Perceptions of future health and cancer risk in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Gibson, Todd M.; Li, Chenghong; Armstrong, Gregory T.; Srivastava, Deo Kumar; Leisenring, Wendy; Mertens, Ann C.; Brinkman, Tara M.; Diller, Lisa; Nathan, Paul C.; Hudson, Melissa M.; Robison, Leslie L.

doi:10.1002/cncr.31397

Cited by 28 publications

(33 citation statements)

References 43 publications

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“…We found that approximately 60.3% of all survivors reported not being worried about subsequent neoplasms, which was somewhat higher than the rate of 40% reported by Gibson et al 1 Many survivors in our cohort (48.6%) did not believe they were at risk of developing late effects. Survivors reported an average of 3.8 treatment-related late effects (range, 0-19 late effects; standard deviation, 3.6), most commonly fatigue (41.9%), memory/learning difficulties (33.7%), and emotional issues (33.4%).…”

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivcontrasting

confidence: 75%

“…Survivors reported an average of 3.8 treatment-related late effects (range, 0-19 late effects; standard deviation, 3.6), most commonly fatigue (41.9%), memory/learning difficulties (33.7%), and emotional issues (33.4%). We found that approximately 60.3% of all survivors reported not being worried about subsequent neoplasms, which was somewhat higher than the rate of 40% reported by Gibson et al 1 Many survivors in our cohort (48.6%) did not believe they were at risk of developing late effects. Survivors perceived themselves to be at risk of developing an average of 4.2 future late effects (range, 0-16 late effects; standard deviation, 3.6).…”

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivcontrasting

confidence: 75%

“…Adding to the findings of Gibson et al, 1 our data demonstrated that a significant percentage of survivors in our cohort still worried about the risk of developing health problems, despite reporting a low perceived risk of subsequent cancers and late effects. The relationship between worry and follow-up engagement appears complex.…”

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivsupporting

confidence: 71%

“…1 The authors concluded that a subset of survivors at risk of treatmentrelated late effects lacked concern regarding developing subsequent neoplasms (35%) and about their future health (24%), thereby potentially reducing their likelihood of engaging in follow-up care. 1 The authors concluded that a subset of survivors at risk of treatmentrelated late effects lacked concern regarding developing subsequent neoplasms (35%) and about their future health (24%), thereby potentially reducing their likelihood of engaging in follow-up care.…”

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivmentioning

confidence: 99%

“…Gibson et al recently evaluated the risk perceptions of adult survivors of childhood cancer. 1 The authors concluded that a subset of survivors at risk of treatmentrelated late effects lacked concern regarding developing subsequent neoplasms (35%) and about their future health (24%), thereby potentially reducing their likelihood of engaging in follow-up care.…”

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivmentioning

confidence: 99%

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Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Signorelli

Wakefield

Fardell

et al. 2019

Cancer

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Section: Perceptions Of Future Health and Cancer Risk In Adult Survivcontrasting

confidence: 75%

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivcontrasting

confidence: 75%

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivsupporting

confidence: 71%

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivmentioning

confidence: 99%

Section: Perceptions Of Future Health and Cancer Risk In Adult Survivmentioning

confidence: 99%

See 3 more Smart Citations

Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Signorelli

Wakefield

Fardell

et al. 2019

Cancer

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Minding the Gap for Survivors of Childhood Cancer

2020

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Reply to Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Gibson

Armstrong

Robison

2019

Cancer

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We thank Signorelli et. al. for their interest in our article 1 and for sharing the complementary data from their ANZCHOG Survivorship Study, which included 402 long-term childhood cancer survivors from Australia and New Zