors of childhood cancer (mean age, 32.0 years [standard deviation, 7.6 years] with a time since diagnosis of 23.2 years [standard deviation, 4.5 years]) who completed measures assessing symptoms of anxiety, depression, and posttraumatic stress. Cardiac, pulmonary, and endocrine conditions were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03; grades 1-4). Structural equation modeling was used to examine hypothesized pathways between cancer treatment exposures, chronic health conditions, and symptoms of emotional distress. Multivariable models were used to estimate relative risks (RRs) for associations between chronic health conditions and distress. Survivors with cardiovascular, endocrine, or pulmonary conditions were found to have a significantly higher prevalence of emotional distress symptoms. In path analyses and multivariable models, significant effects were observed between endocrine (β = .12 [P = .002] and RR, 1.3 [95% confidence interval (95% CI), 1.1-1.6]) and pulmonary (β = .13 [P<.001] and RR, 1.4 [95% CI, 1.1-1.7]) conditions and depression, and between cardiac (β = .13 [P = .001] and RR, 1.5 [95% CI, 1.2-1.8]) and pulmonary (β = .15 [P<.001] and RR, 1.6 [95% CI, 1.3-2.0]) conditions and anxiety. All treatment-related chronic health conditions were found to be associated with posttraumatic stress symptoms (cardiac: β = .09 [P = .004] and RR, 1.3 [95% CI, 1.2-1.5]; endocrine: β = .12 [P<.001] and RR, 1.3 [95% CI, 1.2-1.5]; and pulmonary: β = .13 [P<.001] and RR, 1.4 [95% CI, 1.2-1.6]). Chronic health conditions resulting from childhood cancer therapies contribute to emotional distress in adult survivors. Targeted mental

Unemployment among adult survivors of childhood cancer: a report from the childhood cancer survivor study.

PubMed

Kirchhoff, Anne C; Leisenring, Wendy; Krull, Kevin R; Ness, Kirsten K; Friedman, Debra L; Armstrong, Gregory T; Stovall, Marilyn; Park, Elyse R; Oeffinger, Kevin C; Hudson, Melissa M; Robison, Leslie L; Wickizer, Thomas

2010-11-01

Adult childhood cancer survivors report high levels of unemployment, although it is unknown whether this is because of health or employability limitations. We examined 2 employment outcomes from 2003 in the Childhood Cancer Survivor Study (CCSS): (1) health-related unemployment and (2) unemployed but seeking work. We compared survivors with a nearest-age CCSS sibling cohort and examined demographic and treatment-related risk groups for each outcome. We studied 6339 survivors and 1967 siblings ≥25 years of age excluding those unemployed by choice. Multivariable generalized linear models evaluated whether survivors were more likely to be unemployed than siblings and whether certain survivors were at a higher risk for unemployment. Survivors (10.4%) reported health-related unemployment more often than siblings (1.8%; Relative Risk [RR], 6.07; 95% Confidence Interval [CI], 4.32-8.53). Survivors (5.7%) were more likely to report being unemployed but seeking work than siblings (2.7%; RR, 1.90; 95% CI, 1.43-2.54). Health-related unemployment was more common in female survivors than males (Odds Ratio [OR], 1.73; 95% CI, 1.43-2.08). Cranial radiotherapy doses ≥25 Gy were associated with higher odds of unemployment (health-related: OR, 3.47; 95% CI, 2.54-4.74; seeking work: OR, 1.77; 95% CI, 1.15-2.71). Unemployed survivors reported higher levels of poor physical functioning than employed survivors, and had lower education and income and were more likely to be publicly insured than unemployed siblings. Childhood cancer survivors have higher levels of unemployment because of health or being between jobs. High-risk survivors may need vocational assistance.

Young Adult Cancer Survivors' Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care.

PubMed

Berg, Carla J; Stratton, Erin; Esiashvili, Natia; Mertens, Ann

2016-09-01

We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p < 0.001), lack of insurance (p = 0.002), and having had chemotherapy (p = 0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities.

Childhood cancer patients at school.

PubMed

Lähteenmäki, P M; Huostila, J; Hinkka, S; Salmi, T T

2002-06-01

The aim of this study was to assess the school-related problems of childhood cancer patients. A cross-sectional questionnaire study for school-aged children with extracranial malignancies, in the area of Turku University Hospital serving around 1000000 people. Siblings, healthy pupils and teachers were studied as controls. 43 patients responded. None of the patients or controls was placed in special educational programmes. However, 30.8% of the patients, 15.7% of the controls and 3.7% of the siblings had required extra tutoring. The patients' results differed statistically from both the siblings' (P=0.022) and the controls' (P=0.041) results. The school marks in mathematics (P=0.05) and in foreign languages (P=0.06) tended to be worse for the patients than for the healthy controls. Bullying was reported by 31.7% of the patients, 10.9% of controls (P=0.0012) and 8.3% of the siblings (P=0.056). The biggest problem faced by the cancer patients was bullying-the patients reported approximately 3 times as much bullying as the healthy children did. It seems that there are still several aspects which need to be reconsidered when these children return to school or start their school-life as survivors of childhood cancer. Some proposals are presented.

Early Childhood Dental Caries. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Platt, Laurence J.; Cabezas, Maritza C.

As part of a series of reports designed to support the implementation of Proposition 10: The California Children and Families Act and to provide comprehensive and authoritative information on critical issues concerning young children and families in California, this report describes the scope and severity of early childhood caries (ECC), a…

Young adult cancer survivors and work: a systematic review.

PubMed

Stone, Dawn S; Ganz, Patricia A; Pavlish, Carol; Robbins, Wendie A

2017-12-01

Sixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established. The purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings. A narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English. Twenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors. More research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care. While young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of occupation, employment appears to enhance overall quality of life.

No evidence of response bias in a population-based childhood cancer survivor questionnaire survey — Results from the Swiss Childhood Cancer Survivor Study

PubMed Central

Gianinazzi, Micòl E.; Michel, Gisela; Zwahlen, Marcel; von der Weid, Nicolas X.; Kuehni, Claudia E.

2017-01-01

Purpose This is the first study to quantify potential nonresponse bias in a childhood cancer survivor questionnaire survey. We describe early and late responders and nonresponders, and estimate nonresponse bias in a nationwide questionnaire survey of survivors. Methods In the Swiss Childhood Cancer Survivor Study, we compared characteristics of early responders (who answered an initial questionnaire), late responders (who answered after ≥1 reminder) and nonresponders. Sociodemographic and cancer-related information was available for the whole population from the Swiss Childhood Cancer Registry. We compared observed prevalence of typical outcomes in responders to the expected prevalence in a complete (100% response) representative population we constructed in order to estimate the effect of nonresponse bias. We constructed the complete population using inverse probability of participation weights. Results Of 2328 survivors, 930 returned the initial questionnaire (40%); 671 returned the questionnaire after ≥1reminder (29%). Compared to early and late responders, we found that the 727 nonresponders (31%) were more likely male, aged <20 years, French or Italian speaking, of foreign nationality, diagnosed with lymphoma or a CNS or germ cell tumor, and treated only with surgery. But observed prevalence of typical estimates (somatic health, medical care, mental health, health behaviors) was similar among the sample of early responders (40%), all responders (69%), and the complete representative population (100%). In this survey, nonresponse bias did not seem to influence observed prevalence estimates. Conclusion Nonresponse bias may play only a minor role in childhood cancer survivor studies, suggesting that results can be generalized to the whole population of such cancer survivors and applied in clinical practice. PMID:28463966

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood☆

PubMed Central

Shin, Sunny H.; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A.

2015-01-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18–25 (N = 268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. PMID:25743371

Childhood emotional abuse, negative emotion-driven impulsivity, and alcohol use in young adulthood.

PubMed

Shin, Sunny H; Lee, Sungkyu; Jeon, Sae-Mi; Wills, Thomas A

2015-12-01

Childhood emotional abuse has been linked to problematic alcohol use in later life but there is a paucity of empirically based knowledge about the developmental pathways linking emotional abuse and alcohol use in young adulthood. Using a community sample of young individuals aged 18-25 (N=268; female 52%), we performed structural equation modeling to investigate whether emotional abuse influences alcohol use through urgent personality trait and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD). The present study found that emotional abuse was related to urgency, which in turn influenced four types of alcohol use. Urgency may play a significant role in linking childhood maltreatment to alcohol use in young adulthood. Copyright © 2015. Published by Elsevier Ltd.

Breast-feeding and childhood cancer: A systematic review with metaanalysis.

PubMed

Martin, Richard M; Gunnell, David; Owen, Christopher G; Smith, George Davey

2005-12-20

It has been suggested that breast milk may play a role in the prevention of certain childhood cancers. We undertook a systematic review of published studies investigating the association between breast-feeding and childhood cancers using Medline (1966 to June 2004), supplemented with auto alerts and manual searches. Analyses are based on odds ratios for specific cancers among those ever breast-fed compared with those never breast-fed, pooled using random-effects models. Forty-nine publications were potentially relevant; of these, 26 provided odds ratio estimates for at least one childhood cancer outcome and were included in metaanalyses. Overall, 92% of the studies were case-control studies, 85% relied on long-term recall of feeding history, only 8% examined breast-feeding exclusivity and control response rates were under 80% in over half. Metaanalyses suggested lower risks associated with having been breast-fed of 9% (95% CI = 2-16%) for acute lymphoblastic leukemia, 24% (3-40%) for Hodgkin's disease and 41% (22-56%) for neuroblastoma, with little between-study heterogeneity. The estimates for Hodgkin's disease and neuroblastoma, however, were driven by single studies. There was little evidence that breast-feeding was associated with acute nonlymphoblastic leukemia, non-Hodgkin's lymphoma, central nervous system cancers, malignant germ cell tumors, juvenile bone tumors, or other solid cancers. In conclusion, ever having been breast-fed is inversely associated with acute lymphoblastic leukemia, Hodgkin's disease and neuroblastoma in childhood, but noncausal explanations are possible. Even if causal, the public health importance of these associations may be small. Our estimates suggest that increasing breast-feeding from 50% to 100% would prevent at most 5% of cases of childhood acute leukemia or lymphoma. (c) 2005 Wiley-Liss, Inc.

Spirituality in childhood cancer care

PubMed Central

Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Carvalho, Sionara Melo Figueiredo; Neto, Modesto Leite Rolim; Moreira, Marcial Moreno; Brasil, Aline Quental; Junior, Francisco Telésforo Celestino; de Oliveira, Gislene Farias; Reis, Alberto Olavo Advíncula

2013-01-01

To deal with the suffering caused by childhood cancer, patients and their families use different coping strategies, among which, spirituality appears a way of minimizing possible damage. In this context, the purpose of the present study was to analyze the influence of spirituality in childhood cancer care, involving biopsychosocial aspects of the child, the family, and the health care team facing the disease. To accomplish this purpose, a nonsystematic review of literature of articles on national and international electronic databases (Scientific Electronic Library Online [SciELO], PubMed, and Latin American and Caribbean Health Sciences Literature [LILACS]) was conducted using the search terms “spirituality,” “child psychology,” “child,” and “cancer,” as well as on other available resources. After the search, 20 articles met the eligibility criteria and were included in the final sample. Our review showed that the relation between spirituality and health has lately become a subject of growing interest among researchers, as a positive influence of spirituality in the people’s welfare was noted. Studies that were retrieved using the mentioned search strategy in electronic databases, independently assessed by the authors according to the systematic review, showed that spirituality emerges as a driving force that helps pediatric patients and their families in coping with cancer. Health care workers have been increasingly attentive to this dimension of care. However, it is necessary to improve their knowledge regarding the subject. The search highlighted that spirituality is considered a source of comfort and hope, contributing to a better acceptance of his/her chronic condition by the child with cancer, as well as by the family. Further up-to-date studies facing the subject are, thus, needed. It is also necessary to better train health care practitioners, so as to provide humanized care to the child with cancer. PMID:24133371

[A childhood and adolescence cancer survivors' association: Les Aguerris].

PubMed

Ly, Kai Yan; Vélius, Élodie; Pitot, Maxime; Rivieri, Lionel; Dupont, Morvan

2015-01-01

In France, we can estimate that 50,000 adults are childhood or adolescence cancer survivors. Not all of them will experience late effects but they should be informed about their previous disease and should get a detailed summary of treatment information including a personal plan for late effects screening. They also should have access to appropriate follow-up care including detection and treatment of late effects and provision of support and advice. From a follow-up clinic experience, the need of a survivor association has emerged and "Les Aguerris" has been created with several objectives: to improve the quality of life of survivors providing them information about the possible physical, social and psychological consequences of childhood cancer, to raise awareness of public authorities and other actors on questions regarding the need of long-term follow-up of the patients in dedicated clinics, to support researches about late effects of cancer and treatments and to create a network of adult survivors of childhood cancer in relation with other European survivors or parents associations. This paper describes the activities of the association to fulfill its objectives and the annual national meetings they are organizing. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Childhood Liver Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Treatment options for children with liver cancer include surgery, chemotherapy, radiation, and transarterial chemoembolization or radioembolization. Get detailed information about newly diagnosed and recurrent childhood liver cancer treatment in this summary for clinicians.

Beyond the bench and the bedside: economic and health systems dimensions of global childhood cancer outcomes.

PubMed

Denburg, Avram E; Knaul, Felicia M; Atun, Rifat; Frazier, Lindsay A; Barr, Ronald D

2014-03-01

Globally, the number of new cases of childhood cancer continues to rise, with a widening gulf in outcomes across countries, despite the availability of effective cure options for many pediatric cancers. Economic forces and health system realities are deeply embedded in the foundation of disparities in global childhood cancer outcomes. A truly global effort to close the childhood cancer divide therefore requires systemic solutions. Analysis of the economic and health system dimensions of childhood cancer outcomes is essential to progress in childhood cancer survival around the globe. The conceptual power of this approach is significant. It provides insight into how and where pediatric oncology entwines with broader political and economic conditions, and highlights the mutual benefit derived from systems-oriented solutions. © 2013 Wiley Periodicals, Inc.

Pregnancy outcomes in female childhood and adolescent cancer survivors: a linked cancer-birth registry analysis.

PubMed

Mueller, Beth A; Chow, Eric J; Kamineni, Aruna; Daling, Janet R; Fraser, Alison; Wiggins, Charles L; Mineau, Geraldine P; Hamre, Merlin R; Severson, Richard K; Drews-Botsch, Carolyn

2009-10-01

To compare birth outcomes among female survivors of childhood and adolescent cancer who subsequently bear children, relative to those of women without a history of cancer. Retrospective cohort study. Four US regions. Cancer registries identified girls younger than 20 years who were diagnosed as having cancer from 1973 through 2000. Linked birth records identified the first live births after diagnosis (n = 1898). Comparison subjects were selected from birth records (n = 14 278). Survivors of genital tract carcinomas underwent separate analysis. Cancer diagnosis at younger than 20 years. Infant low birth weight, preterm delivery, sex ratio, malformations, mortality, and delivery method, and maternal diabetes, anemia, and preeclampsia. Infants born to childhood cancer survivors were more likely to be preterm (relative risk [RR], 1.54; 95% confidence interval [CI], 1.30-1.83) and to weigh less than 2500 g (1.31; 1.10-1.57). For the offspring of genital tract carcinoma survivors, RRs were 1.33 (95% CI, 1.13-1.56) and 1.29 (1.10-1.53), respectively. There were no increased risks of malformations, infant death, or altered sex ratio, suggesting no increased germ cell mutagenicity. In exploratory analysis, bone cancer survivors had an increased risk of diabetes (RR, 4.92; 95% CI, 1.60-15.13), and anemia was more common among brain tumor survivors (3.05; 1.16-7.98) and childhood cancer survivors whose initial treatment was chemotherapy only (2.45; 1.16-5.17). Infants born to female survivors of childhood and adolescent cancer were not at increased risk of malformations or death. Increased occurrence of preterm delivery and low birth weight suggest that close monitoring is warranted. Increased diabetes and anemia among subgroups have not been reported, suggesting areas for study.

Racial differences in the consequences of childhood maltreatment for adolescent and young adult depression, heavy drinking, and violence.

PubMed

Lee, Chioun; Cronley, Courtney; White, Helene Raskin; Mun, Eun-Young; Stouthamer-Loeber, Magda; Loeber, Rolf

2012-05-01

This study examined racial differences in the consequences of childhood maltreatment for depression, heavy drinking, and violence during adolescence and young adulthood among black and white young men. Data were obtained from the Pittsburgh Youth Study, a prospective longitudinal study of urban males (N = 971, 56% black). Childhood maltreatment was defined as substantiated physical or sexual abuse, physical neglect, emotional maltreatment, or moral/legal/educational maltreatment, with the first referral before 12 years of age. Self-reports of depressive symptoms and heavy drinking (consuming more than six drinks on a single occasion) and official, parent, and self-reports of violent offending were assessed between 12 and 17 years of age (adolescence) and at 24/25 years of age (young adulthood). Regression analyses were conducted to examine childhood maltreatment and race, as well as maltreatment-by-race interactions, as predictors of the three outcomes. Prevalence of childhood maltreatment was higher for black than for white boys; however, there were no racial differences in timing, type, severity, and chronicity of maltreatment. When socioeconomic status and cohort were controlled, childhood maltreatment significantly predicted depressive symptoms and violence in adolescence but none of the outcomes in young adulthood. Race was a significant predictor of heavy drinking and violence during adolescence, and of all three outcomes in young adulthood. No significant race-by-maltreatment interaction effects were found. Childhood maltreatment has similar negative consequences for black and white male youth during adolescence. Extending intervention efforts through adolescence is important to alleviate these problems among victims. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada.

PubMed

Barker, Brittany; Kerr, Thomas; Dong, Huiru; Wood, Evan; DeBeck, Kora

2017-03-01

While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51-2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young

Maternal and Paternal Resources across Childhood and Adolescence as Predictors of Young Adult Achievement.

PubMed

Sun, Xiaoran; McHale, Susan M; Updegraff, Kimberly A

2017-06-01

Family experiences have been linked to youth's achievements in childhood and adolescence, but we know less about their long term implications for educational and occupational achievements in young adulthood. Grounded in social capital theory and ecological frameworks, this study tested whether mothers' and fathers' education and occupation attainments, as well as the mean level and cross-time consistency of parental warmth during childhood and adolescence, predicted educational and occupational achievements in young adulthood. We also tested interactions between parental achievement and warmth in predicting these young adult outcomes. Data were collected from mothers, fathers, and firstborn and secondborn siblings in 164 families at up to 11 time points. Predictors came from the first nine annual points (youth age M = 10.52 at Time 1) and outcomes from when young adults averaged 26 years old (firstborns at Time 10, secondborns at Time 11). Results from multilevel models revealed that both mothers' and fathers' educational attainment and warmth consistency from childhood through adolescence predicted young adults' educational attainment. Fathers' occupational prestige predicted sons', but not daughters', prestige. An interaction between mothers' warmth consistency, occupational prestige, and youth gender revealed that, for sons whose mothers' prestige was low, warmth consistency positively predicted their prestige, but this association was nonsignificant when mothers' prestige was high. Conversely, for daughters with mothers high in prestige, warmth consistency was a trend level, positive predictor of daughters' prestige, but was nonsignificant when mothers' prestige was low. Thus, maternal resources appeared to have a cumulative impact on daughters, but the process for sons was compensatory. Discussion focuses on the role of family resources in the gender gap in young adult achievement.

Maternal and Paternal Resources across Childhood and Adolescence as Predictors of Young Adult Achievement

PubMed Central

Sun, Xiaoran; McHale, Susan M.; Updegraff, Kimberly A.

2017-01-01

Family experiences have been linked to youth’s achievements in childhood and adolescence, but we know less about their long term implications for educational and occupational achievements in young adulthood. Grounded in social capital theory and ecological frameworks, this study tested whether mothers’ and fathers’ education and occupation attainments, as well as the mean level and cross-time consistency of parental warmth during childhood and adolescence, predicted educational and occupational achievements in young adulthood. We also tested interactions between parental achievement and warmth in predicting these young adult outcomes. Data were collected from mothers, fathers, and firstborn and secondborn siblings in 164 families at up to 11 time points. Predictors came from the first nine annual points (youth age M = 10.52 at Time 1) and outcomes from when young adults averaged 26 years old (firstborns at Time 10, secondborns at Time 11). Results from multilevel models revealed that both mothers’ and fathers’ educational attainment and warmth consistency from childhood through adolescence predicted young adults’ educational attainment. Fathers’ occupational prestige predicted sons’, but not daughters’, prestige. An interaction between mothers’ warmth consistency, occupational prestige, and youth gender revealed that, for sons whose mothers’ prestige was low, warmth consistency positively predicted their prestige, but this association was nonsignificant when mothers’ prestige was high. Conversely, for daughters with mothers high in prestige, warmth consistency was a trend level, positive predictor of daughters’ prestige, but was nonsignificant when mothers’ prestige was low. Thus, maternal resources appeared to have a cumulative impact on daughters, but the process for sons was compensatory. Discussion focuses on the role of family resources in the gender gap in young adult achievement. PMID:28983122

Childhood Cancer and Vulnerability for Significant Academic Underachievement.

ERIC Educational Resources Information Center

Ott, Jeanne S.; And Others

1982-01-01

Learning difficulties related to childhood cancer were examined by comparison of 22 oncology patients and 22 children (6 to 17 years old) referred for psychiatric/psychological evaluation. Findings demonstrated, among children undergoing treatment of cancer, some academic vulnerabilities for which psychosocial aspects may not fully account.…

Early Childhood Teachers' Misconceptions about Mathematics Education for Young Children in the United States

ERIC Educational Resources Information Center

Lee, Joon Sun; Ginsburg, Herbert P.

2009-01-01

In this article we discuss nine common misconceptions about learning and teaching mathematics for young children that are widespread among prospective and practicing early childhood teachers in the United States. These misconceptions include: 1. Young children are not ready for mathematics education; 2. Mathematics is for some bright kids with…

Social Networking Site Usage Among Childhood Cancer Survivors - A Potential Tool for Research Recruitment?

PubMed Central

Seltzer, Erica D.; Stolley, Melinda R.; Mensah, Edward K.; Sharp, Lisa K.

2014-01-01

Purpose The recent and rapid growth of social networking site (SNS) use presents a unique public health opportunity to develop effective strategies for the recruitment of hard-to-reach participants for cancer research studies. This survey investigated childhood cancer survivors’ reported use of SNS such as facebook or MySpace and their perceptions of using SNS, for recruitment into survivorship research. Methods Sixty White, Black and Hispanic, adult childhood cancer survivors (range 18 – 48 years of age) that were randomly selected from a larger childhood cancer study, the Chicago Healthy Living Study (CHLS), participated in this pilot survey. Telephone surveys were conducted to understand current SNS activity and attitudes towards using SNS as a cancer research recruitment tool. Results Seventy percent of participants reported SNS usage of which 80% were at least weekly users and 79 % reported positive attitudes towards the use of SNS as a recruitment tool for survivorship research. Conclusions and implications for cancer survivors The results of this pilot study revealed that SNS use was high and regular among the childhood cancer survivors sampled. Most had positive attitudes towards using SNS for recruitment of research. The results of this pilot survey suggest that SNS may offer an alternative approach for recruitment of childhood cancer survivors into research. PMID:24532046

The cost and cost-effectiveness of childhood cancer treatment in El Salvador, Central America: A report from the Childhood Cancer 2030 Network.

PubMed

Fuentes-Alabi, Soad; Bhakta, Nickhill; Vasquez, Roberto Franklin; Gupta, Sumit; Horton, Susan E

2018-01-15

Although previous studies have examined the cost of treating individual childhood cancers in low-income and middle-income countries, to the authors' knowledge none has examined the overall cost and cost-effectiveness of operating a childhood cancer treatment center. Herein, the authors examined the cost and sources of financing of a pediatric cancer unit in Hospital Nacional de Ninos Benjamin Bloom in El Salvador, and make estimates of cost-effectiveness. Administrative data regarding costs and volumes of inputs were obtained for 2016 for the pediatric cancer unit. Similar cost and volume data were obtained for shared medical services provided centrally (eg, blood bank). Costs of central nonmedical support services (eg, utilities) were obtained from hospital data and attributed by inpatient share. Administrative data also were used for sources of financing. Cost-effectiveness was estimated based on the number of new patients diagnosed annually and survival rates. The pediatric cancer unit cost $5.2 million to operate in 2016 (treating 90 outpatients per day and experiencing 1385 inpatient stays per year). Approximately three-quarters of the cost (74.7%) was attributed to 4 items: personnel (21.6%), pathological diagnosis (11.5%), pharmacy (chemotherapy, supportive care medications, and nutrition; 31.8%), and blood products (9.8%). Funding sources included government (52.5%), charitable foundations (44.2%), and a social security contribution scheme (3.4%). Based on 181 new patients per year and a 5-year survival rate of 48.5%, the cost per disability-adjusted life-year averted was $1624, which is under the threshold considered to be very cost effective. Treating childhood cancer in a specialized unit in low-income and middle-income countries can be done cost-effectively. Strong support from charitable foundations aids with affordability. Cancer 2018;124:391-7. © 2017 American Cancer Society. © 2017 American Cancer Society.

Family Adjustment to Childhood Cancer: A Systematic Review

ERIC Educational Resources Information Center

Long, Kristin A.; Marsland, Anna L.

2011-01-01

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer,…

Ovarian and Uterine Functions in Female Survivors of Childhood Cancers.

PubMed

Oktem, Ozgur; Kim, Samuel S; Selek, Ugur; Schatmann, Glenn; Urman, Bulent

2018-02-01

Adult survivors of childhood cancers are more prone to developing poor reproductive and obstetrical outcomes than their siblings and the general population as a result of previous exposure to chemotherapy and radiation during childhood. Chemotherapy drugs exert cytotoxic effects systemically and therefore can damage the ovaries, leading to infertility, premature ovarian failure, and, to a lesser extent, spontaneous abortions. They have very limited or no deleterious effects on the uterus that can be recognized clinically. By contrast, radiation is detrimental to both the ovaries and the uterus, thereby causing a greater magnitude of adverse effects on the female reproductive function. These include infertility, premature ovarian failure, miscarriage, fetal growth restrictions, perinatal deaths, preterm births, delivery of small-for-gestational-age infants, preeclampsia, and abnormal placentation. Regrettably, the majority of these adverse outcomes arise from radiation-induced uterine injury and are reported at higher incidence in the adult survivors of childhood cancers who were exposed to uterine radiation during childhood in the form of pelvic, spinal, or total-body irradiation. Recent findings of long-term follow-up studies evaluating reproductive performance of female survivors provided some reassurance to female cancer survivors by documenting that pregnancy and live birth rates were not significantly compromised in survivors, including those who had been treated with alkylating agents and had not received pelvic, cranial, and total-body irradiation. We aimed in this narrative review article to provide an update on the impact of chemotherapy and radiation on the ovarian and uterine function in female survivors of childhood cancer. Adult survivors of childhood cancers are more prone to developing a number of poor reproductive and obstetrical outcomes than their siblings and the general population as a result of previous exposure to chemotherapy and radiation

Childhood Oral Cavity Cancer Treatment (PDQ®)—Patient Version

Cancer.gov

Childhood oral cavity cancer (usually lymphoma or sarcoma) treatment may include surgery, chemotherapy, and radiation therapy. Learn more about the symptoms, diagnosis, and treatment of newly diagnosed and recurrent oral cavity cancer in this expert-reviewed summary.

3 CFR 8556 - Proclamation 8556 of September 10, 2010. National Childhood Cancer Awareness Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... Childhood Cancer Awareness Month, 2010 8556 Proclamation 8556 Presidential Documents Proclamations Proclamation 8556 of September 10, 2010 Proc. 8556 National Childhood Cancer Awareness Month, 2010By the... against cancer with inspiring hope and incredible bravery. When a child is diagnosed with cancer, an...

Childhood cancer survival in Switzerland (1976-2013): Time-trends and predictors.

PubMed

Schindler, Matthias; Belle, Fabiën N; Grotzer, Michael A; von der Weid, Nicolas X; Kuehni, Claudia E

2017-01-01

Population-based studies on childhood cancer survival are key to monitor progress against cancer and to detect potential differences between regions and other subgroups in the population. We investigated time trends and factors associated with childhood cancer survival on a national level in Switzerland, from 1976 to 2013. We extracted data from the population-based Swiss Childhood Cancer Registry of 5,776 children (age 0-14 years) diagnosed with cancer from 1985 to 2014 in Switzerland. We calculated age-adjusted 5-year survival, defined the annual reduction in risk of death (ARR), and explored associations of survival with clinical and demographic factors. Overall, 5-year survival improved significantly, from 64% in 1976-1983 to 88% in 2004-2013. ARR over the whole period was 4% for all diagnostic groups, greatest for Hodgkin lymphomas (8%), ependymomas (6%), Burkitt's lymphomas (6%) and germ cell tumours (6%). Children treated in hospitals without specialised paediatric cancer centre for leukaemia (HR 12.9), lymphoma (HR 5.0) and neuroblastoma (HR 3.7) were at higher risk of death. In French-speaking Switzerland, risk of death was lower for lymphoma (HR 0.6), CNS tumours (HR 0.7) and neuroblastoma (HR 0.5). Children with migration background had a higher risk of death from all tumours except bone tumours. Childhood cancer survival significantly improved from 1976 to 2013, but there is room for further improvement. Survival rates varied by type of clinical treatment, language region and nationality. All paediatric cancer patients should be referred to a specialised paediatric cancer centre. Further research is needed to intervene and completely eliminate inequalities in survival. © 2016 UICC.

Fetal Growth and Childhood Cancer: A Population-Based Study

PubMed Central

Sørensen, Henrik Toft; Grotmol, Tom; Engeland, Anders; Stephansson, Olof; Gissler, Mika; Tretli, Steinar; Troisi, Rebecca

2013-01-01

OBJECTIVE: The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth. METHODS: We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17 698 cases and 172 422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression. RESULTS: Risks of all childhood cancers increased with increasing birth weight (Ptrend ≤ .001). Risks of acute lymphoid leukemia and Wilms tumor were elevated when birth weight was >4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2–3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1–4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1–3.1]). Children diagnosed with central nervous system tumors at <1 year of age had elevated risk with increasing head circumference (Ptrend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5–8.7]). CONCLUSIONS: In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero. PMID:24167169

Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

PubMed

Brinkman, Tara M; Li, Chenghong; Vannatta, Kathryn; Marchak, Jordan G; Lai, Jin-Shei; Prasad, Pinki K; Kimberg, Cara; Vuotto, Stefanie; Di, Chongzhi; Srivastava, Deokumar; Robison, Leslie L; Armstrong, Gregory T; Krull, Kevin R

2016-10-01

In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m(2) intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment

Antidepressant use during pregnancy and childhood cancer in the offspring.

PubMed

Momen, Natalie C; Munk-Olsen, Trine; Li, Jiong; Ingstrup, Katja G; Olsen, Jørn; Bergink, Veerle; Liu, Xiaoqin

2018-01-01

Antidepressant use during pregnancy has been increasing in recent years. We evaluated whether in utero exposure to antidepressants increased the risk of childhood cancer. This population-based cohort study using national registers in Denmark comprised 915 128 liveborn singletons during 1998-2012. We categorised children into three mutually exclusive exposure groups according to maternal redemption of an antidepressant prescription from 2 years before pregnancy until delivery of the index child: Unexposed (N = 863 033), prior user (use before but not during pregnancy) (N = 30 607), and use during pregnancy (N = 21 488). The children were followed from birth until first diagnosis of cancer, death, emigration, or December 31, 2012, whichever came first. The children were followed maximum 14.9 years and contributed to 6.9 × 10 6 person-years at risk. We estimated hazard ratios (HRs) of cancer using Cox regression with 95% confidence intervals (CIs). In total, 1298 (0.1%) children were diagnosed with cancer. Antidepressant use during pregnancy was not associated with a significantly increased risk of childhood cancer in general; the HR was 1.03 (95% CI, 0.63-1.68), compared to children born by mothers who discontinued antidepressant use prior to pregnancy. The association between in utero exposure to antidepressants and childhood cancer did not depend on type or duration of antidepressant use. There was no strong evidence indicating a higher risk of leukaemia or nervous system tumours among children exposed to antidepressants in utero. Antidepressant use during pregnancy was not significantly associated with childhood cancer in general nor with leukaemia or nervous system tumours in specific. Copyright © 2017 John Wiley & Sons, Ltd.

Health-related quality of life in young men with testicular cancer: validation of the Cancer Assessment for Young Adults (CAYA).

PubMed

Hoyt, Michael A; Cano, Stefan J; Saigal, Christopher S; Stanton, Annette L

2013-12-01

Patient-reported outcome instruments are needed to measure health-related quality of life (HRQOL) in young adults with cancer. The purpose of this project was to establish a conceptual model and measurement instrument for assessment of HRQOL in young men with testicular cancer. Patient interviews and a literature review were used to develop a conceptual framework of biopsychosocial domains of cancer-related quality of life and an initial pool of questionnaire items. Items were piloted and refined. Revised items were administered to a sample (N = 171) of young (ages 18-29) men with testicular cancer and repeated 4 weeks later. Rasch measurement methods guided item reduction and scale construction. Traditional psychometric analyses were also performed to allow for comparison with existing measures. The conceptual framework included seven biopsychosocial domains: physical, sexual, intrapersonal, cognitive-emotional, social-relational, educational-vocational-avocational, and spiritual to form independent scales of the resulting questionnaire, the Cancer Assessment for Young Adults-Testicular (CAYA-T). Each scale fulfilled Rasch and traditional psychometric criteria (i.e., person separation index, 0.34-0.82; Cronbach's alpha, 0.70-0.91; and an expected pattern of convergent and discriminant validity correlations). The CAYA-T can be used to assess HRQOL across a comprehensive set of domains as identified by young men with cancer. It passes strict psychometric criteria and has potential as a useful research and clinical tool. The CAYA-T has potential research and clinical value for addressing inter-related aspects of HRQOL in young adult men with cancer. The measure may assist with assessing and monitoring HRQOL across a range of domains and contributing to more comprehensive assessment of biopsychosocial needs of young adults.

Childhood victimization and inflammation in young adulthood: A genetically sensitive cohort study.

PubMed

Baldwin, Jessie R; Arseneault, Louise; Caspi, Avshalom; Fisher, Helen L; Moffitt, Terrie E; Odgers, Candice L; Pariante, Carmine; Ambler, Antony; Dove, Rosamund; Kepa, Agnieszka; Matthews, Timothy; Menard, Anne; Sugden, Karen; Williams, Benjamin; Danese, Andrea

2018-01-01

Childhood victimization is an important risk factor for later immune-related disorders. Previous evidence has demonstrated that childhood victimization is associated with elevated levels of inflammation biomarkers measured decades after exposure. However, it is unclear whether this association is (1) already detectable in young people, (2) different in males and females, and (3) confounded by genetic liability to inflammation. Here we sought to address these questions. Participants were 2232 children followed from birth to age 18years as part of the Environmental Risk (E-Risk) Longitudinal Twin Study. Childhood victimization was measured prospectively from birth to age 12years. Inflammation was measured through C-reactive protein (CRP) levels in dried blood spots at age 18years. Latent genetic liability for high inflammation levels was assessed through a twin-based method. Greater exposure to childhood victimization was associated with higher CRP levels at age 18 (serum-equivalent means were 0.65 in non-victimized Study members, 0.74 in those exposed to one victimization type, and 0.81 in those exposed to poly-victimization; p=0.018). However, this association was driven by a significant association in females (serum-equivalent means were 0.75 in non-victimized females, 0.87 in those exposed to one type of victimization, and 1.19 in those exposed to poly-victimization; p=0.010), while no significant association was observed in males (p=0.19). Victimized females showed elevated CRP levels independent of latent genetic influence, as well as childhood socioeconomic status, and waist-hip ratio and body temperature at the time of CRP assessment. Childhood victimization is associated with elevated CRP levels in young women, independent of latent genetic influences and other key risk factors. These results strengthen causal inference about the effects of childhood victimization on inflammation levels in females by accounting for potential genetic confounding. Copyright �

Social networking site usage among childhood cancer survivors--a potential tool for research recruitment?

PubMed

Seltzer, Erica D; Stolley, Melinda R; Mensah, Edward K; Sharp, Lisa K

2014-09-01

The recent and rapid growth of social networking site (SNS) use presents a unique public health opportunity to develop effective strategies for the recruitment of hard-to-reach participants for cancer research studies. This survey investigated childhood cancer survivors' reported use of SNS such as Facebook or MySpace and their perceptions of using SNS, for recruitment into survivorship research. Sixty White, Black, and Hispanic adult childhood cancer survivors (range 18-48 years of age) that were randomly selected from a larger childhood cancer study, the Chicago Healthy Living Study, participated in this pilot survey. Telephone surveys were conducted to understand current SNS activity and attitudes towards using SNS as a cancer research recruitment tool. Seventy percent of participants reported SNS usage of which 80 % were at least weekly users and 79 % reported positive attitudes towards the use of SNS as a recruitment tool for survivorship research. The results of this pilot study revealed that SNS use was high and regular among the childhood cancer survivors sampled. Most had positive attitudes towards using SNS for recruitment of research. The results of this pilot survey suggest that SNS may offer an alternative approach for recruitment of childhood cancer survivors into research.

Childhood family wealth and mental health in a national cohort of young adults.

PubMed

Lê-Scherban, Félice; Brenner, Allison B; Schoeni, Robert F

2016-12-01

Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. We used prospectively collected data from 2060 young adults aged 18-27 in 2005-2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale) and childhood average household wealth during ages 0-18 years (net worth in 2010 dollars). In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to below-median wealth, prevalence ratio (PR) = 0.56 (0.36-0.87) for 3 rd quartile and PR = 0.46 (0.29-0.73) for 4 th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness.

Patterns of Internet-based health information seeking in adult survivors of childhood cancer.

PubMed

Claridy, Mechelle D; Hudson, Melissa M; Caplan, Lee; Mitby, Pauline A; Leisenring, Wendy; Smith, Selina A; Robison, Leslie L; Mertens, Ann C

2018-05-01

To assess where, when, and why survivors of childhood cancer seek health information. Data from the Childhood Cancer Survivor Study (CCSS) cohort (n = 1386) and Health Information National Trends Survey (n = 2385) were analyzed to determine the health information seeking strategies of childhood cancer survivors. Descriptive frequencies, χ 2 analyses, t-tests, and multivariable logistic regression models were used. To seek health-related information for themselves, 54% (n = 742) of the childhood survivors reported using the Internet in the past 12 months, compared to 45% of the general population (adjusted OR: 2.76; 95% CI: 2.40-3.19). Childhood cancer survivors who used the Internet for health information were more likely to be female, between the ages of 18-34, have received some college education or be a college graduate, and report being in poor health. Although survivors were less likely than the general population to trust health information from the Internet (P < 0.01), they indicated that they would like a secure website that uses information from their medical records to provide individualized health-related information. The use of the Internet to access health information among the childhood cancer survivors was over 50%. Information on late effects was a high priority for most survivors, as was their interest in websites related to late effects and a website on patient information tailored to personal situations. Identification of factors associated with searching the Internet for cancer information may provide direction for development of effective cancer communication interventions for this at-risk population. © 2018 Wiley Periodicals, Inc.

Unusual Cancers of Childhood Treatment (PDQ®)—Health Professional Version

Cancer.gov

Very rare cancers in children include nasopharyngeal, thyroid, oral, salivary, laryngeal, breast, lung, esophageal, cardiac, adrenocortical, gastric, pancreatic, GIST, carcinoid tumors, colorectal, bladder, and skin cancer. Get information about the diagnosis and treatment of these unusual childhood cancers in this summary for clinicians.

Effects of Methylphenidate on Attention Deficits in Childhood Cancer Survivors

ClinicalTrials.gov

2015-03-16

ALL, Childhood; Leukemia, Lymphoblastic; Leukemia, Lymphoblastic, Acute; Leukemia, Lymphoblastic, Acute, L1; Leukemia, Lymphoblastic, Acute, L2; Leukemia, Lymphoblastic, Acute, Philadelphia-Positive; Leukemia, Lymphocytic, Acute; Leukemia, Lymphocytic, Acute, L1; Leukemia, Lymphocytic, Acute, L2; Lymphoblastic Leukemia; Lymphoblastic Leukemia, Acute; Lymphoblastic Leukemia, Acute, Childhood; Lymphoblastic Leukemia, Acute, L1; Lymphoblastic Leukemia, Acute, L2; Lymphoblastic Lymphoma; Lymphocytic Leukemia, Acute; Lymphocytic Leukemia, L1; Lymphocytic Leukemia, L2; Brain Tumors; Cancer of the Brain; Cancer of Brain; Malignant Primary Brain Tumors; Brain Neoplasms, Malignant

Clinical implications of malnutrition in childhood cancer patients--infections and mortality.

PubMed

Loeffen, E A H; Brinksma, A; Miedema, K G E; de Bock, G H; Tissing, W J E

2015-01-01

In childhood cancer patients, malnutrition has been proposed to increase infection rates and reduce survival. We investigated whether malnutrition at diagnosis and during treatment and weight loss during treatment are prognostic factors for infection rates and survival, within a heterogeneous childhood cancer population. From two previous studies, all children ≤18 years of age diagnosed with cancer between October 2004 and October 2011 were included in this study. Data regarding BMI, infections, and survival were retrieved. Patients with a BMI z-score lower than -2.0 were classified as malnourished. Weight loss more than 5% was considered relevant. Two hundred sixty-nine childhood cancer patients were included in this study. At diagnosis, 5.2% of all patients were malnourished. These patients showed worse survival than those who were well nourished (hazard ratio (HR) = 3.63, 95% confidence interval (CI) = 1.52-8.70, p = 0.004). Malnourishment at 3 months after diagnosis (3.3% of all patients) also showed worse survival (HR = 6.34, 95% CI = 2.42-16.65, p < 0.001). Weight loss of more than 5% in the first 3 months after diagnosis was related to increased occurrence of febrile neutropenic episodes with bacteremia in the first year after diagnosis (odds ratio (OR) = 3.05, 95 % CI = 1.27-7.30, p = 0.012). We found that malnourishment in the initial phase of therapy is associated with worse survival in childhood cancer patients. In addition, we found for the first time that weight loss during treatment is associated with increased presence of febrile neutropenic episodes with bacteremia. This underlines the importance of optimal feeding designs in childhood cancer patients.

Risk Factors Associated With Secondary Sarcomas in Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henderson, Tara O., E-mail: thenderson@peds.bsd.uchicago.edu; Rajaraman, Preetha; Stovall, Marilyn

Purpose: Childhood cancer survivors have an increased risk of secondary sarcomas. To better identify those at risk, the relationship between therapeutic dose of chemotherapy and radiation and secondary sarcoma should be quantified. Methods and Materials: We conducted a nested case-control study of secondary sarcomas (105 cases, 422 matched controls) in a cohort of 14,372 childhood cancer survivors. Radiation dose at the second malignant neoplasm (SMN) site and use of chemotherapy were estimated from detailed review of medical records. Odds ratios (ORs) and 95% confidence intervals were estimated by conditional logistic regression. Excess odds ratio (EOR) was modeled as a functionmore » of radiation dose, chemotherapy, and host factors. Results: Sarcomas occurred a median of 11.8 years (range, 5.3-31.3 years) from original diagnosis. Any exposure to radiation was associated with increased risk of secondary sarcoma (OR = 4.1, 95% CI = 1.8-9.5). A dose-response relation was observed, with elevated risks at doses between 10 and 29.9 Gy (OR = 15.6, 95% CI = 4.5-53.9), 30-49.9 Gy (OR = 16.0, 95% CI 3.8-67.8) and >50 Gy (OR = 114.1, 95% CI 13.5-964.8). Anthracycline exposure was associated with sarcoma risk (OR = 3.5, 95% CI = 1.6-7.7) adjusting for radiation dose, other chemotherapy, and primary cancer. Adjusting for treatment, survivors with a first diagnosis of Hodgkin lymphoma (OR = 10.7, 95% CI = 3.1-37.4) or primary sarcoma (OR = 8.4, 95% CI = 3.2-22.3) were more likely to develop a sarcoma. Conclusions: Of the risk factors evaluated, radiation exposure was the most important for secondary sarcoma development in childhood cancer survivors; anthracycline chemotherapy exposure was also associated with increased risk.« less

Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study.

PubMed

Perez, Giselle K; Kirchhoff, Anne C; Recklitis, Christopher; Krull, Kevin R; Kuhlthau, Karen A; Nathan, Paul C; Rabin, Julia; Armstrong, Gregory T; Leisenring, Wendy; Robison, Leslie L; Park, Elyse R

2018-04-15

To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p < 0.001). In multivariable models, males (OR = 2.96) and survivors with public (OR = 6.61) or employer-sponsored insurance (ESI; OR = 14.37) were more likely to have mental health coverage. Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

Cardiac Diseases Following Childhood Cancer Treatment: Cohort Study.

PubMed

Haddy, Nadia; Diallo, Stéphanie; El-Fayech, Chiraz; Schwartz, Boris; Pein, François; Hawkins, Mike; Veres, Cristina; Oberlin, Odile; Guibout, Catherine; Pacquement, Hélène; Munzer, Martine; N'Guyen, Tan Dat; Bondiau, Pierre-Yves; Berchery, Delphine; Laprie, Anne; Scarabin, Pierre-Yves; Jouven, Xavier; Bridier, André; Koscielny, Serge; Deutsch, Eric; Diallo, Ibrahima; de Vathaire, Florent

2016-01-05

Cardiac disease (CD) is one of the major side effects of childhood cancer therapy, but until now little has been known about the relationship between the heart radiation dose (HRD) received during childhood and the risk of CD. The cohort comprised 3162 5-year survivors of childhood cancer. Chemotherapy information was collected and HRD was estimated. There were 347 CDs in 234 patients, 156 of them were rated grade ≥3. Cox and Poisson regression models were used. The cumulative incidence of any type of CD at 40 years of age was 11.0% (95% confidence interval [CI], 9.5-12.7) and 7·4% (95% CI, 6.2-8.9) when only the CDs of grade ≥3 were considered. In comparison with patients who received no anthracycline and either no radiotherapy or an HRD<0·1Gy, the risk was multiplied by 18·4 (95% CI, 7.1-48.0) in patients who had received anthracycline and no radiotherapy or a HRD <0.1Gy, by 60.4 (95% CI, 22.4-163.0) in those who had received no anthracycline and an HRD≥30Gy, and 61.5 (95% CI, 19.6-192.8) in those who had received both anthracycline and an HRD≥30Gy. Survivors of childhood cancers treated with radiotherapy and anthracycline run a high dose-dependent risk of developing CD. CDs develop earlier in patients treated with anthracycline than in those treated without it. © 2015 American Heart Association, Inc.

Predictors of Marriage and Divorce in Adult Survivors of Childhood Cancers: A Report from the Childhood Cancer Survivor Study

PubMed Central

Janson, Christopher; Leisenring, Wendy; Cox, Cheryl; Termuhlen, Amanda M.; Mertens, Ann C.; Whitton, John A.; Goodman, Pamela; Zeltzer, Lonnie; Robison, Leslie L.; Krull, Kevin R.; Kadan-Lottick, Nina S.

2009-01-01

Background/Objective Adult survivors of childhood cancer can have altered social functioning. We sought to identify factors that predict marriage and divorce outcomes in this growing population. Methods Retrospective cohort study of 8,928 ≥ five-year adult survivors of childhood malignancy and 2,879 random sibling controls participating in the Childhood Cancer Survivor Study. Marital status, current health, psychological status, and neurocognitive functioning were determined from surveys and validated instruments. Results Survivors were more likely to be never-married than siblings (relative risk (RR) = 1.21; 95% confidence interval (CI) 1.15–1.26) and the U.S. population (RR=1.25; 95% CI= 1.21 – 1.29), after adjusting for age, gender, and race. Patients with central nervous system (CNS) tumors were at greatest risk for not marrying (RR=1.50; 95% CI= 1.41–1.59). Married survivors divorced at frequencies similar to controls. In multivariable regression analysis, non-marriage was most associated with cranial radiation (RR=1.15; 95% CI=1.02–1.31 for >2400 centigray). In analysis of neurobehavioral functioning, non-marriage was associated with worse task efficiency (RR=1.27; 95% CI=1.20–1.35), but not with emotional distress, or problems with emotional regulation, memory, or organization. Physical conditions predictive of non-marriage included short stature (RR=1.27; 95% CI=1.20–1.34) and poor physical function (RR=1.08; 95% CI=1.00–1.18). Structural equation modeling suggested that cranial radiation influenced marriage status through short stature, cognitive problems, and poor physical function. Conclusions Childhood cancer survivors married at lower frequencies compared to peers. Patients with CNS tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers. PMID:19815636

Predictors of marriage and divorce in adult survivors of childhood cancers: a report from the Childhood Cancer Survivor Study.

PubMed

Janson, Christopher; Leisenring, Wendy; Cox, Cheryl; Termuhlen, Amanda M; Mertens, Ann C; Whitton, John A; Goodman, Pamela; Zeltzer, Lonnie; Robison, Leslie L; Krull, Kevin R; Kadan-Lottick, Nina S

2009-10-01

Adult survivors of childhood cancer can have altered social functioning. We sought to identify factors that predict marriage and divorce outcomes in this growing population. This was a retrospective cohort study of 8,928 > or = 5-year adult survivors of childhood malignancy and 2,879 random sibling controls participating in the Childhood Cancer Survivor Study. Marital status, current health, psychological status, and neurocognitive functioning were determined from surveys and validated instruments. Survivors were more likely to be never-married than siblings [relative risk (RR), 1.21; 95% confidence interval (95% CI), 1.15-1.26] and the U.S. population (RR, 1.25; 95% CI, 1.21-1.29), after adjusting for age, gender, and race. Patients with central nervous system tumors were at greatest risk of not marrying (RR, 1.50; 95% CI, 1.41-1.59). Married survivors divorced at frequencies similar to controls. In multivariable regression analysis, nonmarriage was most associated with cranial radiation (RR, 1.15; 95% CI, 1.02-1.31 for > 2,400 centigray). In analysis of neurobehavioral functioning, nonmarriage was associated with worse task efficiency (RR, 1.27; 95% CI, 1.20-1.35), but not with emotional distress, or problems with emotional regulation, memory, or organization. Physical conditions predictive of nonmarriage included short stature (RR, 1.27; 95% CI, 1.20-1.34) and poor physical function (RR, 1.08; 95% CI, 1.00-1.18). Structural equation modeling suggested that cranial radiation influenced marriage status through short stature, cognitive problems, and poor physical function. Childhood cancer survivors married at lower frequencies compared with peers. Patients with central nervous system tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers.

Improving treatment of cardiovascular risk factors in childhood cancer survivors | Division of Cancer Prevention

Cancer.gov

ABSTRACT Children and adolescents diagnosed with cancer now have on average >80% 5-year survival. However, premature cardiovascular (CV) disease has become the leading non-cancer cause of late mortality among childhood cancer survivors. Our existing work has shown that traditional CV risk factors such as hypertension, dyslipidemia, insulin resistance/diabetes remain very

Childhood cancers, birthplaces, incinerators and landfill sites.

PubMed

Knox, E

2000-06-01

In all, 70 municipal incinerators, 307 hospital incinerators and 460 toxic-waste landfill sites in Great Britain were examined for evidence of effluents causing childhood cancers. Municipal incinerators had previously shown significant excesses of adult cancers within 7.5 and 3.0 km. The relative risks for adults had been marginal and an analysis of childhood cancers seemed to offer a more sensitive approach. A newly developed technique of analysis compares distances from suspect sources to the birth addresses and to the death addresses of cancer-children who had moved house. A localized hazard, effective at only one of these times, must be preferentially associated with the corresponding address. This creates an asymmetry of migrations towards or away from age-restricted effective sources. The child-cancer/leukaemia data showed no systematic migration-asymmetries around toxic-waste landfill sites; but showed highly significant excesses of migrations away from birthplaces close to municipal incinerators. Relative risks within 5.0 km of these sites were about 2:1. Hospital incinerators gave analogous results. The ratios greatly exceed findings around 'non-combustion' urban sites. Because of their locations, the specific effects of the municipal incinerators could not be separated clearly from those of adjacent industrial sources of combustion-effluents. Both were probably carcinogenic. Landfill waste sites showed no such effect.

Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention

USDA-ARS?s Scientific Manuscript database

Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (medi...

Witnessing Domestic Abuse in Childhood as an Independent Risk Factor for Depressive Symptoms in Young Adulthood

ERIC Educational Resources Information Center

Russell, David; Springer, Kristen W.; Greenfield, Emily A.

2010-01-01

Objective: This study addresses the relationship between retrospective reports of witnessing domestic abuse in childhood and levels of depressive symptoms in young adulthood. We examine whether the association between having witnessed violence in childhood and depression is independent of having been the direct target of sexual and/or physical…

Introduction to Adolescent and Young Adult Cancers

Cancer.gov

Cancer researchers, advocates, and a cancer survivor introduce the topic of adolescent and young adult (AYA) cancers, covering distinct aspects of cancer in these patients and research questions to answer.

Hawai‘i's Multiethnic Adolescent and Young Adult Survivors of Childhood Cancer: Are Their Health Behavior Risks Similar to State and National Samples?

PubMed Central

Glaser, Darryl W; O'Carroll Bantum, Erin; Orimoto, Trina; Steffen, Alana D; Elia, Jennifer L; Albright, Cheryl L

2013-01-01

Due to toxicities associated with their malignancies and treatments, adolescent and young adult survivors of childhood cancer (AYASCC) are at high risk for developing chronic diseases. This can be compounded by a greater prevalence of unhealthy behaviors relative to similarly aged non-cancer peers. Disparities in health behaviors have been noted for Black and Hispanic AYASCC, but data on Asian American (AA) or Native Hawaiian and Other Pacific Islander (NHOPI) minorities are lacking. The purpose of this study was to help bridge these information gaps by gathering data from Hawai‘i AA and NHOPI AYSCC. Telephone surveys were used to collect health behavior data from survivors 13–24 years of age (N=64); 55% of the sample was female, 77% AA or NHOPI, 63% leukemia/lymphoma survivors, and 32% overweight/obese. These were compared to state/national survey data for similarly aged individuals (Youth Risk Behavior Surveillance System data for 13–17 year olds, and Behavioral Risk Factor Surveillance System data for 18–24 year olds). While Hawai‘i AYASCC had significantly lower rates of tobacco/alcohol use, a higher proportion did not eat five fruits/vegetables a day (96%) compared to state (83%) and national (78%) samples (P < .001). Although many met age-specific physical activity recommendations, 44% of <18 year olds and 29% of ≥18 year olds still failed to meet national guidelines. Low intake of fruits/vegetables and suboptimal levels of physical activity place these vulnerable, ethnic minority cancer survivors at higher risk for chronic disease. These findings underscore the need to assess and advise survivors about their diet and exercise habits as part of post-treatment care. PMID:24251083

3 CFR 8705 - Proclamation 8705 of September 1, 2011. National Childhood Cancer Awareness Month, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... Childhood Cancer Awareness Month, 2011 8705 Proclamation 8705 Presidential Documents Proclamations Proclamation 8705 of September 1, 2011 Proc. 8705 National Childhood Cancer Awareness Month, 2011By the... fight pediatric cancer each year, facing life-threatening battles that would challenge men and women of...

Patterns of Neural Connectivity during an Attention Bias Task Moderate Associations between Early Childhood Temperament and Internalizing Symptoms in Young Adulthood

PubMed Central

Hardee, Jillian E.; Benson, Brenda E.; Bar-Haim, Yair; Mogg, Karin; Bradley, Brendan P; Chen, Gang; Britton, Jennifer C.; Ernst, Monique; Fox, Nathan A.; Pine, Daniel S.; Pérez-Edgar, Koraly

2013-01-01

Background Biased attention to threat is found in both individuals with anxiety symptoms and children with the childhood temperament of behavioral inhibition (BI). Although perturbed fronto-amygdala function is implicated in biased attention among anxious individuals, no work has examined the neural correlates of attention biases in BI. Work in this area may clarify underlying mechanisms for anxiety in a sample at risk for internalizing disorders. We examined the relations among early childhood BI, fronto-amygdala connectivity during an attention bias task in young adulthood, and internalizing symptoms, assessed in young adulthood. Methods Children were assessed for BI at multiple age points from infancy through age seven. Based on a composite of observational and maternal report data, we selected 21 young adults classified as having a history of BI and 23 classified as non-BI for this study (N=44). Participants completed an event-related fMRI attention-bias task involving threat (angry faces) and neutral trials. Internalizing symptoms were assessed by self-report and diagnostic interviews. Results The young adults characterized in childhood with BI exhibited greater strength in threat-related connectivity than non-behaviorally inhibited young adults. Between-group differences manifested in connections between the amygdala and two frontal regions: dorsolateral prefrontal cortex and anterior insula. Amygdala-insula connectivity also interacted with childhood BI to predict young adult internalizing symptoms. Conclusions BI during early childhood predicts differences as young adults in threat and attention-related fronto-amygdala connectivity. Connectivity strength, in turn, moderated the relations between early BI and later psychopathology. PMID:23489415

Association between childhood and adult attention deficit hyperactivity disorder symptoms in Korean young adults with Internet addiction.

PubMed

Kim, DongIll; Lee, Deokjong; Lee, Junghan; Namkoong, Kee; Jung, Young-Chul

2017-09-01

Background and aims Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric comorbidities of Internet addiction (IA); however, the possible mechanisms that contribute to this high comorbidity are still under debate. This study aims to analyze these possible mechanisms by comparing the effect of IA severity and childhood ADHD on inattention, hyperactivity, and impulsivity in young adults with IA. We hypothesized that IA might have associations with ADHD-like cognitive and behavior symptoms aside from childhood ADHD. Methods Study participants consisted of 61 young male adults. Participants were administered a structured interview. The severity of IA, childhood and current ADHD symptoms, and psychiatry comorbid symptoms were assessed through self-rating scales. The associations between the severity of IA and ADHD symptoms were examined through hierarchical regression analyses. Results Hierarchical regression analyses showed that the severity of IA significantly predicted most dimensions of ADHD symptoms. By contrast, childhood ADHD predicted only one dimension. Discussion The high comorbidity of inattention and hyperactivity symptoms in IA should not solely be accounted by an independent ADHD disorder but should consider the possibility of cognitive symptoms related to IA. Functional and structural brain abnormalities associated with excessive and pathologic Internet usage might be related to these ADHD-like symptoms. Conclusion Inattention and hyperactivity in young adults with IA are more significantly associated with the severity of IA than that of childhood ADHD.

Long-term inpatient disease burden in the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: A cohort study of 21,297 childhood cancer survivors.

PubMed

de Fine Licht, Sofie; Rugbjerg, Kathrine; Gudmundsdottir, Thorgerdur; Bonnesen, Trine G; Asdahl, Peter Haubjerg; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Tryggvadottir, Laufey; Wesenberg, Finn; Hasle, Henrik; Winther, Jeanette F; Olsen, Jørgen H

2017-05-01

Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943-2008 in Denmark, 1971-2008 in Finland, 1955-2008 in Iceland, and 1958-2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977-2010; Finland, 1975-2012; Iceland, 1999-2008; and Sweden, 1968-2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors' standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0-42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91-1.97). The AER was 3,068 (2,980-3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess hospitalisations were for diseases of the nervous system (19

Long-term inpatient disease burden in the Adult Life after Childhood Cancer in Scandinavia (ALiCCS) study: A cohort study of 21,297 childhood cancer survivors

PubMed Central

Rugbjerg, Kathrine; Bonnesen, Trine G.; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Wesenberg, Finn; Winther, Jeanette F.

2017-01-01

Background Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. Methods and findings From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943–2008 in Denmark, 1971–2008 in Finland, 1955–2008 in Iceland, and 1958–2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977–2010; Finland, 1975–2012; Iceland, 1999–2008; and Sweden, 1968–2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors’ standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0–42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91–1.97). The AER was 3,068 (2,980–3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess

The contribution of childhood cardiorespiratory fitness and adiposity to inflammation in young adults.

PubMed

Sun, Cong; Magnussen, Costan G; Ponsonby, Anne-Louise; Schmidt, Michael D; Carlin, John B; Huynh, Quan; Venn, Alison J; Dwyer, Terence

2014-12-01

Cardiorespiratory fitness and adiposity may influence cardiovascular risk through their effects on inflammation. The long-term effects of these modifiable factors on adult inflammation remain uncertain. The associations of childhood and adulthood cardiorespiratory fitness and adiposity with adult inflammation [C-reactive protein (CRP), fibrinogen] were examined. 1,976 children examined in 1985 and re-examined as young adults in 2004-2006 were included. Cardiorespiratory fitness and adiposity were assessed at both waves. CRP and fibrinogen were measured at follow-up. Higher childhood fitness was associated with lower adult inflammation in both sexes. After adjusting for childhood adiposity, the association with CRP attenuated in males, but remained in females (average reduction of CRP 18.1% (95% CI 11.3-24.4%) per 1-SD increase in childhood fitness). Higher adult fitness, adjusting for childhood fitness (an increase in fitness from childhood to adulthood), was associated with lower adult CRP in females and lower fibrinogen in males. Higher childhood and adulthood adiposity (an increase in adiposity from childhood to adulthood) were associated with higher adult inflammation in both sexes. Prevention programs to increase fitness and reduce adiposity in childhood, and maintain a favorable fitness and weight into adulthood, may lead to reduction in adult systemic inflammation. © 2014 The Obesity Society.

Multi-Exposure and Clustering of Adverse Childhood Experiences, Socioeconomic Differences and Psychotropic Medication in Young Adults

PubMed Central

Björkenstam, Emma; Hjern, Anders; Mittendorfer-Rutz, Ellenor; Vinnerljung, Bo; Hallqvist, Johan; Ljung, Rickard

2013-01-01

Purpose Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. Methods This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR) with 95% confidence intervals (CIs) using logistic regression analysis. Results Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3–2.5) and for men 3.1 (95% CI 2.9–3.2). The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. Conclusions Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences. PMID:23341951

Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

PubMed

Björkenstam, Emma; Hjern, Anders; Mittendorfer-Rutz, Ellenor; Vinnerljung, Bo; Hallqvist, Johan; Ljung, Rickard

2013-01-01

Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR) with 95% confidence intervals (CIs) using logistic regression analysis. Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5) and for men 3.1 (95% CI 2.9-3.2). The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

Challenges Evaluating Chemotherapy-Induced Peripheral Neuropathy in Childhood Cancer Survivors.

PubMed

Mohrmann, Caroline; Armer, Jane; Hayashi, Robert J

Children treated for cancer are exposed to a variety of chemotherapeutic agents with known toxicity to the peripheral nervous system. The side effect of peripheral neuropathy can cause changes in sensation, function, and even cause pain. Although peripheral neuropathy is recognized by pediatric oncology nurses as an important and significant side effect, measuring neuropathy can be quite complex for clinical care and research efforts. With more children surviving a cancer diagnosis today, this issue is increasingly important for childhood cancer survivors. This article has reviewed existing literature examining peripheral neuropathy in childhood cancer survivors with particular interest paid to measurement tools available and needs for future research. It is important for nurses to choose appropriate measures for clinical care and research methods in order to have an impact on patients experiencing this condition.

Occupational outcomes of adult childhood cancer survivors: A report from the childhood cancer survivor study.

PubMed

Kirchhoff, Anne C; Krull, Kevin R; Ness, Kirsten K; Park, Elyse R; Oeffinger, Kevin C; Hudson, Melissa M; Stovall, Marilyn; Robison, Leslie L; Wickizer, Thomas; Leisenring, Wendy

2011-07-01

The authors examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher-skill occupations than a sibling comparison and whether certain survivors were at higher risk for lower-skill jobs. The authors created 3 mutually exclusive occupational categories for participants aged ≥ 25 years: Managerial/Professional, Nonphysical Service/Blue Collar, and Physical Service/Blue Collar. The authors examined currently employed survivors (4845) and their siblings (1727) in multivariable generalized linear models to evaluate the likelihood of being in 1 of the 3 occupational categories. Multinomial logistic regression was used among all participants to examine the likelihood of these outcomes compared to being unemployed (survivors, 6671; siblings, 2129). Multivariable linear models were used to assess survivor occupational differences by cancer-  and treatment-related variables. Personal income was compared by occupation. Employed survivors were less often in higher-skilled Managerial/Professional occupations (relative risk, 0.93; 95% confidence interval 0.89-0.98) than their siblings. Survivors who were black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Managerial/Professional occupations than other survivors. In multinomial models, female survivors' likelihood of being in full-time Managerial/Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors' personal income was lower than siblings within each of the 3 occupational categories in models adjusted for sociodemographic variables. Adult childhood cancer survivors are employed in lower-skill jobs than siblings. Survivors with certain treatment histories are at higher risk for lower-skill jobs and may require vocational assistance throughout adulthood. Copyright © 2011 American Cancer Society.

Paternal occupational exposures and childhood cancer.

PubMed Central

Feychting, M; Plato, N; Nise, G; Ahlbom, A

2001-01-01

The objective of the study described here was to test the hypothesis that paternal occupational exposure near conception increases the risk of cancer in the offspring. We conducted a cohort study based on a population of 235,635 children born shortly after two different censuses in Sweden. The children were followed from birth to 14 years, and cases of cancer were identified in the Swedish Cancer Registry. Occupational hygienists assessed the probability of exposure to different agents in each combination of the father's industry and occupation as reported in the censuses. We also analyzed individual job titles. We compared the cancer incidence among children of exposed fathers to that among children of unexposed fathers using Cox proportional hazards modeling. The main findings were an increased risk of nervous system tumors related to paternal occupational exposure to pesticides [relative risk (RR) = 2.36; 95% confidence interval (CI), 1.27-4.39] and work as a painter (RR = 3.65; 95% CI, 1.71-7.80), and an increased risk of leukemia related to wood work by fathers (RR = 2.18; 95% CI, 1.26-3.78). We found no associations between childhood leukemia and paternal exposure to pesticides or paint. Our results support previous findings of an increased risk of childhood brain tumors and leukemia associated with certain paternal occupational exposures. Some findings in previous studies were not confirmed in this study. PMID:11266332

The Impact of Childhood ADHD on Dropping out of High School in Urban Adolescents/Young Adults

ERIC Educational Resources Information Center

Trampush, Joey W.; Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.

2009-01-01

Objective: To examine cognitive and psychosocial factors associated with high school dropout in urban adolescents with and without childhood ADHD. Method: In a longitudinal study, 49 adolescents/young adults with childhood ADHD and 44 controls who either dropped out or graduated from high school are included. Risk factors examined as potential…

Long-term risks of subsequent primary neoplasms among survivors of childhood cancer.

PubMed

Reulen, Raoul C; Frobisher, Clare; Winter, David L; Kelly, Julie; Lancashire, Emma R; Stiller, Charles A; Pritchard-Jones, Kathryn; Jenkinson, Helen C; Hawkins, Michael M

2011-06-08

Survivors of childhood cancer are at excess risk of developing subsequent primary neoplasms but the long-term risks are uncertain. To investigate long-term risks of subsequent primary neoplasms in survivors of childhood cancer, to identify the types that contribute most to long-term excess risk, and to identify subgroups of survivors at substantially increased risk of particular subsequent primary neoplasms that may require specific interventions. British Childhood Cancer Survivor Study--a population-based cohort of 17,981 5-year survivors of childhood cancer diagnosed with cancer at younger than 15 years between 1940 and 1991 in Great Britain, followed up through December 2006. Standardized incidence ratios (SIRs), absolute excess risks (AERs), and cumulative incidence of subsequent primary neoplasms. After a median follow-up time of 24.3 years (mean = 25.6 years), 1354 subsequent primary neoplasms were ascertained; the most frequently observed being central nervous system (n = 344), nonmelanoma skin cancer (n = 278), digestive (n = 105), genitourinary (n = 100), breast (n = 97), and bone (n = 94). The overall SIR was 4 times more than expected (SIR, 3.9; 95% confidence interval [CI], 3.6-4.2; AER, 16.8 per 10,000 person-years). The AER at older than 40 years was highest for digestive and genitourinary subsequent primary neoplasms (AER, 5.9 [95% CI, 2.5-9.3]; and AER, 6.0 [95%CI, 2.3-9.6] per 10,000 person-years, respectively); 36% of the total AER was attributable to these 2 subsequent primary neoplasm sites. The cumulative incidence of colorectal cancer for survivors treated with direct abdominopelvic irradiation was 1.4% (95% CI, 0.7%-2.6%) by age 50 years, comparable with the 1.2% risk in individuals with at least 2 first-degree relatives affected by colorectal cancer. Among a cohort of British childhood cancer survivors, the greatest excess risk associated with subsequent primary neoplasms at older than 40 years was for digestive and genitourinary neoplasms.

Recollections of pressure to eat during childhood, but not picky eating, predict young adult eating behavior.

PubMed

Ellis, Jordan M; Galloway, Amy T; Webb, Rose Mary; Martz, Denise M; Farrow, Claire V

2016-02-01

Picky eating is a childhood behavior that vexes many parents and is a symptom in the newer diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in adults. Pressure to eat, a parental controlling feeding practice aimed at encouraging a child to eat more, is associated with picky eating and a number of other childhood eating concerns. Low intuitive eating, an insensitivity to internal hunger and satiety cues, is also associated with a number of problem eating behaviors in adulthood. Whether picky eating and pressure to eat are predictive of young adult eating behavior is relatively unstudied. Current adult intuitive eating and disordered eating behaviors were self-reported by 170 college students, along with childhood picky eating and pressure through retrospective self- and parent reports. Hierarchical regression analyses revealed that childhood parental pressure to eat, but not picky eating, predicted intuitive eating and disordered eating symptoms in college students. These findings suggest that parental pressure in childhood is associated with problematic eating patterns in young adulthood. Additional research is needed to understand the extent to which parental pressure is a reaction to or perhaps compounds the development of problematic eating behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Suicidal behaviors among young adults: risk factors during development from early childhood to adolescence].

PubMed

Buchmann, Arlette F; Blomeyer, Dorothea; Laucht, Manfred

2012-01-01

Suicidal behaviors are prevalent among young people. Numerous risk factors have been implicated in their development. In the framework of the longitudinal Mannheim Study of Children at Risk, 311 young adults (143 males, 168 females) aged 19-23 years were investigated in order 1) to determine the significance of different risk factors during development in predicting suicidal behaviors in young adulthood, 2) to identify potential risk factors discriminating between suicidal ideation and suicide attempts, and 3) to examine whether the effect of early risk factors was mediated by later occurring predictors. Young adults with suicidal behaviors displayed a number of abnormalities during development, including high load of early family adversity, suicidal ideation and psychiatric problems in childhood and adolescence, as well as low self esteem, poor school functioning, higher levels of novelty seeking, and enhanced affiliations with deviant peers in adolescence. Independent contributions to predicting suicidal behaviors in young adults were provided by early family adversity, suicidal ideation during childhood and adolescence, and low self esteem (with regard to suicidal ideation) and novelty seeking (with regard to suicide attempt), respectively. The impact of early adversity was mediated by child and adolescent externalizing disorders and low self esteem in adolescence. Possible implications of these findings for the prevention and treatment of suicidal behaviors are discussed.

Counseling Preferences of Young Adults with Cancer

ERIC Educational Resources Information Center

Taylor, Jessica Z.; Kashubeck-West, Susan

2017-01-01

This study examined preferences for counseling topics to discuss in individual, group, and family counseling among young adults with cancer, as well as their ranked preferences for attending individual, group, and family counseling. A sample of 320 young adults with cancer (18-39 years old) completed an online survey containing items relevant to…

Pathways between childhood/adolescent adversity, adolescent socioeconomic status, and long-term cardiovascular disease risk in young adulthood.

PubMed

Doom, Jenalee R; Mason, Susan M; Suglia, Shakira F; Clark, Cari Jo

2017-09-01

The current study investigated mediators between childhood/adolescent adversities (e.g., dating violence, maltreatment, homelessness, and parental death), low socioeconomic status (SES) during adolescence, and cardiovascular disease (CVD) risk in young adulthood. The purpose of these analyses was to understand whether SES during adolescence and childhood/adolescent adversities affect CVD risk through similar pathways, including maternal relationship quality, health behaviors, financial stress, medical/dental care, educational attainment, sleep problems, and depressive symptoms. Using the National Longitudinal Study of Adolescent to Adult Health (N = 14,493), which has followed US adolescents (Wave 1; M = 15.9 years) through early adulthood (Wave 4; M = 28.9 years), associations were examined between childhood/adolescent adversity and SES to 30-year CVD risk in young adulthood. The outcome was a Framingham-based prediction model of CVD risk that included age, sex, body mass index, smoking, systolic blood pressure, diabetes, and antihypertensive medication use at Wave 4. Path analysis was used to examine paths through the adolescent maternal relationship to young adult mediators of CVD risk. Childhood/adolescent adversity significantly predicted greater adult CVD risk through the following pathways: maternal relationship, health behaviors, financial stress, lack of medical/dental care, and educational attainment; but not through depressive symptoms or sleep problems. Lower SES during adolescence significantly predicted greater adult CVD risk through the following pathways: health behaviors, financial stress, lack of medical/dental care, and educational attainment, but not maternal relationship, depressive symptoms, or sleep problems. Childhood/adolescent adversities and SES affected CVD risk in young adulthood through both similar and unique pathways that may inform interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Molecular profiling of childhood cancer: Biomarkers and novel therapies.

PubMed

Saletta, Federica; Wadham, Carol; Ziegler, David S; Marshall, Glenn M; Haber, Michelle; McCowage, Geoffrey; Norris, Murray D; Byrne, Jennifer A

2014-06-01

Technological advances including high-throughput sequencing have identified numerous tumor-specific genetic changes in pediatric and adolescent cancers that can be exploited as targets for novel therapies. This review provides a detailed overview of recent advances in the application of target-specific therapies for childhood cancers, either as single agents or in combination with other therapies. The review summarizes preclinical evidence on which clinical trials are based, early phase clinical trial results, and the incorporation of predictive biomarkers into clinical practice, according to cancer type. There is growing evidence that molecularly targeted therapies can valuably add to the arsenal available for treating childhood cancers, particularly when used in combination with other therapies. Nonetheless the introduction of molecularly targeted agents into practice remains challenging, due to the use of unselected populations in some clinical trials, inadequate methods to evaluate efficacy, and the need for improved preclinical models to both evaluate dosing and safety of combination therapies. The increasing recognition of the heterogeneity of molecular causes of cancer favors the continued development of molecularly targeted agents, and their transfer to pediatric and adolescent populations.

Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer.

PubMed

Casillas, Jacqueline; Goyal, Anju; Bryman, Jason; Alquaddoomi, Faisal; Ganz, Patricia A; Lidington, Emma; Macadangdang, Joshua; Estrin, Deborah

2017-08-01

This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer. Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes. The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system. The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources. The text messaging system has the potential to improve the receipt of survivorship care.

Continuity of Functional-Somatic Symptoms from Late Childhood to Young Adulthood in a Community Sample

ERIC Educational Resources Information Center

Steinhausen, Hans-Christoph; Metzke, Christa Winkler

2007-01-01

Background: The goal of this study was to assess the course of functional-somatic symptoms from late childhood to young adulthood and the associations of these symptoms with young adult psychopathology. Methods: Data were collected in a large community sample at three different points in time (1994, 1997, and 2001). Functional-somatic symptoms…

Childhood social withdrawal, interpersonal impairment, and young adult depression: a mediational model.

PubMed

Katz, Shaina J; Conway, Christopher C; Hammen, Constance L; Brennan, Patricia A; Najman, Jake M

2011-11-01

Building on interpersonal theories of depression, the current study sought to explore whether early childhood social withdrawal serves as a risk factor for depressive symptoms and diagnoses in young adulthood. The researchers hypothesized that social impairment at age 15 would mediate the association between social withdrawal at age 5 and depression by age 20. This mediational model was tested in a community sample of 702 Australian youth followed from mother's pregnancy to youth age 20. Structural equation modeling analyses found support for a model in which childhood social withdrawal predicted adolescent social impairment, which, in turn, predicted depression in young adulthood. Additionally, gender was found to moderate the relationship between adolescent social impairment and depression in early adulthood, with females exhibiting a stronger association between social functioning and depression at the symptom and diagnostic level. This study illuminates one potential pathway from early developing social difficulties to later depressive symptoms and disorders.

Childhood Social Withdrawal, Interpersonal Impairment, and Young Adult Depression: A Mediational Model

PubMed Central

Katz, Shaina J.; Conway, Christopher C.; Hammen, Constance L.; Brennan, Patricia A.; Najman, Jake M.

2012-01-01

Building on interpersonal theories of depression, the current study sought to explore whether early childhood social withdrawal serves as a risk factor for depressive symptoms and diagnoses in young adulthood. The researchers hypothesized that social impairment at age 15 would mediate the association between social withdrawal at age 5 and depression by age 20. This mediational model was tested in a community sample of 702 Australian youth followed from mother’s pregnancy to youth age 20. Structural equation modeling analyses found support for a model in which childhood social withdrawal predicted adolescent social impairment, which, in turn, predicted depression in young adulthood. Additionally, gender was found to moderate the relationship between adolescent social impairment and depression in early adulthood, with females exhibiting a stronger association between social functioning and depression at the symptom and diagnostic level. This study illuminates one potential pathway from early developing social difficulties to later depressive symptoms and disorders. PMID:21744059

Improved nutrition in adolescents and young adults after childhood cancer - INAYA study.

PubMed

Quidde, J; von Grundherr, J; Koch, B; Bokemeyer, C; Escherich, G; Valentini, L; Buchholz, D; Schilling, G; Stein, A

2016-11-08

Multimodality treatment improves the chance of survival but increases the risk for long-term side effects in young cancer survivors, so-called" Adolescents and Young Adults"(AYAs). Compared to the general population AYAs have a 5 to 15-fold increased risk of cardiovascular morbidity. Thus, improving modifiable lifestyle risk factors is of particular importance. The INAYA trial included AYAs between 18 and 39 years receiving an intensified individual nutrition counseling at four time points in a 3-month period based on a 3-day dietary record. At week 0 and 12 AYAs got a face-to-face counseling, at week 2 and 6 by telephone. Primary endpoint was change in nutritional behavior measured by Healthy Eating Index - European Prospective Investigation into Cancer and Nutrition (HEI-EPIC). Twenty-three AYAs (11 female, 12 male, median age 20 years (range 19-23 years), median BMI: 21.4 kg/m 2 (range: 19.7-23.9 kg/m 2 ) after completion of cancer treatment for sarcoma (n = 2), carcinoma (n = 2), blastoma (n = 1), hodgkin lymphoma (n = 12), or leukemia (n = 6) were included (median time between diagnosis and study inclusion was 44 month). The primary endpoint was met, with an improvement of 20 points in HEI-EPIC score in 52.2 % (n = 12) of AYAs. At baseline, median HEI-EPIC score was 47.0 points (range from 40.0 to 55.0 points) and a good, moderate and bad nutritional intake was seen in 4.3, 73.9 and 21.7 % of AYAs. At week 12, median HEI-EPIC improved significantly to 65.0 points (range from 55.0 to 76.0 points) (p ≤ 0.001) and a good, moderate and bad nutritional intake was seen in 47.8, 52.2 and 0 % of AYAs. No change was seen in quality of life, waist-hip ratio and blood pressure. Intensified nutrition counseling is feasible and seem to improve nutritional behavior of AYAs. Further studies will be required to demonstrate long-term sustainability and confirm the results in a randomized design in larger cohorts. Clinical trial identifier

Deficits in Physical Function Among Young Childhood Cancer Survivors

PubMed Central

Hoffman, Megan C.; Mulrooney, Daniel A.; Steinberger, Julia; Lee, Jill; Baker, K. Scott; Ness, Kirsten K.

2013-01-01

Purpose Childhood cancer survivors (CCSs) are at risk for physical disability. The aim of this investigation was to characterize and compare physical performance among CCSs and a group of siblings age < 18 years and determine if diagnosis, treatment, and physical activity levels were associated with lower performance scores. Methods CCSs ≥ 5 years from diagnosis and a sibling comparison group were recruited and evaluated for strength, mobility, and fitness. Physical performance measures were compared in regression models between survivors and siblings by diagnosis and among survivors by treatment exposures and physical activity levels. Results CCSs (n = 183; mean age ± standard deviation [SD], 13.5 ± 2.5 years; 53% male) scored lower than siblings (n = 147; mean age ± SD, 13.4 ± 2.4 years; 50% male) on lower-extremity strength testing, the timed up-and-go (TUG) test, and the 6-minute walk (6MW) test, despite reporting similar levels and types of habitual physical activity. The lowest scores were prevalent among survivors of CNS tumors and bone and soft tissue sarcomas on strength testing (score ± SD: CNS tumors, 76.5 ± 4.7; sarcoma 67.1 ± 7.2 v siblings, 87.3 ± 2.4 Newton-meters quadricep strength at 90° per second; P = .04 and .01, respectively) and among CNS tumor survivors on the TUG (score ± SD: 5.1 ± 0.1 v siblings, 4.4 ± 0.1 seconds; P < .001) and 6MW tests (score ± SD: 533.3 ± 15.6 v siblings, 594.1 ± 8.3 m; P < .001). Conclusion CCSs may have underlying physiologic deficits that interfere with function that cannot be completely overcome by participation in regular physical activity. These survivors may need referral for specialized exercise interventions in addition to usual counseling to remain physically active. PMID:23796992

Principles and Recommendations for the Provision of Healthcare in Canada to Adolescent and Young Adult–Aged Cancer Patients and Survivors

PubMed Central

Fernandez, Conrad; Fraser, Graeme A.M.; Freeman, Carolyn; Grunfeld, Eva; Gupta, Abha; Mery, Leslie Stephen; De Pauw, Sonja

2011-01-01

Adolescents and young adults (AYA) with cancer and survivors of cancer in childhood, adolescence, and young adulthood are a constituency facing disparities of care affecting quality of life and other outcomes in many parts of the world. In Canada, this situation occurs in a nation with population-based cancer control programs and a government-funded healthcare system. The Canadian Task Force on Adolescents and Young Adults with Cancer was established in 2008 with a mission to ensure that AYA-aged Canadians with cancer and AYA survivors of cancer have prompt, equitable access to the best care, and to establish and support research to identify how their health outcomes and quality of life can be optimized. Following a survey of existing services, and in consultation with survivors, healthcare professionals, and policy makers, the Task Force identified principles of care, priority issues for research and the establishment of outcome metrics, and strategies for implementing change that are designed to improve the outcomes and quality of life of this specific cohort of patients and survivors with unique developmental needs. The six broad recommendations highlight the need for age-appropriate psychosocial, survivorship, palliative, and medical care as well as research to redress inequities in the care provided to this group relative to both younger and older cancer patients. Improved care for this group will enable individuals to reach their full potential as productive, functioning members of society, and will provide economic and other societal benefits. PMID:23610731

Obesity in Childhood Cancer Survivors: Call for Early Weight Management123

PubMed Central

Zhang, Fang Fang; Parsons, Susan K

2015-01-01

A high prevalence of obesity and cardiometabolic conditions has been increasingly recognized in childhood cancer survivors. In particular, survivors of pediatric acute lymphoblastic leukemia have been found to be at risk of becoming overweight or obese early in treatment, with increases in weight maintained throughout treatment and beyond. Nutrition plays an important role in the etiology of obesity and cardiometabolic conditions and is among the few modifiable factors that can prevent or delay the early onset of these chronic conditions. However, nutritional intake in childhood cancer survivors has not been adequately examined and the evidence is built on data from small cohorts of survivors. In addition, the long-term impact of cancer diagnosis and treatment on survivors’ nutritional intake as well as how survivors’ nutritional intake is associated with chronic health conditions have not been well quantified in large-scale studies. Promoting family-based healthy lifestyles, preferably at a sensitive window of unhealthy weight gain, is a priority for preventing the early onset of obesity and cardiometabolic conditions in childhood cancer survivors. PMID:26374183

Income in Adult Survivors of Childhood Cancer

PubMed Central

Wengenroth, Laura; Sommer, Grit; Schindler, Matthias; Spycher, Ben D.; von der Weid, Nicolas X.; Stutz-Grunder, Eveline; Michel, Gisela; Kuehni, Claudia E.

2016-01-01

Introduction Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. Methods As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age <21 years, who had survived ≥5 years after diagnosis of the primary tumor. Siblings were used as a comparison group. We asked questions about education, profession and income and retrieved clinical data from the SCCR. We used multivariable logistic regression to identify characteristics associated with income. Results We analyzed data from 1’506 survivors and 598 siblings. Survivors were less likely than siblings to have a high monthly income (>4’500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, p<0.001). Older age, male sex, personal and parental education, and number of working hours were associated with high income. Survivors of leukemia (OR = 0.40, p<0.001), lymphoma (OR = 0.63, p = 0.040), CNS tumors (OR = 0.22, p<0.001), bone tumors (OR = 0.24, p = 0.003) had a lower income than siblings. Survivors who had cranial irradiation, had a lower income than survivors who had no cranial irradiation (OR = 0.48, p = 0.006). Discussion Even after adjusting for socio-demographic characteristics, education and working hours, survivors of various diagnostic groups have lower incomes than siblings. Further research needs to identify the underlying causes. PMID:27213682

'Will I be able to have a baby?' Results from online focus group discussions with childhood cancer survivors in Sweden.

PubMed

Nilsson, J; Jervaeus, A; Lampic, C; Eriksson, L E; Widmark, C; Armuand, G M; Malmros, J; Marshall Heyman, M; Wettergren, L

2014-12-01

What do adolescent and young adult survivors of childhood cancer think about the risk of being infertile? The potential infertility, as well as the experience of having had cancer, affects well-being, intimate relationships and the desire to have children in the future. Many childhood cancer survivors want to have children and worry about possible infertility. For this qualitative study with a cross-sectional design, data were collected through 39 online focus group discussions during 2013. Cancer survivors previously treated for selected diagnoses were identified from The Swedish Childhood Cancer Register (16-24 years old at inclusion, ≥5 years after diagnosis) and approached regarding study participation. Online focus group discussions of mixed sex (n = 133) were performed on a chat platform in real time. Texts from the group discussions were analysed using qualitative content analysis. The analysis resulted in the main category Is it possible to have a baby? including five generic categories: Risk of infertility affects well-being, Dealing with possible infertility, Disclosure of possible infertility is a challenge, Issues related to heredity and Parenthood may be affected. The risk of infertility was described as having a negative impact on well-being and intimate relationships. Furthermore, the participants described hesitation about becoming a parent due to perceived or anticipated physical and psychological consequences of having had cancer. Given the sensitive topic of the study, the response rate (36%) is considered acceptable. The sample included participants who varied with regard to received fertility-related information, current fertility status and concerns related to the risk of being infertile. The results may be transferred to similar contexts with other groups of patients of childbearing age and a risk of impaired fertility due to disease. The findings imply that achieving parenthood, whether or not with biological children, is an area that

Pulmonary Outcomes in Survivors of Childhood Cancer

PubMed Central

Hudson, Melissa M.; Stokes, Dennis C.; Krasin, Matthew J.; Spunt, Sheri L.; Ness, Kirsten K.

2011-01-01

Background: The purpose of this article is to summarize the literature that documents the long-term impact of cancer treatment modalities on pulmonary function among survivors of cancer and to identify potential areas for further research. Methods: Systematic reviews of clinical trials, observational studies, case series, and review articles were conducted. Articles were limited to the studies that discussed pulmonary toxicity or late effects among pediatric cancer survivors and to follow-up investigations that were conducted a minimum of 2 years after completion of cancer-related treatment or 1 year after hematopoietic stem cell transplant. Results: Sixty publications (51 clinical studies/reports and nine reviews) published from January 1970 to June 2010 in PubMed met the inclusion criteria. Data showed an association between radiotherapy, alkylating agents, bleomycin, hematopoietic stem cell transplant, and thoracic surgery and pulmonary toxicity, as well as possible interactions among these modalities. Conclusions: Pulmonary toxicity is a common long-term complication of exposure to certain anticancer therapies in childhood and can vary from subclinical to life threatening. Pulmonary function and associated loss of optimal exercise capacity may have adverse effects on long-term quality of life in survivors. Lung function diminishes as a function of normal aging, and the effects of early lung injury from cancer therapy may compound these changes. The information presented in this review is designed to provide a stimulus to promote both observational and interventional research that expands our knowledge and aids in the design of interventions to prevent or ameliorate pulmonary late effects among survivors of childhood cancer. PMID:21415131

Patterns of neural connectivity during an attention bias task moderate associations between early childhood temperament and internalizing symptoms in young adulthood.

PubMed

Hardee, Jillian E; Benson, Brenda E; Bar-Haim, Yair; Mogg, Karin; Bradley, Brendan P; Chen, Gang; Britton, Jennifer C; Ernst, Monique; Fox, Nathan A; Pine, Daniel S; Pérez-Edgar, Koraly

2013-08-15

Biased attention to threat is found in both individuals with anxiety symptoms and children with the childhood temperament of behavioral inhibition (BI). Although perturbed fronto-amygdala function is implicated in biased attention among anxious individuals, no work has examined the neural correlates of attention biases in BI. Work in this area might clarify underlying mechanisms for anxiety in a sample at risk for internalizing disorders. We examined the relations among early childhood BI, fronto-amygdala connectivity during an attention bias task in young adulthood, and internalizing symptoms, assessed in young adulthood. Children were assessed for BI at multiple age points from infancy through age seven. On the basis of a composite of observational and maternal report data, we selected 21 young adults classified as having a history of BI and 23 classified as non-BI for this study (n = 44). Participants completed an event-related functional magnetic resonance imaging attention-bias task involving threat (angry faces) and neutral trials. Internalizing symptoms were assessed by self-report and diagnostic interviews. The young adults characterized in childhood with BI exhibited greater strength in threat-related connectivity than non-behaviorally inhibited young adults. Between-group differences manifested in connections between the amygdala and two frontal regions: dorsolateral prefrontal cortex and anterior insula. Amygdala-insula connectivity also interacted with childhood BI to predict young adult internalizing symptoms. Behavioral inhibition during early childhood predicts differences as young adults in threat and attention-related fronto-amygdala connectivity. Connectivity strength, in turn, moderated the relations between early BI and later psychopathology. Copyright © 2013 Society of Biological Psychiatry. All rights reserved.

The burden of childhood cancer in Mexico: Implications for low- and middle-income countries.

PubMed

Rivera-Luna, Roberto; Zapata-Tarres, Marta; Shalkow-Klincovstein, Jaime; Velasco-Hidalgo, Liliana; Olaya-Vargas, Alberto; Finkelstein-Mizrahi, Nicole; Cárdenas-Cardós, Rocío; Aguilar-Ortiz, Marco R

2017-06-01

In Mexico, childhood cancer incidence and mortality have increased in the last decade. Through government actions since 2005, the Popular Medical Insurance (PMI) program for childhood cancer was created. The objective of PMI was to offer early cancer diagnosis, standardized treatment regimens, and numerous pediatric oncology residency programs. It has also accredited 55 national hospitals for the care of these children. Current problems still present under the PMI include shortage of pediatric oncologists and nurses and high rate of abandonment of treatment. Our aim is to describe the current scenario of childhood cancer care in Mexico, especially from the perspective of the PMI and how it has impacted human resources, infrastructure, and medical education. © 2016 Wiley Periodicals, Inc.

Young Adult Outcomes of the Abecedarian and CARE Early Childhood Educational Interventions

ERIC Educational Resources Information Center

Campbell, Frances A.; Wasik, Barbara H.; Pungello, Elizabeth; Burchinal, Margaret; Barbarin, Oscar; Kainz, Kirsten; Sparling, Joseph J.; Ramey, Craig T.

2008-01-01

Adult benefits for participants in Project CARE were compared with those of the Abecedarian Project, a closely related randomized study of early childhood educational intervention for children from low-income families who were at risk of developmental delays and school failure. CARE replicated Abecedarian's young adult treatment-related…

Solar UV radiation and cancer in young children

PubMed Central

Lombardi, Christina; Heck, Julia E.; Cockburn, Myles; Ritz, Beate

2013-01-01

Background Studies have shown that higher solar UV radiation exposure (UVR) may be related to lower risk of some cancers in adults. Recently an ecological study reported lower risks of some cancers among children living in higher UVR cities and countries. In a large population-based case-control study in California we tested the hypothesis that childhood cancers may be influenced by UVR. Methods Cancers in children ages 0 to 5 years were identified from California Cancer Registry records for 1986–2007 and linked to birth certificate data. Controls were sampled from the birth certificates at a ratio of 20:1. Based on birth address, we assigned UVR exposure in units of Watt-hours/m2 using a geostatistical exposure model developed with data from the National Solar Radiation Database. Results For cases with UVR exposure of 5111 Watt-hrs/m2 or above we estimated a reduction in odds of developing acute lymphoblastic leukemia (OR: 0.89, 95% CI: 0.81, 0.99), hepatoblastoma (OR: 0.69, 95% CI: 0.48, 1.00), and non-Hodgkin’s lymphoma (OR: 0.71, 95% CI: 0.50, 1.02) adjusting for mother’s age, mother’s race and child’s year of birth. We also observed a small increase in odds for intracranial/intraspinal embryonal tumors (OR: 1.29, 95% CI: 1.01, 1.65). Conclusions Our findings suggest that UVR during pregnancy may decrease the odds of some childhood cancers. Future studies should explore additional factors that may be correlated with UVR exposure and possibly include biomarkers of immune function and vitamin D. Impact This study shows protective associations of UVR with some childhood cancers. PMID:23585515

Childhood victimization experiences of young adults in St. Petersburg, Russia.

PubMed

Bogolyubova, Olga; Skochilov, Roman; Smykalo, Lyubov

2015-04-01

The purpose of this study was to assess the prevalence of childhood victimization experiences in a sample of young adults in St. Petersburg, Russia. The study sample included 743 students aged 19 to 25 from 15 universities in St. Petersburg, Russia. All of the study participants completed a reliable questionnaire assessing the following types of childhood victimization: conventional crime, child maltreatment, peer victimization, sexual victimization, and witnessing violence. Participation in the study was anonymous. High rates of victimization and exposure to violence were reported by the study participants. The majority of the sample experienced at least one type of victimization during childhood or adolescence, and poly-victimization was reported frequently. The most common type of victimization reported was peer or sibling assault (66.94%), followed by witnessing an assault without weapon (63.91%), personal theft (56.19%), vandalism (56.06%), and emotional bullying (49.99%). Sexual assault by a known adult was reported by 1.45% males and 5.16% of females. This study provides new information on the scope of childhood victimization experiences in Russia. Further research is warranted, including epidemiological research with representative data across the country and studies of the impact of trauma and victimization on mental health and well-being of Russian adults and children. © The Author(s) 2014.

INTERNATIONAL CHILDHOOD CANCER COHORT CONSORTIUM (Journal Article)

EPA Science Inventory

Childhood cancers are rare conditions whose etiology is poorly understood. There is evidence that for some, the causal pathway may commence in utero or during peri-conception. One traditional epidemiologic approach to the study of rare diseases is the use of a retrospective cas...

Childhood Social Functioning and Young Adult Intimate Partner Violence in Girls With and Without ADHD: Response Inhibition as a Moderator.

PubMed

Youn, Cherry; Meza, Jocelyn I; Hinshaw, Stephen P

2018-06-01

Examine the moderating effects of response inhibition on the longitudinal association between social preference/relational aggression measured in childhood, and intimate partner violence (IPV) measured in young adulthood, among women with ( n = 140) and without ( n = 88) histories of childhood ADHD. During childhood, social preference was measured through confidential peer sociometric nominations, yielding negative and positive peer regard; relational aggression was assessed via staff behavioral observations; and response inhibition was assessed using commission errors from the continuous performance task. During young adulthood, IPV was ascertained via a clinician-administered, semistructured interview. Social preference and relational aggression independently predicted IPV; this prospective link was moderated by response inhibition. In combination with low social preference or high relational aggression in childhood, poor response inhibition predicted the highest levels of young-adult IPV. Given the developmental significance of peer relationships, additional research on the causes of and treatments for poor social functioning in ADHD is warranted.

Remaining challenges in childhood cancer and newer targeted therapeutics.

PubMed

Smith, Malcolm A; Reaman, Gregory H

2015-02-01

Despite the enormously important and gratifying advances in cancer treatment outcomes for children with cancer, cancer remains the biggest cause of death from disease in children. Because the etiology and biology of cancers that occur in children differ dramatically from those that occur in adults, the immediate extrapolation of efficacy and safety of new cancer drugs to childhood cancer indications is not possible. We discuss factors that will play key roles in guiding pediatric oncologists as they select lines of research to pursue in their quest for more effective treatments for children with cancer. Published by Elsevier Inc.

Inter-Regional Epidemiological Study of Childhood Cancer (IRESCC): childhood cancer and the consumption of debendox and related drugs in pregnancy.

PubMed Central

McKinney, P. A.; Cartwright, R. A.; Stiller, C. A.; Hopton, P. A.; Mann, J. R.; Birch, J. M.; Hartley, A. L.; Waterhouse, J. A.; Johnston, H. E.

1985-01-01

Attention has recently focused on the possible teratogenic effects of the combination antiemetic doxylamine succinate, dicyclomine hydrochloride and pyridoxine hydrochloride (Debendox/Bendectin) prescribed to pregnant women. The Inter-Regional Epidemiological Study of Childhood Cancer (IRESCC), a case-control investigation has analysed data derived from interview reports and medical records of 555 mothers of children (under 15 years) with cancer and 1110 mothers of matched control children. Separate analyses of interview reports and medical records both suggested that antiemetic ingestion during the index pregnancy does not increase the risk of developing childhood malignant disease in the exposed foetus. No dose-response relationship was evident. The lack of any significant relative risks held good for diagnostic sub-groups and when the trimester of ingestion was considered. Our results suggest that antimetics of this type are unlikely to be transplacental carcinogens. PMID:4074645

Inter-Regional Epidemiological Study of Childhood Cancer (IRESCC): childhood cancer and the consumption of debendox and related drugs in pregnancy.

PubMed

McKinney, P A; Cartwright, R A; Stiller, C A; Hopton, P A; Mann, J R; Birch, J M; Hartley, A L; Waterhouse, J A; Johnston, H E

1985-12-01

Attention has recently focused on the possible teratogenic effects of the combination antiemetic doxylamine succinate, dicyclomine hydrochloride and pyridoxine hydrochloride (Debendox/Bendectin) prescribed to pregnant women. The Inter-Regional Epidemiological Study of Childhood Cancer (IRESCC), a case-control investigation has analysed data derived from interview reports and medical records of 555 mothers of children (under 15 years) with cancer and 1110 mothers of matched control children. Separate analyses of interview reports and medical records both suggested that antiemetic ingestion during the index pregnancy does not increase the risk of developing childhood malignant disease in the exposed foetus. No dose-response relationship was evident. The lack of any significant relative risks held good for diagnostic sub-groups and when the trimester of ingestion was considered. Our results suggest that antimetics of this type are unlikely to be transplacental carcinogens.

Health and well-being in adolescent survivors of early childhood cancer: a report from the Childhood Cancer Survivor Study.

PubMed

Mertens, Ann C; Brand, Sarah; Ness, Kirsten K; Li, Zhenghong; Mitby, Pauline A; Riley, Anne; Patenaude, Andrea Farkas; Zeltzer, Lonnie

2014-03-01

With the growing number of childhood cancer survivors in the US, it is important to assess the well-being of these individuals, particularly during the transitional phase of adolescence. Data about adolescent survivors' overall health and quality of life will help identify survivor subgroups most in need of targeted attention to successfully transition to adulthood. This ancillary study to the Childhood Cancer Survivor Study focused on children 15-19 years of age who had been diagnosed with cancer before the age of 4 years. A cohort of siblings of pediatric cancer survivors of the same ages served as a comparison sample. Adolescent health was assessed using the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) survey. The teen survey was sent to 444 survivor teens and 189 siblings. Of these, 307(69%) survivors and 97 (51%) siblings completed and returned the survey. The overall health profiles of siblings and survivors were similar. Among survivors, females scored significantly below males on satisfaction, discomfort, and disorders domains. Survivors diagnosed with central nervous system tumors scored less favorably than leukemia survivors in the global domains of satisfaction and disorders. In general, adolescent survivors fare favorably compared to healthy siblings. However, identification of the subset of pediatric cancer survivors who are more vulnerable to medical and psychosocial disorders in adolescence provides the opportunity for design and implementation of intervention strategies that may improve quality of life. Copyright © 2013 John Wiley & Sons, Ltd.

Neural correlates of childhood trauma with executive function in young healthy adults.

PubMed

Lu, Shaojia; Pan, Fen; Gao, Weijia; Wei, Zhaoguo; Wang, Dandan; Hu, Shaohua; Huang, Manli; Xu, Yi; Li, Lingjiang

2017-10-03

The aim of this study was to investigate the relationship among childhood trauma, executive impairments, and altered resting-state brain function in young healthy adults. Twenty four subjects with childhood trauma and 24 age- and gender-matched subjects without childhood trauma were recruited. Executive function was assessed by a series of validated test procedures. Localized brain activity was evaluated by fractional amplitude of low frequency fluctuation (fALFF) method and compared between two groups. Areas with altered fALFF were further selected as seeds in subsequent functional connectivity analysis. Correlations of fALFF and connectivity values with severity of childhood trauma and executive dysfunction were analyzed as well. Subjects with childhood trauma exhibited impaired executive function as assessed by Wisconsin Card Sorting Test and Stroop Color Word Test. Traumatic individuals also showed increased fALFF in the right precuneus and decreased fALFF in the right superior temporal gyrus. Significant correlations of specific childhood trauma severity with executive dysfunction and fALFF value in the right precuneus were found in the whole sample. In addition, individuals with childhood trauma also exhibited diminished precuneus-based connectivity in default mode network with left ventromedial prefrontal cortex, left orbitofrontal cortex, and right cerebellum. Decreased default mode network connectivity was also associated with childhood trauma severity and executive dysfunction. The present findings suggest that childhood trauma is associated with executive deficits and aberrant default mode network functions even in healthy adults. Moreover, this study demonstrates that executive dysfunction is related to disrupted default mode network connectivity.

Overall environmental quality and incidence of childhood cancers

EPA Science Inventory

Childhood cancer is associated with individual ambient environmental exposures such as hazardous air pollutants and pesticides. However, the role of cumulative ambient environmental exposures is not well-understood. To estimate cumulative environmental exposures, an Environmental...

Early Childhood Inclusion: A Joint Position Statement of the Division for Early Childhood (DEC) and the National Association for the Education of Young Children (NAEYC)

ERIC Educational Resources Information Center

Young Exceptional Children, 2009

2009-01-01

Today an ever-increasing number of infants and young children with and without disabilities play, develop, and learn together in a variety of places--homes, early childhood programs, neighborhoods, and other community-based settings. The notion that young children with disabilities and their families are full members of the community reflects…

Childhood Social Withdrawal, Interpersonal Impairment, and Young Adult Depression: A Mediational Model

ERIC Educational Resources Information Center

Katz, Shaina J.; Conway, Christopher C.; Hammen, Constance L.; Brennan, Patricia A.; Najmanm, Jake M.

2011-01-01

Building on interpersonal theories of depression, the current study sought to explore whether early childhood social withdrawal serves as a risk factor for depressive symptoms and diagnoses in young adulthood. The researchers hypothesized that social impairment at age 15 would mediate the association between social withdrawal at age 5 and…

Occupational outcomes of adult childhood cancer survivors: A report from the Childhood Cancer Survivor Study

PubMed Central

Kirchhoff, Anne C.; Krull, Kevin R.; Ness, Kirsten K.; Park, Elyse R.; Oeffinger, Kevin C.; Hudson, Melissa M.; Stovall, Marilyn; Robison, Leslie L.; Wickizer, Thomas; Leisenring, Wendy

2010-01-01

Background We examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher skill occupations than a sibling comparison and whether certain survivors were at higher risk. Methods We created three mutually-exclusive occupational categories for participants aged ≥25 years: Managerial/Professional and Non-Physical and Physical Service/Blue Collar. We examined currently employed survivors (N=4845) and siblings (N=1727) in multivariable generalized linear models to evaluate the likelihood of being in the three occupational categories. Among all participants, we used multinomial logistic regression to examine the likelihood of these outcomes in comparison to being unemployed (survivors N=6671; siblings N=2129). Multivariable linear models were used to assess survivor occupational differences by cancer and treatment variables. Personal income was compared by occupation. Results Employed survivors were less often in higher skilled Managerial/Professional occupations (Relative Risk=0.93, 95% Confidence Interval 0.89–0.98) than siblings. Survivors who were Black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Professional occupations than other survivors. In multinomial models, female survivors’ likelihood of being in full-time Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors’ personal income was lower than siblings within each of the three occupational categories in models adjusted for sociodemographic variables. Conclusions Adult childhood cancer survivors are employed in lower skill jobs than siblings. Survivors with certain treatment histories are at higher risk and may require vocational assistance throughout adulthood. PMID:21246530

Measuring Development of Adolescent and Young Adult Cancer Patients: An Integrative Review of Available Instruments.

PubMed

Bell, Cynthia J; Bell, Ryan A; Zebrack, Brad; Kato, Ikuko; Morse, Alyssa; Borinstein, Scott C

2018-06-01

Adolescents and young adults (AYAs) 15-39 years old face unique challenges during cancer treatment as developmental and social needs are often disrupted to achieve cure. Developmentally appropriate supportive care for AYAs across the cancer trajectory is needed. The purpose of this review is to identify and describe instruments that measure AYA development across physical, psychological, and social domains, commenting on the instruments' psychometric properties and usefulness in clinical practice and research. A computerized literature search published in English from 1950 to January of 2017 was conducted utilizing the following databases: Mental Measurements Yearbook (MMY), Health and Psychosocial Instruments, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Google Scholar. The following instruments were identified and described: the Child Health and Illness Profile-Adolescent Edition (CHIP-AE); the Course of Life Questionnaire; the Developmental Task Questionnaire (DTQ); the Impact of Cancer scale for childhood survivors and AYAs (IOC-CS and IOC-AYA); the McCleery Scale of Adolescent Development (MSAD); and the Minneapolis-Manchester Quality of Life Adolescent and Young Adult Form (MMQL-AF and MMQL-YA). Among currently available instruments, the IOC-AYA and MMQL-AF were relevant to AYAs undergoing or completing cancer therapy. However, validation for the IOC-AYA occurred in cancer survivors off treatment so further psychometric evaluation is needed in AYAs currently undergoing cancer treatment. Furthermore, the MMQL-AF has been validated for use during active cancer treatment, but is limited to adolescents 13-20 years. Further research may be needed to create or refine instruments measuring the developmental impact in AYAs, particularly emerging adults undergoing active cancer treatment.

The influence of prenatal exposure to trans-fatty acids for development of childhood haematopoietic neoplasms (EnTrance): a natural societal experiment and a case-control study.

PubMed

Specht, Ina Olmer; Huybrechts, Inge; Frederiksen, Peder; Steliarova-Foucher, Eva; Chajes, Veronique; Heitmann, Berit Lilienthal

2018-01-24

Little is known about the causes of childhood cancer, partly as not many children develop cancer, although childhood cancer is a leading cause of death by disease in the young. The young age of the children suggests that risk factors for childhood cancer may be present during pregnancy. Previous studies have shown that exposure to trans-fat, a type of unsaturated fat common in industrially produced foods (iTFA), has adverse health effects in adults, including the risk of developing cancer. Haematopoietic neoplasms are the most common cancer types among European children under the age of 15 years. This study will bring new knowledge as to whether trans-fat and other fatty acids may also increase the risk of developing haematopoietic neoplasms during childhood. We will investigate if the Danish iTFA legislation ban, which radically reduced the use of iTFA in foodstuffs, influenced the risk of childhood haematopoietic neoplasms in children born either before or after the change in legislation, adjusting for relevant secular trends. Further, in a case-control study, we will examine if levels of fatty acids in dried blood spots from newborns can predict the risk of developing childhood haematopoietic neoplasms. Permission from the Danish Data Protection Agency and the Ethical Committee has been granted. The results from this study will provide important information about fatty acids in the mother's diet as a contributor to development of haematopoietic neoplasms during childhood, which may result in relevant preventive action. Not relevant.

Dietary quality, caloric intake, and adiposity of childhood cancer survivors and their siblings: an analysis from the cardiac risk factors in childhood cancer survivors study.

PubMed

Landy, David C; Lipsitz, Stuart R; Kurtz, Joy M; Hinkle, Andrea S; Constine, Louis S; Adams, M Jacob; Lipshultz, Steven E; Miller, Tracie L

2013-01-01

Childhood cancer survivors are at increased risk of cardiovascular disease, in part because of adiposity. Whether survivors have healthy diets and whether dietary quality is associated with adiposity among survivors are not known. Survivors and siblings from the Cardiac Risk Factors in Childhood Cancer Survivors Study completed 3-day food records that were used to estimate daily caloric intake relative to recommended and dietary quality using the Healthy Eating Index-2005 (HEI). Medical records were reviewed for cancer therapies. Body composition was measured by dual-energy x-ray absorptiometry. Of 91 childhood cancer survivors and 30 sibling controls, there were no marked differences in mean daily caloric intakes (98% vs. 100% of recommended) or HEI total scores (55.5 vs. 53.3), respectively, with both groups scoring worst for the consumption of dark green vegetables and whole grains. Survivors exposed to cranial irradiation had lower total HEI scores (-6.4, P = 0.01). Among survivors, better dietary quality, as reflected by the total HEI score, was associated with decreasing percent body fat (β = -0.19, P = 0.04). Survivors consume diets similar to their siblings although these diets are only moderately adherent to current guidelines. Decreased dietary quality is associated with higher body fat and receipt of cranial irradiation in survivors.

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer.

PubMed

Kuhlman, Kate Ryan; Boyle, Chloe C; Irwin, Michael R; Ganz, Patricia A; Crespi, Catherine M; Asher, Arash; Petersen, Laura; Bower, Julienne E

2017-10-01

Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Disorganized attachment in young adulthood as a partial mediator of relations between severity of childhood abuse and dissociation.

PubMed

Byun, Sooyeon; Brumariu, Laura E; Lyons-Ruth, Karlen

2016-01-01

Disorganized attachment has been proposed as a mediating mechanism in the relation between childhood abuse and dissociation. However, support for mediation has been mixed when interview or self-report measures of attachment have been used. In the current work, relations among severity of abuse, attachment disorganization, and dissociation were assessed in young adulthood using both interview and interaction-based measures of attachment. A total of 112 low-income young adults were assessed for socioeconomic stresses, abusive experiences in childhood, and attachment disorganization at age 20. Attachment disorganization was assessed with the Adult Attachment Interview, coded independently for Unresolved states of mind and for Hostile-Helpless states of mind. Attachment disorganization was also measured using a newly validated assessment of young adult-parent interaction during a conflict discussion. Mediation analyses revealed that the link between childhood abuse and dissociation was partially explained by disturbances in young adult-parent interaction. Narrative disturbances on the Adult Attachment Interview were related to abuse and to dissociation but did not mediate the link between the two. Results are discussed in relation to the role of parent-child communication processes in pathways to dissociation.

Childhood cancer incidence trends in association with US folic acid fortification (1986-2008).

PubMed

Linabery, Amy M; Johnson, Kimberly J; Ross, Julie A

2012-06-01

Epidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification. Using Surveillance, Epidemiology, and End Results program data (1986-2008), we calculated incidence rate ratios and 95% confidence intervals to compare pre- and postfortification cancer incidence rates in children aged 0 to 4 years. Incidence trends were also evaluated by using joinpoint and loess regression models. From 1986 through 2008, 8829 children aged 0 to 4 years were diagnosed with malignancies, including 3790 and 3299 in utero during the pre- and postfortification periods, respectively. Pre- and postfortification incidence rates were similar for all cancers combined and for most specific cancer types. Rates of Wilms tumor (WT), primitive neuroectodermal tumors (PNETs), and ependymomas were significantly lower postfortification. Joinpoint regression models detected increasing WT incidence from 1986 through 1997 followed by a sizable decline from 1997 through 2008, and increasing PNET incidence from 1986 through 1993 followed by a sharp decrease from 1993 through 2008. Loess curves indicated similar patterns. These results provide support for a decrease in WT and possibly PNET incidence, but not other childhood cancers, after US folic acid fortification.

Individual prediction of heart failure among childhood cancer survivors.

PubMed

Chow, Eric J; Chen, Yan; Kremer, Leontien C; Breslow, Norman E; Hudson, Melissa M; Armstrong, Gregory T; Border, William L; Feijen, Elizabeth A M; Green, Daniel M; Meacham, Lillian R; Meeske, Kathleen A; Mulrooney, Daniel A; Ness, Kirsten K; Oeffinger, Kevin C; Sklar, Charles A; Stovall, Marilyn; van der Pal, Helena J; Weathers, Rita E; Robison, Leslie L; Yasui, Yutaka

2015-02-10

To create clinically useful models that incorporate readily available demographic and cancer treatment characteristics to predict individual risk of heart failure among 5-year survivors of childhood cancer. Survivors in the Childhood Cancer Survivor Study (CCSS) free of significant cardiovascular disease 5 years after cancer diagnosis (n = 13,060) were observed through age 40 years for the development of heart failure (ie, requiring medications or heart transplantation or leading to death). Siblings (n = 4,023) established the baseline population risk. An additional 3,421 survivors from Emma Children's Hospital (Amsterdam, the Netherlands), the National Wilms Tumor Study, and the St Jude Lifetime Cohort Study were used to validate the CCSS prediction models. Heart failure occurred in 285 CCSS participants. Risk scores based on selected exposures (sex, age at cancer diagnosis, and anthracycline and chest radiotherapy doses) achieved an area under the curve of 0.74 and concordance statistic of 0.76 at or through age 40 years. Validation cohort estimates ranged from 0.68 to 0.82. Risk scores were collapsed to form statistically distinct low-, moderate-, and high-risk groups, corresponding to cumulative incidences of heart failure at age 40 years of 0.5% (95% CI, 0.2% to 0.8%), 2.4% (95% CI, 1.8% to 3.0%), and 11.7% (95% CI, 8.8% to 14.5%), respectively. In comparison, siblings had a cumulative incidence of 0.3% (95% CI, 0.1% to 0.5%). Using information available to clinicians soon after completion of childhood cancer therapy, individual risk for subsequent heart failure can be predicted with reasonable accuracy and discrimination. These validated models provide a framework on which to base future screening strategies and interventions. © 2014 by American Society of Clinical Oncology.

Treatment Modification in Young Breast Cancer Patients.

PubMed

Scharl, Anton; Salterberg, Annette; Untch, Michael; Liedtke, Cornelia; Stickeler, Elmar; Papathemelis, Thomas

2016-01-01

Patients not older than 40 years are referred to as young patients. These women benefit from chemo-, endocrine and anti-HER2 therapy to a similar degree as older women. Surgery and radiation therapy also follow the same recommendations. This manuscript deals with the following topics that need special consideration in young women: endocrine therapy and ovarian suppression; fertility protection and family planning; and genetic counselling. There is an on-going debate on whether tamoxifen is sufficient as an endocrine treatment in young patients with endocrine-responsive tumours or whether suppression of ovarian function in combination with tamoxifen or aromatase inhibitor should be preferred. Recent data suggest a benefit from ovarian suppression plus exemestane in women of 35 years or younger with high-risk breast cancer. However, increased side effects bear the risk of lesser compliance, which eventually results in higher mortality. Child bearing is nowadays frequently postponed to the 4th decade of life, thereby increasing the number of women who have not yet finished their reproductive desires when diagnosed with breast cancer. These patients are in urgent need of counselling for fertility protection. Breast cancer diagnosis at young age is an indication for a possible mutation in breast cancer susceptibility genes. This has an impact on the cancer risk of the whole family, especially the offspring. Drugs that are specifically targeted to cancer cells with genetic alterations that impair DNA repair are already entering the arsenal of oncologists. © 2016 S. Karger GmbH, Freiburg.

Genome-Wide Association Study to Identify Susceptibility Loci That Modify Radiation-Related Risk for Breast Cancer After Childhood Cancer.

PubMed

Morton, Lindsay M; Sampson, Joshua N; Armstrong, Gregory T; Chen, Ting-Huei; Hudson, Melissa M; Karlins, Eric; Dagnall, Casey L; Li, Shengchao Alfred; Wilson, Carmen L; Srivastava, Deo Kumar; Liu, Wei; Kang, Guolian; Oeffinger, Kevin C; Henderson, Tara O; Moskowitz, Chaya S; Gibson, Todd M; Merino, Diana M; Wong, Jeannette R; Hammond, Sue; Neglia, Joseph P; Turcotte, Lucie M; Miller, Jeremy; Bowen, Laura; Wheeler, William A; Leisenring, Wendy M; Whitton, John A; Burdette, Laurie; Chung, Charles; Hicks, Belynda D; Jones, Kristine; Machiela, Mitchell J; Vogt, Aurelie; Wang, Zhaoming; Yeager, Meredith; Neale, Geoffrey; Lear, Matthew; Strong, Louise C; Yasui, Yutaka; Stovall, Marilyn; Weathers, Rita E; Smith, Susan A; Howell, Rebecca; Davies, Stella M; Radloff, Gretchen A; Onel, Kenan; Berrington de González, Amy; Inskip, Peter D; Rajaraman, Preetha; Fraumeni, Joseph F; Bhatia, Smita; Chanock, Stephen J; Tucker, Margaret A; Robison, Leslie L

2017-11-01

Childhood cancer survivors treated with chest-directed radiotherapy have substantially elevated risk for developing breast cancer. Although genetic susceptibility to breast cancer in the general population is well studied, large-scale evaluation of breast cancer susceptibility after chest-directed radiotherapy for childhood cancer is lacking. We conducted a genome-wide association study of breast cancer in female survivors of childhood cancer, pooling two cohorts with detailed treatment data and systematic, long-term follow-up: the Childhood Cancer Survivor Study and St. Jude Lifetime Cohort. The study population comprised 207 survivors who developed breast cancer and 2774 who had not developed any subsequent neoplasm as of last follow-up. Genotyping and subsequent imputation yielded 16 958 466 high-quality variants for analysis. We tested associations in the overall population and in subgroups stratified by receipt of lower than 10 and 10 or higher gray breast radiation exposure. We report P values and pooled per-allele risk estimates from Cox proportional hazards regression models. All statistical tests were two-sided. Among survivors who received 10 or higher gray breast radiation exposure, a locus on 1q41 was associated with subsequent breast cancer risk (rs4342822, nearest gene PROX1 , risk allele frequency in control subjects [RAF controls ] = 0.46, hazard ratio = 1.92, 95% confidence interval = 1.49 to 2.44, P = 7.09 × 10 -9 ). Two rare variants also showed potentially promising associations (breast radiation ≥10 gray: rs74949440, 11q23, TAGLN , RAF controls = 0.02, P = 5.84 × 10 -8 ; <10 gray: rs17020562, 1q32.3, RPS6KC1 , RAF controls = 0.0005, P = 6.68 × 10 -8 ). Associations were restricted to these dose subgroups, with consistent findings in the two survivor cohorts. Our study provides strong evidence that germline genetics outside high-risk syndromes could modify the effect of radiation exposure on breast cancer risk after

Identifying Common Practice Elements to Improve Social, Emotional, and Behavioral Outcomes of Young Children in Early Childhood Classrooms.

PubMed

McLeod, Bryce D; Sutherland, Kevin S; Martinez, Ruben G; Conroy, Maureen A; Snyder, Patricia A; Southam-Gerow, Michael A

2017-02-01

Educators are increasingly being encouraged to implement evidence-based interventions and practices to address the social, emotional, and behavioral needs of young children who exhibit problem behavior in early childhood settings. Given the nature of social-emotional learning during the early childhood years and the lack of a common set of core evidence-based practices within the early childhood literature, selection of instructional practices that foster positive social, emotional, and behavioral outcomes for children in early childhood settings can be difficult. The purpose of this paper is to report findings from a study designed to identify common practice elements found in comprehensive intervention models (i.e., manualized interventions that include a number of components) or discrete practices (i.e., a specific behavior or action) designed to target social, emotional, and behavioral learning of young children who exhibit problem behavior. We conducted a systematic review of early childhood classroom interventions that had been evaluated in randomized group designs, quasi-experimental designs, and single-case experimental designs. A total of 49 published articles were identified, and an iterative process was used to identify common practice elements. The practice elements were subsequently reviewed by experts in social-emotional and behavioral interventions for young children. Twenty-four practice elements were identified and classified into content (the goal or general principle that guides a practice element) and delivery (the way in which a teacher provides instruction to the child) categories. We discuss implications that the identification of these practice elements found in the early childhood literature has for efforts to implement models and practices.

Distress among young adult cancer survivors: a cohort study.

PubMed

Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

2013-09-01

Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05). Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

Impact of Remembering Childhood Sexual Abuse on Addiction Recovery for Young Adult Lesbians

ERIC Educational Resources Information Center

Galvin, Christina R.; Brooks-Livingston, Angela

2011-01-01

This article examines the impact of childhood sexual abuse on young adult lesbians' sexual identity and their recovery from chemical dependency. The authors recommend that counselors assess for sexual orientation (past and present), sexual abuse, and possible dual diagnosis. Implications for counselors are discussed.

Occurrence of Multiple Subsequent Neoplasms in Long-Term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Armstrong, Gregory T.; Liu, Wei; Leisenring, Wendy; Yasui, Yutaka; Hammond, Sue; Bhatia, Smita; Neglia, Joseph P.; Stovall, Marilyn; Srivastava, Deokumar; Robison, Leslie L.

2011-01-01

Purpose Childhood cancer survivors experience an increased incidence of subsequent neoplasms (SNs). Those surviving the first SN (SN1) remain at risk to develop multiple SNs. Because SNs are a common cause of late morbidity and mortality, characterization of rates of multiple SNs is needed. Patients and Methods In a total of 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, analyses were carried out among 1,382 survivors with an SN1. Cumulative incidence of second subsequent neoplasm (SN2), either malignant or benign, was calculated. Results A total of 1,382 survivors (9.6%) developed SN1, of whom 386 (27.9%) developed SN2. Of those with SN2, 153 (39.6%) developed more than two SNs. Cumulative incidence of SN2 was 46.9% (95% CI, 41.6% to 52.2%) at 20 years after SN1. The cumulative incidence of SN2 among radiation-exposed survivors was 41.3% (95% CI, 37.2% to 45.4%) at 15 years compared with 25.7% (95% CI, 16.5% to 34.9%) for those not treated with radiation. Radiation-exposed survivors who developed an SN1 of nonmelanoma skin cancer (NMSC) had a cumulative incidence of subsequent malignant neoplasm (SMN; ie, malignancies excluding NMSC) of 20.3% (95% CI, 13.0% to 27.6%) at 15 years compared with only 10.7% (95% CI, 7.2% to 14.2%) for those who were exposed to radiation and whose SN1 was an invasive SMN (excluding NMSC). Conclusion Multiple SNs are common among aging survivors of childhood cancer. SN1 of NMSC identifies a population at high risk for invasive SMN. Survivors not exposed to radiation who develop multiple SNs represent a population of interest for studying genetic susceptibility to neoplasia. PMID:21709189

Evolution of modern treatment of childhood acute leukemia and cancer: adventures and battles in the 1970s and 1980s.

PubMed

Ravindranath, Yaddanapudi

2015-02-01

This article summarizes the adventures and explorations in the 1970s and 1980s in the treatment of children with leukemia and cancer that paved the way for the current success in childhood cancers. Indeed, these were adventures and bold steps into unchartered waters. Because childhood leukemia the most common of the childhood cancers, success in childhood leukemia was pivotal in the push toward cure of all childhood cancers. The success in childhood leukemia illustrates how treatment programs were designed using clinical- and biology-based risk factors seen in the patients. Copyright © 2015. Published by Elsevier Inc.

Promoting Physical Activity in Childhood Cancer Survivors: Targets for Intervention

PubMed Central

Montgomery, Michele; Oeffinger, Kevin C.; Leisenring, Wendy; Zeltzer, Lonnie; Whitton, John A.; Mertens, Ann C.; Hudson, Melissa M.; Robison, Leslie L.

2009-01-01

Purpose Although physical activity may modify the late effects of childhood cancer treatment, 20%-52% of adult survivors are sedentary. We sought to identify modifiable factors that influence survivors' participation in physical activity. Methods Structural equation modeling of data from the Childhood Cancer Survivors Study of adult survivors (current mean age, 30.98 years; mean years since diagnosis, 23.74; mean age at diagnosis, 9.25 years) diagnosed between 1970 and 1986. Results Forty percent of the variance in male survivors' recent participation vs. nonparticipation in physical activity was explained directly and/or indirectly by self-reported health fears (P=0.01), perceived primary-care physician (PCP) expertise (P=0.01), baseline exercise frequency (P=<0.001), education level (P=0.01), self-reported stamina (P=0.01), cancer-related pain (P=<0.001), fatigue (P=<0.001), age at diagnosis (P=0.01), cancer-related anxiety (P=<0.001), motivation (P=0.01), affect (P=0.01), and discussion of subsequent cancer risk with the PCP (P=<0.001) (N=256; X2=53.38, df=51, P=0.38, CFI=1.000, TLI=1.000, RMSEA=0.014,WRMR=0.76). Thirty-one percent of the variance in females' recent physical activity participation was explained directly and/or indirectly by self-reported stamina (P=<0.001), fatigue (P=0.01), baseline exercise frequency (P=0.01), cancer-related pain (P=<0.001), cancer-related anxiety (P=0.01), recency of visits with PCP (<0.001), quality of interaction with the PCP (P=0.01), and motivation (P=<0.001) (N=366; X2=67.52 df=55, P=0.12, CFI=0.98, TLI=0.98, RMSEA=0.025, WRMR=0.76). Conclusions Gender-tailored intervention strategies in which providers specifically target motivation, fear, and affect may support physical activity in childhood cancer survivors. PMID:19117349

Childhood cancer in the cinema: how the celluloid mirror reflects psychosocial care.

PubMed

Pavisic, Jovana; Chilton, Julie; Walter, Garry; Soh, Nerissa L; Martin, Andrés

2014-08-01

This study aims to evaluate the childhood cancer experience in commercially produced, readily available films that include a character with childhood cancer, with a particular focus on psychosocial care. We reviewed 29 films, using quantitative and qualitative content analysis, to identify the medical and psychosocial characteristics of the cinematic childhood cancer experience. We rated psychosocial support on a 5-point scale (0 to 4) based on the availability and efficacy of support characters in the categories of nonprofessional internal (eg, parent), nonprofessional external (eg, friend), professional medical (eg, oncologist), and professional psychosocial (eg, social worker) supports. Film depicts an unrealistic, bleak picture of childhood cancer, with a 66% mortality rate among the 35 characters evaluated. Psychosocial supports portrayed in film are generally limited to resources already available to families before the cancer diagnosis: mean ratings across films were 2.4 for both nonprofessional, 1.6 for professional medical, and 0.3 for professional psychosocial supports (Kruskal-Wallis χ3=43.1051, P<0.0001). Seven main themes emerged: disruption, social impact, psychological impact, physical toll, struggle/war/fight, coping, and barren landscape. Film generally depicts images of an isolated family courageously battling cancer alone with limited support from a treatment team solely dedicated to medical care. Commercially available films minimize the importance of the psychosocial dimension of care, which can perpetuate stigma around psychosocial needs and interventions. These films can be used to encourage discussion about how to optimize psychosocial care in pediatric oncology so that such care is not abandoned in actual practice as it is, for entertainment purposes, on the screen.

Caregiver Sexual and HPV Communication among Female Survivors of Childhood Cancer

PubMed Central

Peasant, Courtney; Foster, Rebecca H.; Russell, Kathryn M.; Favaro, Brianne E.; Klosky, James L.

2018-01-01

HPV vaccination is recommended for all female survivors of childhood cancer; yet, it is underutilized. Parent-child sexual communication and healthcare provider recommendation for HPV vaccination influence familial vaccination decisions. However, caregivers may be less likely to discuss sexual health issues with survivors as compared to healthy peers. Therefore, this study compared mothers of daughters with/without history of childhood cancer on measures of sexual communication, HPV-specific communication, and healthcare provider recommendation for HPV vaccination, and examined the effects of sociodemographic and medical factors on these measures. There were no differences between mothers of survivors/non-cancer survivors on the outcomes (ps > .05). Among all mothers, daughter’s age was associated with sexual communication (ps < .05). Household income and daughter’s age were associated with healthcare provider recommendation for vaccination (ps < .05). Among mothers of survivors, daughter’s age at diagnosis was associated with sexual communication, HPV-specific communication, and healthcare provider recommendation for vaccination (ps < .05). Findings have implications for the role of healthcare providers as advocates for mother-daughter sexual communication and HPV vaccination, especially among survivors of childhood cancer. PMID:26668213

Childhood socioeconomic status and lifetime health behaviors: The Young Finns Study.

PubMed

Puolakka, Elina; Pahkala, Katja; Laitinen, Tomi T; Magnussen, Costan G; Hutri-Kähönen, Nina; Männistö, Satu; Pälve, Kristiina S; Tammelin, Tuija; Tossavainen, Päivi; Jokinen, Eero; Smith, Kylie J; Laitinen, Tomi; Elovainio, Marko; Pulkki-Råback, Laura; Viikari, Jorma S A; Raitakari, Olli T; Juonala, Markus

2018-05-01

Differences in health behaviors partly explain the socioeconomic gap in cardiovascular health. We prospectively examined the association between childhood socioeconomic status (SES) and lifestyle factors in adulthood, and the difference of lifestyle factors according to childhood SES in multiple time points from childhood to adulthood. The sample comprised 3453 participants aged 3-18 years at baseline (1980) from the longitudinal Young Finns Study. The participants were followed up for 31 years (N = 1675-1930). SES in childhood was characterized as reported annual family income and classified on an 8-point scale. Diet, smoking, alcohol intake and physical activity were used as adult and life course lifestyle factors. Higher childhood SES predicted a healthier diet in adulthood in terms of lower consumption of meat (β ± SE -3.6 ± 0.99,p < 0.001), higher consumption of fish (1.1 ± 0.5, p = 0.04) and higher diet score (0.14 ± 0.044, p = 0.01). Childhood SES was also directly associated with physical activity index (0.059 ± 0.023, p = 0.009) and inversely with the risk of being a smoker (RR 0.90 95%CI 0.85-0.95, p < 0.001) and the amount of pack years (-0.47 ± 0.18, p = 0.01). Life course level of smoking was significantly higher and physical activity index lower among those below the median childhood SES when compared with those above the median SES. These results show that childhood SES associates with several lifestyle factors 31 years later in adulthood. Therefore, attention could be paid to lifestyle behaviors of children of low SES families to promote cardiovascular health. Copyright © 2017 Elsevier B.V. All rights reserved.

Media Culture and Media Violence: Making the Television Work for Young Children, Early Childhood Educators, and Parents.

ERIC Educational Resources Information Center

Eastman, Wayne

This paper provides an overview of the impact of television on young children, with a special emphasis on the relationship among TV, childhood, and violence, and on developmentally appropriate television. Further, the paper provides strategies for parents and early childhood educators to use in taking control of the television. The paper is…

High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance.

PubMed

Hudson, Melissa M; Mulrooney, Daniel A; Bowers, Daniel C; Sklar, Charles A; Green, Daniel M; Donaldson, Sarah S; Oeffinger, Kevin C; Neglia, Joseph P; Meadows, Anna T; Robison, Leslie L

2009-05-10

Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this manuscript is to review how data derived from Childhood Cancer Survivor Study (CCSS) investigations have facilitated identification of childhood cancer survivor populations at high risk for specific organ toxicity and secondary carcinogenesis and how this has informed clinical screening practices. Articles previously published that used the resource of the CCSS to identify risk factors for specific organ toxicity and subsequent cancers were reviewed and results summarized. CCSS investigations have characterized specific groups to be at highest risk of morbidity related to endocrine and reproductive dysfunction, pulmonary toxicity, cerebrovascular injury, neurologic and neurosensory sequelae, and subsequent neoplasms. Factors influencing risk for specific outcomes related to the individual survivor (eg, sex, race/ethnicity, age at diagnosis, attained age), sociodemographic status (eg, education, household income, health insurance) and cancer history (eg, diagnosis, treatment, time from diagnosis) have been consistently identified. These CCSS investigations that clarify risk for treatment complications related to specific treatment modalities, cumulative dose exposures, and sociodemographic factors identify profiles of survivors at high risk for cancer-related morbidity who deserve heightened surveillance to optimize outcomes after treatment for childhood cancer.

Neurocognitive Effects of Treatment for Childhood Cancer

ERIC Educational Resources Information Center

Butler, Robert W.; Haser, Jennifer K.

2006-01-01

We review research on the neuropsychological effects that central nervous system (CNS) cancer treatments have on the cognitive abilities of children and adolescents. The authors focus on the two most common malignancies of childhood: leukemias and brain tumors. The literature review is structured so as to separate out earlier studies, generally…

Unemployment and substance use problems among young adults: Does childhood low socioeconomic status exacerbate the effect?

PubMed Central

Lee, Jungeun Olivia; Hill, Karl G.; Hartigan, Lacey. A.; Boden, Joseph; Guttmannova, Katarina; Kosterman, Rick; Bailey, Jennifer A.; Catalano, Richard F.

2015-01-01

The current study tested whether unemployment predicted young adults’ heavy episodic drinking, cigarette smoking, and cannabis use after taking into account individual development in substance use. Furthermore, building on the life course perspective, this study examined whether the link between unemployment and substance use among young adults differed for those who experienced low childhood SES compared to those who did not. Data for the present study came from the Seattle Social Development Project (SSDP), a panel study examining a broad range of developmental outcomes from ages 10 to 33. A life history calendar (LHC) was administered to assess substance use and unemployment status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and adult educational attainment. Results suggest that unemployment is associated with young adults’ heavy episodic drinking and possibly cigarette use, but not cannabis use. Moreover, for all three substances, the detrimental impact of unemployment on substance use seems to be exacerbated among young adults who spent their childhood and adolescence in a lower SES household. Public health efforts that provide other viable and affordable options to cope with unemployment among young adults from low SES backgrounds are needed to address this disproportionate concentration of adverse impacts of unemployment on behavioral health. PMID:26342911

Aspects of mental health dysfunction among survivors of childhood cancer.

PubMed

Fidler, Miranda M; Ziff, Oliver J; Wang, Sarra; Cave, Joshua; Janardhanan, Pradeep; Winter, David L; Kelly, Julie; Mehta, Susan; Jenkinson, Helen; Frobisher, Clare; Reulen, Raoul C; Hawkins, Michael M

2015-09-29

Some previous studies have reported that survivors of childhood cancer are at an increased risk of developing long-term mental health morbidity, whilst others have reported that this is not the case. Therefore, we analysed 5-year survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS) to determine the risks of aspects of long-term mental health dysfunction. Within the BCCSS, 10 488 survivors completed a questionnaire that ascertained mental health-related information via 10 questions from the Short Form-36 survey. Internal analyses were conducted using multivariable logistic regression to determine risk factors for mental health dysfunction. External analyses were undertaken using direct standardisation to compare mental health dysfunction in survivors with UK norms. This study has shown that overall, childhood cancer survivors had a significantly higher prevalence of mental health dysfunction for 6/10 questions analysed compared to UK norms. Central nervous system (CNS) and bone sarcoma survivors reported the greatest dysfunction, compared to expected, with significant excess dysfunction in 10 and 6 questions, respectively; the excess ranged from 4.4-22.3% in CNS survivors and 6.9-15.9% in bone sarcoma survivors. Compared to expected, excess mental health dysfunction increased with attained age; this increase was greatest for reporting 'limitations in social activities due to health', where the excess rose from 4.5% to 12.8% in those aged 16-24 and 45+, respectively. Within the internal analyses, higher levels of educational attainment and socio-economic classification were protective against mental health dysfunction. Based upon the findings of this large population-based study, childhood cancer survivors report significantly higher levels of mental health dysfunction than those in the general population, where deficits were observed particularly among CNS and bone sarcoma survivors. Limitations were also observed to increase

Traumatic Stress Symptoms and Breast Cancer: The Role of Childhood Abuse

ERIC Educational Resources Information Center

Goldsmith, Rachel E.; Jandorf, Lina; Valdimarsdottir, Heiddis; Amend, Kandace L.; Stoudt, Brett G.; Rini, Christine; Hershman, Dawn; Neugut, Alfred; Reilly, James J.; Tartter, Paul I.; Feldman, Sheldon M.; Ambrosone, Christine B.; Bovbjerg, Dana H.

2010-01-01

Objective: The present study investigated relations between reported childhood abuse and recent traumatic stress symptoms in women newly diagnosed with breast cancer (n = 330). Methods: As part of a larger ongoing study, patients from eight public and private hospitals were referred by their physicians and completed the Childhood Trauma…

Direct and Indirect Effects of Childhood Adversity on Depressive Symptoms in Young Adults.

ERIC Educational Resources Information Center

Turner, Heather A.; Butler, Melissa J.

2003-01-01

Examined whether cumulative trauma in childhood and adolescence is related to depressive symptoms in young adults and explored mediating factors. Results for 649 college students indicate clear differences in cumulative trauma by sociodemographic characteristics, with high trauma associated with early onset of depression and later depressive…

Childhood parental divorce and cortisol in young adulthood: evidence for mediation by family income.

PubMed

Kraft, Amy J; Luecken, Linda J

2009-10-01

Childhood parental divorce has been linked with negative physical and psychological health in adulthood, potentially due to alterations in adrenocortical activity resulting from chronic stress. The current study evaluated cortisol in 94 young adults (mean age 19.9) from families characterized by parental divorce (n=43) or intact parental marriages (n=51). Salivary cortisol was assessed prior to and at 3 time points after a challenging speech task. Participants from divorced families had significantly lower cortisol across the experimental period than those from intact families, even after controlling for family conflict and current depression and anxiety. Lower family income was also associated with lower cortisol, and partially mediated the relationship between parental divorce and cortisol. Findings suggest that childhood parental divorce is associated with attenuated cortisol in young adulthood, which may be explained by lower income in divorced families.

Approaches to reduce the long-term burden of treatment-related complications in survivors of childhood cancer.

PubMed

Armenian, Saro H; Kremer, Leontien C; Sklar, Charles

2015-01-01

Advances in diagnostics, treatment strategies, and supportive care have contributed to a marked improvement in outcomes for children with cancer. This has resulted in a growing number of long-term childhood cancer survivors. Currently there are over 360,000 individuals who are survivors of childhood cancer in the United States. However, treatment for patients with childhood cancer with chemotherapy, radiation, and/or hematopoietic stem cell transplantation can result in health-related complications that may not become evident until years after completion of treatment. As a result, several initiatives have been established to help standardize the surveillance for treatment-related late effects in childhood cancer survivors. This review highlights emerging concepts related to commonly reported late effects, such as subsequent malignant neoplasms, cardiovascular disease, and endocrinopathies. It also discusses relevant population-based screening strategies to mitigate the long-term health-related burden in vulnerable populations of survivors.

Korean Early Childhood Educators' Perceptions of Importance and Implementation of Strategies to Address Young Children's Social-Emotional Competence

ERIC Educational Resources Information Center

Heo, Kay H.; Cheatham, Gregory A.; Hemmeter, Mary Louise; Noh, Jina

2014-01-01

In South Korea, there has been a rapid increase in challenging behaviors and other social-emotional difficulties at the early childhood level. Korean early childhood educators' perspectives and strategies to address young children's social-emotional competencies and challenging behaviors were investigated. Overall, results suggest that many Korean…

Health behaviors of minority childhood cancer survivors.

PubMed

Stolley, Melinda R; Sharp, Lisa K; Tangney, Christy C; Schiffer, Linda A; Arroyo, Claudia; Kim, Yoonsang; Campbell, Richard T; Schmidt, Mary Lou; Breen, Kathleen; Kinahan, Karen E; Dilley, Kim J; Henderson, Tara O; Korenblit, Allen D; Seligman, Katya

2015-05-15

Available data have suggested that childhood cancer survivors (CCSs) are comparable to the general population with regard to many lifestyle parameters. However, to the authors' knowledge, little is known regarding minority CCSs. This cross-sectional study describes and compares the body mass index and health behaviors of African American, Hispanic, and white survivors with each other and with noncancer controls. Participants included 452 adult CCSs (150 African American, 152 Hispanic, and 150 white individuals) recruited through 4 childhood cancer treating institutions and 375 ethnically matched noncancer controls (125 in each racial/ethnic group) recruited via targeted digit dial. All participants completed a 2-hour in-person interview. Survivors and noncancer controls reported similar health behaviors. Within survivors, smoking and physical activity were found to be similar across racial/ethnic groups. African American and Hispanic survivors reported lower daily alcohol use compared with white individuals, but consumed unhealthy diets and were more likely to be obese. This unique study highlights that many minority CCSs exhibit lifestyle profiles that contribute to an increased risk of chronic diseases and late effects. Recommendations for behavior changes must consider the social and cultural context in which minority survivors may live. © 2015 American Cancer Society.

Discursive constructions of youth cancer: findings from creative methods research with healthy young people.

PubMed

Mooney-Somers, Julie; Lewis, Peter; Kerridge, Ian

2016-06-01

As part of work to understand the experiences of young people who had cancer, we were keen to examine the perspectives of peers who share their social worlds. Our study aimed to examine how cancer in young people, young people with cancer and young cancer survivors are represented through language, metaphor and performance. We generated data using creative activities and focus group discussions with three high school drama classes and used Foucauldian discourse analysis to identify the discursive constructions of youth cancer. Our analysis identified two prevailing discursive constructions: youth cancer as an inevitable decline towards death and as overwhelming personhood by reducing the young person with cancer to 'cancer victim'. If we are to understand life after cancer treatment and how to support young people who have been treated for cancer, we need a sophisticated understanding of the social contexts they return to. Discourses shape the way young people talk and think about youth cancer; cancer as an inevitable decline towards death and as overwhelming personhood is a key discursive construction that young people draw on when a friend discloses cancer. The way cancer is constructed shapes how friends react to and relate to a young person with cancer. These constructions are likely to shape challenging social dynamics, such as bullying, that many young cancer survivors experience. Awareness of these discursive constructions can better equip young cancer survivors, their family and health professionals negotiate life after cancer.

3 CFR 8851 - Proclamation 8851 of August 31, 2012. National Childhood Cancer Awareness Month, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... Childhood Cancer Awareness Month, 2012 8851 Proclamation 8851 Presidential Documents Proclamations Proclamation 8851 of August 31, 2012 Proc. 8851 National Childhood Cancer Awareness Month, 2012By the President... diagnosed with cancer—an often life-threatening illness that remains the leading cause of death by disease...

Fertility of Male Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Green, Daniel M.; Kawashima, Toana; Stovall, Marilyn; Leisenring, Wendy; Sklar, Charles A.; Mertens, Ann C.; Donaldson, Sarah S.; Byrne, Julianne; Robison, Leslie L.

2010-01-01

Purpose This study was undertaken to determine the effect of treatment for childhood cancer on male fertility. Patients and Methods We reviewed the fertility of male Childhood Cancer Survivor Study survivor and sibling cohorts who completed a questionnaire. We abstracted the chemotherapeutic agents administered, the cumulative dose of drug administered for selected drugs, and the doses and volumes of all radiation therapy from medical records. Risk factors for siring a pregnancy were evaluated using Cox proportional hazards models. Results The 6,224 survivors age 15 to 44 years who were not surgically sterile were less likely to sire a pregnancy than siblings (hazard ratio [HR], 0.56; 95% CI, −0.49 to 0.63). Among survivors, the HR of siring a pregnancy was decreased by radiation therapy of more than 7.5 Gy to the testes (HR, 0.12; 95% CI, −0.02 to 0.64), higher cumulative alkylating agent dose (AAD) score or treatment with cyclophosphamide (third tertile HR, 0.42; 95% CI, −0.31 to 0.57) or procarbazine (second tertile HR, 0.48; 95% CI, −0.26 to 0.87; third tertile HR, 0.17; 95% CI, −0.07 to 0.41). Compared with siblings, the HR for ever siring a pregnancy for survivors who had an AAD score = 0, a hypothalamic/pituitary radiation dose = 0 Gy, and a testes radiation dose = 0 Gy was 0.91 (95% CI, 0.73 to 1.14; P = .41). Conclusion This large study identified risk factors for decreased fertility that may be used for counseling male cancer patients. PMID:19949008

Childhood growth, schooling, and cognitive development: further evidence from the Young Lives study.

PubMed

Fink, Günther; Rockers, Peter C

2014-07-01

A growing literature has linked early childhood growth to later-life cognition and schooling outcomes in developing countries. Although existing evidence suggests that children's ability to recover from early growth delays in later childhood is limited, longitudinal studies on the persistence and risk of growth faltering beyond age 5 y remain scarce. Using longitudinal data recently collected from 4 developing countries as part of the Young Lives study, we investigated catch-up growth in children between the ages of 8 and 15 y and the effects of growth during this late-childhood and early-adolescence period on schooling and developmental outcomes. We analyzed the associations between children's physical growth and development by using longitudinal data from 3327 children aged 8-15 y collected in Ethiopia, India, Peru, and Vietnam as part of the Young Lives project. The study yielded 2 main results. First, 36% of children stunted at age 8 y managed to catch up with their peers by age 15 y, and those who caught up had smaller deficits in cognitive scores than did children who remained stunted. Second, physical growth faltering was not restricted to early childhood but rather affected a substantial share of children in the 8-15-y age range, with large negative consequences for cognition and schooling outcomes. The results from this study suggest that child development in developing countries is a dynamic process offering continued opportunities for children to catch up during adolescence and sustained risks for children to fall behind in their developmental trajectories. © 2014 American Society for Nutrition.

Developmental Status and Intimacy in Adult Survivors of Childhood Cancer.

ERIC Educational Resources Information Center

Zevon, Michael A.; Corn, Barbara; Lowrie, Geoffrey; Green, Daniel M.

Whereas aggressive multimodal therapies are responsible for improved survival rates of children and adolescents diagnosed with cancer, concern has grown regarding the potential for adverse and delayed developmental effects resulting from these treatments. In light of this concern, this study assessed 207 adult survivors of childhood cancer in…

Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study.

PubMed

Hauri, Dimitri; Spycher, Ben; Huss, Anke; Zimmermann, Frank; Grotzer, Michael; von der Weid, Nicolas; Weber, Damien; Spoerri, Adrian; Kuehni, Claudia E; Röösli, Martin

2013-10-01

In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results. We investigated the association between domestic radon exposure and childhood cancers, particularly leukemia and central nervous system (CNS) tumors. We conducted a nationwide census-based cohort study including all children < 16 years of age living in Switzerland on 5 December 2000, the date of the 2000 census. Follow-up lasted until the date of diagnosis, death, emigration, a child's 16th birthday, or 31 December 2008. Domestic radon levels were estimated for each individual home address using a model developed and validated based on approximately 45,000 measurements taken throughout Switzerland. Data were analyzed with Cox proportional hazard models adjusted for child age, child sex, birth order, parents' socioeconomic status, environmental gamma radiation, and period effects. In total, 997 childhood cancer cases were included in the study. Compared with children exposed to a radon concentration below the median (< 77.7 Bq/m3), adjusted hazard ratios for children with exposure ≥ the 90th percentile (≥ 139.9 Bq/m3) were 0.93 (95% CI: 0.74, 1.16) for all cancers, 0.95 (95% CI: 0.63, 1.43) for all leukemias, 0.90 (95% CI: 0.56, 1.43) for acute lymphoblastic leukemia, and 1.05 (95% CI: 0.68, 1.61) for CNS tumors. We did not find evidence that domestic radon exposure is associated with childhood cancer, despite relatively high radon levels in Switzerland.

Autoimmune diseases in Adult Life after Childhood Cancer in Scandinavia (ALiCCS).

PubMed

Holmqvist, Anna Sällfors; Olsen, Jørgen H; Mellemkjaer, Lene; Garwicz, Stanislaw; Hjorth, Lars; Moëll, Christian; Månsson, Bengt; Tryggvadottir, Laufey; Hasle, Henrik; Winther, Jeanette Falck

2016-09-01

The pattern of autoimmune diseases in childhood cancer survivors has not been investigated previously. We estimated the risk for an autoimmune disease after childhood cancer in a large, population-based setting with outcome measures from comprehensive, nationwide health registries. From the national cancer registries of Denmark, Iceland and Sweden, we identified 20 361 1-year survivors of cancer diagnosed before the age of 20 between the start of cancer registration in the 1940s and 1950s through 2008; 125 794 comparison subjects, matched by age, gender and country, were selected from national population registers. Study subjects were linked to the national hospital registers. Standardised hospitalisation rate ratios (SHRRs) and absolute excess risks (AERs) were calculated. Childhood cancer survivors had a significantly increased SHRR of 1.4 (95% CI 1.3 to 1.5) of all autoimmune diseases combined, corresponding to an AER of 67 per 100 000 person-years. The SHRRs were significantly increased for autoimmune haemolytic anaemia (16.3), Addison's disease (13.9), polyarteritis nodosa (5.8), chronic rheumatic heart disease (4.5), localised scleroderma (3.6), idiopathic thrombocytopenic purpura (3.4), Hashimoto's thyroiditis (3.1), pernicious anaemia (2.7), sarcoidosis (2.2), Sjögren's syndrome (2.0) and insulin-dependent diabetes mellitus (1.6). The SHRRs for any autoimmune disease were significantly increased after leukaemia (SHRR 1.6), Hodgkin's lymphoma (1.6), renal tumours (1.6) and central nervous system neoplasms (1.4). Childhood cancer survivors are at increased risk for certain types of autoimmune diseases. These findings underscore the need for prolonged follow-up of these survivors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Protective Connections and Educational Attainment among Young Adults with Childhood-Onset Chronic Illness

ERIC Educational Resources Information Center

Maslow, Gary; Haydon, Abigail A.; McRee, Annie-Laurie; Halpern, Carolyn T.

2012-01-01

Background: Youth with childhood-onset chronic illness (COCI) are at risk of poor educational attainment. Specific protective factors that promote college graduation in this population have not been studied previously. In this study, we examine the role protective factors during adolescence play in promoting college graduation among young adults…

UNRECOGNIZED OR POTENTIAL RISK FACTORS FOR CHILDHOOD CANCER

EPA Science Inventory

Traditional epidemiological studies suggest that the contribution of environmental agents to childhood cancer may be minor. However, epidemiological methods can only seldom identify causal factors associated with a relative risk of less than a factor of one and a half to two. App...

Childhood Thyroid Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Childhood thyroid cancer usually presents as a thyroid mass with or without painless cervical adenopathy. It may occur as part of a tumor predisposition syndrome such as multiple endocrine neoplasia or DICER1 syndrome. Get detailed information about the risk factors, histopathology, molecular features, presentation, diagnostic evaluation, and treatment of papillary, follicular, and medullary thyroid cancer in this summary for clinicians.

Adverse childhood experiences and behavioral problems in middle childhood.

PubMed

Hunt, Tenah K A; Slack, Kristen S; Berger, Lawrence M

2017-05-01

Children who have been exposed to maltreatment and other adverse childhood experiences (ACEs) are at increased risk for various negative adult health outcomes, including cancer, liver disease, substance abuse, and depression. However, the proximal associations between ACEs and behavioral outcomes during the middle childhood years have been understudied. In addition, many of the ACE studies contain methodological limitations such as reliance on retrospective reports and limited generalizability to populations of lower socioeconomic advantage. The current study uses data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort, to prospectively assess the adverse experiences and subsequent behavior problems of over 3000 children. Eight ACE categories to which a child was exposed by age 5 were investigated: childhood abuse (emotional and physical), neglect (emotional and physical), and parental domestic violence, anxiety or depression, substance abuse, or incarceration. Results from bivariate analyses indicated that Black children and children with mothers of low education were particularly likely to have been exposed to multiple ACE categories. Regression analyses showed that exposure to ACEs is strongly associated with externalizing and internalizing behaviors and likelihood of ADHD diagnosis in middle childhood. Variation in these associations by racial/ethnic, gender, and maternal education subgroups are examined. This study provides evidence that children as young as 9 begin to show behavioral problems after exposure to early childhood adversities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adverse Childhood Experiences and Behavioral Problems in Middle Childhood

PubMed Central

Berger, Lawrence M.; Slack, Kristen S.

2016-01-01

Children who have been exposed to maltreatment and other adverse childhood experiences (ACEs) are at increased risk for various negative adult health outcomes, including cancer, liver disease, substance abuse, and depression. However, the proximal associations between ACEs and behavioral outcomes during the middle childhood years have been understudied. In addition, many of the ACE studies contain methodological limitations such as reliance on retrospective reports and limited generalizability to populations of lower socioeconomic advantage. The current study uses data from the Fragile Families and Child Well being Study, a national urban birth cohort, to prospectively assess the adverse experiences and subsequent behavior problems of over 3,000 children. Eight ACE categories to which a child was exposed by age 5 were investigated: childhood abuse (emotional and physical), neglect (emotional and physical), and parental domestic violence, anxiety or depression, substance abuse, or incarceration. Results from bivariate analyses indicated that Black children and children with mothers of low education were particularly likely to have been exposed to multiple ACE categories. Regression analyses showed that exposure to ACEs is strongly associated with externalizing and internalizing behaviors and likelihood of ADHD diagnosis in middle childhood. Variation in these associations by racial/ethnic, gender, and maternal education subgroups are examined. This study provides evidence that children as young as 9 begin to show behavioral problems after exposure to early childhood adversities. PMID:27884508

Health-Related Behaviour Among Children of Childhood Cancer Survivors in Germany.

PubMed

Balcerek, M; Schuster, T; Korte, E; Seidel, J; Schilling, R; Hölling, H; Borgmann-Staudt, A

2017-05-01

Purpose: Childhood cancer survivors fear that previous therapy could not only impair their own but also their children's health. We examined whether health-related behaviour in children of childhood cancer survivors differs from the general population. Methods: Our first nationwide survey wave (2013-2014) surveyed offspring health in 396 German childhood cancer survivors known to have a child of their own. Answers about health behaviour were analysed using descriptive statistics. Data were collected for 418 offspring and 394 could be integrated for matched-pair analyses with data from the German general population (KIGGS, n=17 641). Results: Teeth-cleaning routine, body-mass-index or subjective body image evaluation by parents were no different from children in the general population. Parents who included a cancer survivor smoked less in the presence of their children (p=0.01). During pregnancy, mothers in cancer survivor parent pairs abstained from drinking alcohol more often (p=0.01) and smoked less (p=0.05). While the calculated effect sizes (Phi) were generally low (0.135-0.247), children from cancer survivors played less outdoors than peers did (p=0.01). Boys participated in sports outside a club more often (p=0.05) and watched less TV on weekdays (p=0.01) and girls spent more time on the computer during weekdays than peers did (p=0.01). Conclusions: This study provides the first data for health-related behaviour in cancer survivors' offspring and sheds light on differences to parenting in the general population. Multivariate analyses in a larger study population are needed to relate these differences to fear issues in cancer survivors. © Georg Thieme Verlag KG Stuttgart · New York.

Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

PubMed Central

Hauri, Dimitri; Spycher, Ben; Huss, Anke; Zimmermann, Frank; Grotzer, Michael; von der Weid, Nicolas; Weber, Damien; Spoerri, Adrian; Kuehni, Claudia E.

2013-01-01

Background: In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results. Objective: We investigated the association between domestic radon exposure and childhood cancers, particularly leukemia and central nervous system (CNS) tumors. Methods: We conducted a nationwide census-based cohort study including all children < 16 years of age living in Switzerland on 5 December 2000, the date of the 2000 census. Follow-up lasted until the date of diagnosis, death, emigration, a child’s 16th birthday, or 31 December 2008. Domestic radon levels were estimated for each individual home address using a model developed and validated based on approximately 45,000 measurements taken throughout Switzerland. Data were analyzed with Cox proportional hazard models adjusted for child age, child sex, birth order, parents’ socioeconomic status, environmental gamma radiation, and period effects. Results: In total, 997 childhood cancer cases were included in the study. Compared with children exposed to a radon concentration below the median (< 77.7 Bq/m3), adjusted hazard ratios for children with exposure ≥ the 90th percentile (≥ 139.9 Bq/m3) were 0.93 (95% CI: 0.74, 1.16) for all cancers, 0.95 (95% CI: 0.63, 1.43) for all leukemias, 0.90 (95% CI: 0.56, 1.43) for acute lymphoblastic leukemia, and 1.05 (95% CI: 0.68, 1.61) for CNS tumors. Conclusions: We did not find evidence that domestic radon exposure is associated with childhood cancer, despite relatively high radon levels in Switzerland. Citation: Hauri D, Spycher B, Huss A, Zimmermann F, Grotzer M, von der Weid N, Weber D, Spoerri A, Kuehni C, Röösli M, for the Swiss National Cohort and the Swiss Paediatric Oncology Group (SPOG). 2013. Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study. Environ Health Perspect 121:1239–1244; http://dx.doi.org/10

Researchers identify potential therapeutic targets for a rare childhood cancer | Center for Cancer Research

Cancer.gov

CCR researchers have identified the mechanism behind a rare but extremely aggressive childhood cancer called alveolar rhabdomyosarcoma (ARMS) and have pinpointed a potential drug target for its treatment. Learn more...

School attendance in childhood cancer survivors and their siblings.

PubMed

French, Amy E; Tsangaris, Elena; Barrera, Maru; Guger, Sharon; Brown, Robert; Urbach, Stacey; Stephens, Derek; Nathan, Paul C

2013-01-01

To investigate school absenteeism among childhood cancer survivors and their siblings and examine factors related to absenteeism in survivors. A cross-sectional study was conducted among consecutive cancer survivors attending a large pediatric cancer survivor clinic. Absenteeism rates were obtained for survivors and their closest in age sibling from school report cards. Absenteeism was compared with a population control group of 167752 students using 1-sample t tests. The Child Vulnerability Scale, Pediatric Quality of Life Inventory, and Behavior Assessment System for Children were administered to survivors. Univariate and multiple regression analyses assessed variables associated with days absent. One hundred thirty-one survivors (median age at assessment: 13.4 years, range 8.0-19.2; median age at diagnosis: 9.4 years, range 4.3-17.3) and 77 siblings (median age at assessment: 13 years, age range 7-18) participated. Survivors and siblings missed significantly more school days than the population control group (mean ± SD: 9.6 ± 9.2 and 9.9 ± 9.8 vs 5.0 ± 5.6 days, respectively, P < .0001). Among matched survivor-sibling pairs (N = 77), there was no difference in absenteeism (9.6 ± 9.2 vs 9.9 ± 9.8 days, P = .85). Absenteeism in survivors was significantly associated with a low Pediatric Quality of Life Inventory Physical Health Summary Score (P = .01). Parents' perception of their child's vulnerability and emotional and social functioning were not associated with absenteeism. Childhood cancer survivors and siblings miss more school than the general population. The only predictor of absenteeism in survivors is poor physical quality of health. More research should be devoted to school attendance and other outcomes in siblings of childhood cancer survivors. Copyright © 2013 Mosby, Inc. All rights reserved.

Protective connections and educational attainment among young adults with childhood-onset chronic illness.

PubMed

Maslow, Gary; Haydon, Abigail A; McRee, Annie-Laurie; Halpern, Carolyn T

2012-08-01

Youth with childhood-onset chronic illness (COCI) are at risk of poor educational attainment. Specific protective factors that promote college graduation in this population have not been studied previously. In this study, we examine the role protective factors during adolescence play in promoting college graduation among young adults with COCI. Data were collected from 10,925 participants in the National Longitudinal Study of Adolescent Health (Add Health). Protective factors present before 18 years of age included mentoring, parent relationship quality, school connectedness, and religious attendance. College graduation was the outcome of interest assessed when participants had a mean age of 28 years. Analysis was stratified by presence of COCI. About 2% of participants (N = 230) had 1 of 4 COCIs (cancer, diabetes, epilepsy, or heart disease). All 4 protective factors were associated with college graduation for youth without COCI. In the final multivariate model, only school connectedness was associated with college graduation for youth with COCI. School connectedness is of particular importance in promoting educational attainment for youth with COCI. © 2012, American School Health Association.

Quality of life questionnaires for children with cancer and childhood cancer survivors: a review of the development of available measures.

PubMed

Klassen, Anne F; Strohm, Sonya J; Maurice-Stam, Heleen; Grootenhuis, Martha A

2010-09-01

To identify and appraise all published quality of life (QOL) measures developed for use with children with cancer and childhood cancer survivors. MEDLINE, CINAHL, EMBASE, PsycINFO, CancerLit, and Sociological Abstracts were searched from the inception of each database to 15 June 2009. Included articles were ones that described the development and/or psychometric evaluation of a QOL measure developed for use with children with cancer or childhood cancer survivors. Articles were appraised for adherence to internationally recommended guidelines for item generation, item reduction, and psychometric evaluation. Thirteen QOL questionnaires were identified by our search. Eleven measures are applicable to measuring QOL in children with any type of cancer, and two are specific to children with brain cancer. Four measures can be used to measure QOL in children undergoing cancer treatment, six can be used with children on or off treatment, and three are specific to childhood cancer survivors. While all measures underwent some degree of formal development and validation, item generation often did not involve children with cancer or their parents, and a number of measures did not describe or utilize recommended methods for item reduction and psychometric evaluation. Most of the measures identified in this review were designed to measure QOL concerns of children with any type of cancer and at any time, during treatment or survivorship. Our findings can help researchers and clinicians identify scientifically sound measures.

Childhood Cancer Incidence Trends in Association With US Folic Acid Fortification (1986–2008)

PubMed Central

Johnson, Kimberly J.; Ross, Julie A.

2012-01-01

OBJECTIVE: Epidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996–1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification. METHODS: Using Surveillance, Epidemiology, and End Results program data (1986–2008), we calculated incidence rate ratios and 95% confidence intervals to compare pre- and postfortification cancer incidence rates in children aged 0 to 4 years. Incidence trends were also evaluated by using joinpoint and loess regression models. RESULTS: From 1986 through 2008, 8829 children aged 0 to 4 years were diagnosed with malignancies, including 3790 and 3299 in utero during the pre- and postfortification periods, respectively. Pre- and postfortification incidence rates were similar for all cancers combined and for most specific cancer types. Rates of Wilms tumor (WT), primitive neuroectodermal tumors (PNETs), and ependymomas were significantly lower postfortification. Joinpoint regression models detected increasing WT incidence from 1986 through 1997 followed by a sizable decline from 1997 through 2008, and increasing PNET incidence from 1986 through 1993 followed by a sharp decrease from 1993 through 2008. Loess curves indicated similar patterns. CONCLUSIONS: These results provide support for a decrease in WT and possibly PNET incidence, but not other childhood cancers, after US folic acid fortification. PMID:22614769

Childhood trauma and increased peripheral cytokines in young adults with major depressive: Population-based study.

PubMed

Pedrotti Moreira, Fernanda; Wiener, Carolina David; Jansen, Karen; Portela, Luis Valmor; Lara, Diogo R; Souza, Luciano Dias de Mattos; da Silva, Ricardo Azevedo; Oses, Jean Pierre

2018-06-15

The aim of this study was to evaluate the effect of childhood trauma in cytokine serum levels of individuals with MDD. This was a cross-sectional study population-based, with people aged 18 to 35. The Mini International Neuropsychiatric Interview (M.I.N.I) measured to current major depressive disorder (MDD). To evaluate traumatic experiences during childhood, the Childhood Trauma Questionnaire (CTQ) was applied. Serum TNF- α, IL-6 and IL-10 levels were measured by ELISA using a commercial kit. The total sample comprised 166 young adults, of these: 40.4% were subjects with MDD and childhood trauma and 59.6% were diagnosed with MDD without childhood trauma. In relation to serum interleukin levels, subjects with childhood trauma showed a significantly higher serum IL-6 (p = 0.013) and IL-10 levels (p = 0.022) to compare no childhood trauma. Subjects with childhood trauma was observed positive correlation between serum IL-6 and physical abuse (r = 0.232, p = 0.035) and emotional abuse (r = 0.460, p ≤ 0.001). Moreover, IL-10 were positive correlation with physical abuse (r = 0.258, p = 0.013). TNF- α was not associated with childhood trauma. Childhood maltreatment may result higher inflammation dysregulation in individuals with depression than individuals that no has childhood maltreatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.

PubMed

Kazak, Anne E; Derosa, Branlyn Werba; Schwartz, Lisa A; Hobbie, Wendy; Carlson, Claire; Ittenbach, Richard F; Mao, Jun J; Ginsberg, Jill P

2010-04-20

PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.

Assessment of hepatitis B virus antibody titers in childhood cancer survivors.

PubMed

Fayea, Najwa Yahya; Kandil, Shaimaa Mohamed; Boujettif, Khadijah; Fouda, Ashraf Elsayed

2017-09-01

Pediatric patients suffering from cancer are at risk of hepatitis B virus (HBV) infection and its related complications even though it is considered a vaccine preventable disease. Little is known of the effects of chemotherapy, and even less is known regarding the impact of HBV booster on HBV antibody titers. It is the purpose of this study to investigate and measure the prevalence of the antihepatitis B surface antibodies (HBsAb) in childhood cancer survivors after completion of their chemotherapy treatment and to further evaluate survivors' response to a single booster dose of HBV vaccine. This observational, cross-sectional retrospective study included 43 patients, of which 37 (86%) were found to be seronegative (HBsAb titer <10 mIU/ml). The notable result was that, of the seronegative patients who received a booster dose of HBV vaccine, 90% of the tested cases exhibited a successful raising of HBsAb titers >10 mIU/ml. Childhood cancer survivors have high seronegative rates for HBV and the majority of the patients achieved HBsAb titer > 10mIU/ml with a single booster dose of HBV vaccine, which is worth further investigation and research. This study suggests revaccination against HBV post-chemotherapy treatment, as the recommended advice, especially in countries with a high prevalence of HBV infection. What is Known: • There is a variable prevalence of low HBsAb titers measured after the end of chemotherapy in childhood cancer survivors. • There are no universal guidelines for revaccination of these patients. What is New: • This research identified that 86% of childhood cancer survivors treated with standard chemotherapy were seronegative for HBV infection. • A single booster dose HBV vaccine was successful for the majority of patients (90%) to achieve HBsAb titers >10 mIU/ml.

Childhood onset inflammatory bowel disease and risk of cancer: a Swedish nationwide cohort study 1964-2014

PubMed Central

Askling, J; Sachs, MC; Frumento, P; Neovius, M; Smedby, KE; Ekbom, A; Malmborg, P; Ludvigsson, JF

2017-01-01

Objective To assess risk of cancer in patients with childhood onset inflammatory bowel disease in childhood and adulthood. Design Cohort study with matched general population reference individuals using multivariable Cox regression to estimate hazard ratios. Setting Swedish national patient register (both inpatient and non-primary outpatient care) 1964-2014. Participants Incident cases of childhood onset (<18 years) inflammatory bowel disease (n=9405: ulcerative colitis, n=4648; Crohn’s disease, n=3768; unclassified, n=989) compared with 92 870 comparators from the general population matched for sex, age, birth year, and county. Main outcome measures Any cancer and cancer types according to the Swedish Cancer Register. Results During follow-up through adulthood (median age at end of follow-up 27 years), 497 (3.3 per 1000 person years) people with childhood onset inflammatory bowel disease had first cancers, compared with 2256 (1.5 per 1000 person years) in the general population comparators (hazard ratio 2.2, 95% confidence interval 2.0 to 2.5). Hazard ratios for any cancer were 2.6 in ulcerative colitis (2.3 to 3.0) and 1.7 in Crohn’s disease (1.5 to 2.1). Patients also had an increased risk of cancer before their 18th birthday (2.7, 1.6 to 4.4; 20 cancers in 9405 patients, 0.6 per1000 person years). Gastrointestinal cancers had the highest relative risks, with a hazard ratio of 18.0 (14.4 to 22.7) corresponding to 202 cancers in patients with inflammatory bowel disease. The increased risk of cancer (before 25th birthday) was similar over time (1964-1989: 1.6, 1.0 to 2.4; 1990-2001: 2.3, 1.5 to 3.3); 2002-06: 2.9, 1.9 to 4.2; 2007-14: 2.2, 1.1 to 4.2). Conclusion Childhood onset inflammatory bowel disease is associated with an increased risk of any cancer, especially gastrointestinal cancers, both in childhood and later in life. The higher risk of cancer has not fallen over time. PMID:28931512

Childhood onset inflammatory bowel disease and risk of cancer: a Swedish nationwide cohort study 1964-2014.

PubMed

Olén, O; Askling, J; Sachs, M C; Frumento, P; Neovius, M; Smedby, K E; Ekbom, A; Malmborg, P; Ludvigsson, J F

2017-09-20

Objective  To assess risk of cancer in patients with childhood onset inflammatory bowel disease in childhood and adulthood. Design  Cohort study with matched general population reference individuals using multivariable Cox regression to estimate hazard ratios. Setting  Swedish national patient register (both inpatient and non-primary outpatient care) 1964-2014. Participants  Incident cases of childhood onset (<18 years) inflammatory bowel disease (n=9405: ulcerative colitis, n=4648; Crohn's disease, n=3768; unclassified, n=989) compared with 92 870 comparators from the general population matched for sex, age, birth year, and county. Main outcome measures  Any cancer and cancer types according to the Swedish Cancer Register. Results  During follow-up through adulthood (median age at end of follow-up 27 years), 497 (3.3 per 1000 person years) people with childhood onset inflammatory bowel disease had first cancers, compared with 2256 (1.5 per 1000 person years) in the general population comparators (hazard ratio 2.2, 95% confidence interval 2.0 to 2.5). Hazard ratios for any cancer were 2.6 in ulcerative colitis (2.3 to 3.0) and 1.7 in Crohn's disease (1.5 to 2.1). Patients also had an increased risk of cancer before their 18th birthday (2.7, 1.6 to 4.4; 20 cancers in 9405 patients, 0.6 per1000 person years). Gastrointestinal cancers had the highest relative risks, with a hazard ratio of 18.0 (14.4 to 22.7) corresponding to 202 cancers in patients with inflammatory bowel disease. The increased risk of cancer (before 25th birthday) was similar over time (1964-1989: 1.6, 1.0 to 2.4; 1990-2001: 2.3, 1.5 to 3.3); 2002-06: 2.9, 1.9 to 4.2; 2007-14: 2.2, 1.1 to 4.2). Conclusion  Childhood onset inflammatory bowel disease is associated with an increased risk of any cancer, especially gastrointestinal cancers, both in childhood and later in life. The higher risk of cancer has not fallen over time. Published by the BMJ Publishing Group Limited. For permission to use

Unemployment and substance use problems among young adults: Does childhood low socioeconomic status exacerbate the effect?

PubMed

Lee, Jungeun Olivia; Hill, Karl G; Hartigan, Lacey A; Boden, Joseph M; Guttmannova, Katarina; Kosterman, Rick; Bailey, Jennifer A; Catalano, Richard F

2015-10-01

The current study tested whether unemployment predicted young adults' heavy episodic drinking, cigarette smoking, and cannabis use after taking into account individual development in substance use. Furthermore, building on the life course perspective, this study examined whether the link between unemployment and substance use among young adults differed for those who experienced low childhood SES compared to those who did not. Data for the present study came from the Seattle Social Development Project (SSDP), a panel study examining a broad range of developmental outcomes from ages 10 to 33. A life history calendar (LHC) was administered to assess substance use and unemployment status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and adult educational attainment. Results suggest that unemployment is associated with young adults' heavy episodic drinking and possibly cigarette use, but not cannabis use. Moreover, for all three substances, the detrimental impact of unemployment on substance use seems to be exacerbated among young adults who spent their childhood and adolescence in a lower SES household. Public health efforts that provide other viable and affordable options to cope with unemployment among young adults from low SES backgrounds are needed to address this disproportionate concentration of adverse impacts of unemployment on behavioral health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pediatric Cancer Survivorship Research: Experience of the Childhood Cancer Survivor Study

PubMed Central

Leisenring, Wendy M.; Mertens, Ann C.; Armstrong, Gregory T.; Stovall, Marilyn A.; Neglia, Joseph P.; Lanctot, Jennifer Q.; Boice, John D.; Whitton, John A.; Yasui, Yutaka

2009-01-01

The Childhood Cancer Survivor Study (CCSS) is a comprehensive multicenter study designed to quantify and better understand the effects of pediatric cancer and its treatment on later health, including behavioral and sociodemographic outcomes. The CCSS investigators have published more than 100 articles in the scientific literature related to the study. As with any large cohort study, high standards for methodologic approaches are imperative for valid and generalizable results. In this article we describe methodological issues of study design, exposure assessment, outcome validation, and statistical analysis. Methods for handling missing data, intrafamily correlation, and competing risks analysis are addressed; each with particular relevance to pediatric cancer survivorship research. Our goal in this article is to provide a resource and reference for other researchers working in the area of long-term cancer survivorship. PMID:19364957

Physical punishment/maltreatment during childhood and adjustment in young adulthood.

PubMed

Fergusson, D M; Lynskey, M T

1997-07-01

To study the relationships between retrospective reports of physical punishment/maltreatment and rates of adjustment difficulties at age 18 in a birth cohort of New Zealand subjects. Data were gathered over the course of an 18 year longitudinal study of a birth cohort of 1,265 New Zealand born children. At age 18 retrospective reports of exposure to physical punishment/maltreatment were obtained. At this time the cohort was also assessed on measures of psychosocial adjustment juvenile offending, substance abuse behaviors, and psychiatric disorder. Young people reporting exposure to harsh or abusive treatment during childhood had elevated rates of juvenile offending, substance abuse, and mental health problems. However, subsequent analysis using logistic regression methods showed that much of the elevated risk shown by this group was explained by social and contextual factors that were associated with patterns of childhood punishment/maltreatment. Nonetheless, even after control for confounding factors those reporting harsh or abusive childhood experiences were at increased risks of violent offending, suicide attempts, being a victim of violence, and alcohol abuse. This study leads to three major conclusions: (1) Those exposed to harsh or abusive treatment during childhood are an at-risk population for juvenile offending, substance abuse, and mental health problems; (2) Much of this elevated risk arises from the social context within which harsh or abusive treatment occurs; (3) Nonetheless, exposure to abuse appears to increase risks of involvement in violent behavior and alcohol abuse.

Adult attachment as a moderator of the association between childhood traumatic experiences and depression symptoms among young Black gay and bisexual men.

PubMed

Cook, Stephanie H; Valera, Pamela; Calebs, Benjamin J; Wilson, Patrick A

2017-07-01

The present study examined the moderating effect of adult attachment on the association between childhood traumatic experiences, (i.e., physical abuse, emotional abuse, emotional neglect, and being bullied), age of childhood traumatic experience, and young adult depression symptoms among young Black gay and bisexual men (YBGBM). Self-report measures of attachment, childhood traumatic experiences, and depression symptoms were collected from a community-based sample of YBGBM living in New York City (n = 228). Regression analyses were conducted to address the study goals. Findings indicated that YBGBM who were more anxious in their adult attachment style and experienced being bullied or physically abused by a non-family member during childhood experienced greater depression in young adulthood than YBGBM who were less anxious in their adult attachment style. In addition, we found that being bullied later in childhood was associated with greater depression symptoms than being bullied earlier. Lastly, we found that YBGBM who were more avoidant and bullied later in adolescence reported more depression symptoms in young adulthood than YBGBM who were less avoidant in their attachment style. The findings suggest that it may be important to utilize an attachment perspective that is sensitive to age of traumatic experience when creating mental health and trauma interventions for YBGBM. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Perceptual and Motor Inhibition in Adolescents/Young Adults with Childhood-Diagnosed ADHD

PubMed Central

Bedard, Anne-Claude V.; Trampush, Joey W.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.

2010-01-01

Objective This study examined perceptual and motor inhibition in a longitudinal sample of adolescents/young adults who were diagnosed with ADHD in childhood, and as a function of the relative persistence of ADHD. Method Ninety-eight participants diagnosed with ADHD in childhood were re-evaluated approximately 10 years later. Eighty-five never-ADHD controls similar in age, IQ, sociodemographic background, and gender distribution served as a comparison group. Participants were administered a psychiatric interview and the Stimulus and Response Conflict Tasks (Nassauer & Halperin, 2003). Results Participants with childhood ADHD demonstrated slower and less accurate responses to both control and conflict conditions relative to the comparison group, as well as more variable responses in both conditions of the motor inhibition task; there was no specific effect of childhood ADHD on perceptual or motor inhibition. ADHD persisters and partial remitters did not differ in overall accuracy, speed or variability in responding, but relative to partial remitters, persisters demonstrated greater slowing in response to perceptual conflict. Conclusions These findings are consistent with theories positing state regulation, but not inhibitory control deficits in the etiology of ADHD, and suggest that improved perceptual inhibition may be associated with better outcome for ADHD. PMID:20604617

Cancer in adolescents and young adults in countries with limited resources.

PubMed

Magrath, Ian; Epelman, Sidnei

2013-08-01

Cancer in adolescents and young adults (AYA) represents a higher fraction of all cancer in countries that are still undergoing a demographic transition. Such countries tend to have much younger populations, and therefore unless they have a particularly low incidence of cancer in this age group, will have a higher burden of cancer (absolute number of cases with cancer) in AYA. Cancers in AYA are comprised of the tail end of the incidence curve of cancers that have their peak incidence, or occur almost exclusively in childhood, the beginning of the incidence curve of cancers that primarily affect the elderly, and a third set of cancers that have their peak incidence (or are at least common) in the AYA age group (e.g., testicular cancer, sarcomas, melanoma, thyroid cancer). Many, but not all, of these cancers require radiation or cancer surgery, but the poorest countries do not have a sufficient number of radiation therapy units and surgical oncologists, or indeed medical and pediatric oncologists, to deal with the burden of cancer they face. The AYA age group is particularly important, both with regard to their contribution to the economy now and in the future (the majority are in the "working" age-group defined as 15-64 years), as well as their important role in caring for their families. Moreover, some of these cancers are eminently curable with chemotherapy alone, and more could be cured by simply improving the efficiency of existing health services and providing education and training to both the public as well as oncologists and other specialists required for the care of AYA (although such individuals will not necessarily be exclusively concerned with this age group). Of particular importance is the detection and diagnosis of cancer patients at the earliest possible time in the course of their disease. Avoiding delays in initiating therapy, which are partly due to the poverty and lack of education of the public as well as to a failure on the part of primary

Genetic effects of radiotherapy for childhood cancer: gonadal dose reconstruction.

PubMed

Stovall, Marilyn; Donaldson, Sarah S; Weathers, Rita E; Robison, Leslie L; Mertens, Ann C; Winther, Jeanette Falck; Olsen, Jorgen H; Boice, John D

2004-10-01

To estimate the doses of radiation to organs of interest during treatment of childhood cancer for use in an epidemiologic study of possible heritable diseases, including birth defects, chromosomal abnormalities, cancer, stillbirth, and neonatal and premature death. The study population was composed of more than 25,000 patients with cancer in Denmark and the United States who were survivors of childhood cancer and subsequently had nearly 6,500 children of their own. Radiation therapy records were sought for the survivors who parented offspring who had adverse pregnancy outcomes (>300 offspring), and for a sample of all survivors in a case-cohort design. The records were imaged and centrally abstracted. Water phantom measurements were made to estimate doses for a wide range of treatments. Mathematical phantoms were used to apply measured results to estimate doses to ovaries, uterus, testes, and pituitary for patients ranging in age from newborn to 25 years. Gonadal shielding, ovarian pinning (oophoropexy), and field blocking were taken into account. Testicular radiation doses ranged from <1 to 700 cGy (median, 7 cGy) and ovarian doses from <1 to >2,500 cGy (median, 13 cGy). Ten percent of the records were incomplete, but sufficient data were available for broad characterizations of gonadal dose. More than 49% of the gonadal doses were >10 cGy and 16% were >100 cGy. Sufficient radiation therapy data exist as far back as 1943 to enable computation of gonadal doses administered for curative therapy for childhood cancer. The range of gonadal doses is broad, and for many cancer survivors, is high and just below the threshold for infertility. Accordingly, the epidemiologic study has >90% power to detect a 1.3-fold risk of an adverse pregnancy outcome associated with radiation exposure to the gonads. This study should provide important information on the genetic consequences of radiation exposure to humans.

Young adults' childhood experiences of support when living with a parent with a mental illness.

PubMed

Nilsson, Stefan; Gustafsson, Lisa; Nolbris, Margaretha Jenholt

2015-12-01

There are several concerns in relation to children living with a parent suffering from a mental illness. In such circumstances, the health-care professionals need to involve the whole family, offering help to the parents on parenting as well as support for their children. These children are often helped by participating in meetings that provide them with contact with others with similar experiences. The aim of this study was to investigate young adults' childhood experiences of support groups when living with a mentally ill parent. Seven young women were chosen to participate in this study. A qualitative descriptive method was chosen. The main category emerged as 'the influence of life outside the home because of a parent's mental illness' from the two generic categories: 'a different world' and 'an emotion-filled life'. The participants' friends did not know that their parent was ill and they 'always had to…take responsibility for what happened at home'. These young adults appreciated the support group activities they participated in during their childhood, stating that the meetings had influenced their everyday life as young adults. Despite this, they associated their everyday life with feelings of being different. This study highlights the need for support groups for children whose parents suffer from mental illness. © The Author(s) 2014.

The 5-minute Apgar score as a predictor of childhood cancer: a population-based cohort study in five million children.

PubMed

Li, Jiong; Cnattingus, Sven; Gissler, Mika; Vestergaard, Mogens; Obel, Carsten; Ahrensberg, Jette; Olsen, Jørn

2012-01-01

The aetiology of childhood cancer remains largely unknown but recent research indicates that uterine environment plays an important role. We aimed to examine the association between the Apgar score at 5 min after birth and the risk of childhood cancer. Nationwide population-based cohort study. Nationwide register data in Denmark and Sweden. All live-born singletons born in Denmark from 1978 to 2006 (N=1 771 615) and in Sweden from 1973 to 2006 (N=3 319 573). Children were followed up from birth to 14 years of age. Rates and HRs for all childhood cancers and for specific childhood cancers. A total of 8087 children received a cancer diagnosis (1.6 per 1000). Compared to children with a 5-min Apgar score of 9-10, children with a score of 0-5 had a 46% higher risk of cancer (adjusted HR 1.46, 95% CI 1.15 to 1.89). The potential effect of low Apgar score on overall cancer risk was mostly confined to children diagnosed before 6 months of age. Children with an Apgar score of 0-5 had higher risks for several specific childhood cancers including Wilms' tumour (HR 4.33, 95% CI 2.42 to 7.73). A low 5 min Apgar score was associated with a higher risk of childhood cancers diagnosed shortly after birth. Our data suggest that environmental factors operating before or during delivery may play a role on the development of several specific childhood cancers.

Examining the Role of Psychological Distress in Linking Childhood Maltreatment and Alcohol Use in Young Adulthood

PubMed Central

Shin, Sunny H.; Hassamal, Sameer; Groves, Lauren Peasley

2017-01-01

Background and Objectives Childhood maltreatment is related to alcohol use as well as psychological distress in young adulthood. Few studies have examined whether psychological distress mediates the relationship between child maltreatment and alcohol use. We examined the role of psychological distress in linking child maltreatment subtypes (ie, emotional abuse, physical abuse, sexual abuse, neglect) to four patterns of alcohol use, including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol dependence. Methods We used a community sample of young adults (N=337), who completed an interview assessing exposure to childhood maltreatment, current psychological distress, and drinking behaviors. Results Emotional abuse was associated with psychological distress, whereas psychological distress was related to more pathological drinking behaviors such as alcohol-related problems and alcohol dependence. Subsequent analyses indicated significant mediated effects between emotional abuse and alcohol-related problems and alcohol dependence via psychological distress, even after controlling for demographic factors, other maltreatment subtypes, parental alcoholism, and peer alcohol use. Conclusions and Scientific Significance Findings suggest that among four types of childhood maltreatment, emotional abuse might be the major driver of pathological drinking among child maltreatment victims. Interventions aimed at negative emotionality may be useful in preventing and treating problematic drinking among the victims of childhood emotional abuse. PMID:26346173

Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study

PubMed Central

Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D.; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

2015-01-01

Objective Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity as well as having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Methods Participants were 2265 men and women (age range: 24-39 years in 2001) from the on-going Cardiovascular Risk in Young Finns study whose carotid IMT were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life-events, parental health behavior family, socioeconomic status, and childhood emotional environment). Results The cumulative risk score was associated with higher IMT in 2007 (b=.004; se=.001; p<.001) and increased IMT progression from 2001 to 2007 (b=.003; se=.001; p=.001). The associations were robust to adjustment for conventional cardiovascular risk factors in childhood and adulthood, including adulthood health behavior, adulthood socioeconomic status and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life-events was associated with higher IMT in 2001 (b=.007; se=.003; p=.016) and poorer parental health behavior predicted higher IMT in 2007 (b=.004; se=.002; p=.031) after adjustment for age, sex and childhood cardiovascular risk factors. Conclusions Early life psychosocial environment influences cardiovascular risk later in life and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood. PMID:26809108

Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study.

PubMed

Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

2016-01-01

Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity and having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Participants were 2265 men and women (age range, 24-39 years in 2001) from the ongoing Cardiovascular Risk in Young Finns study whose carotid IMTs were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life events, parental health behavior family, socioeconomic status, and childhood emotional environment). The cumulative risk score was associated with higher IMT in 2007 (b = 0.004, standard error [SE] = 0.001, p < .001) and increased IMT progression from 2001 to 2007 (b = 0.003, SE = 0.001, p = .001). The associations were robust to adjustment for conventional cardiovascular risk factors in childhood and adulthood, including adulthood health behavior, adulthood socioeconomic status, and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life events was associated with higher IMT in 2001 (b = 0.007, SE = 0.003, p = .016) and poorer parental health behavior predicted higher IMT in 2007 (b = 0.004, SE = 0.002, p = .031) after adjustment for age, sex, and childhood cardiovascular risk factors. Early life psychosocial environment influences cardiovascular risk later in life, and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood.

Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue.

PubMed

Bower, Julienne E; Crosswell, Alexandra D; Slavich, George M

2014-01-01

Fatigue is a common symptom in healthy and clinical populations, including cancer survivors. However, risk factors for cancer-related fatigue have not been identified. On the basis of research linking stress with other fatigue-related disorders, we tested the hypothesis that stress exposure during childhood and throughout the life span would be associated with fatigue in breast cancer survivors. Stress exposure was assessed using the Stress and Adversity Inventory, a novel computer-based instrument that assesses for 96 types of acute and chronic stressors that may affect health. Results showed that breast cancer survivors with persistent fatigue reported significantly higher levels of cumulative lifetime stress exposure, including more stressful experiences in childhood and in adulthood, compared to a control group of nonfatigued survivors. These findings identify a novel risk factor for fatigue in the growing population of cancer survivors and suggest targets for treatment.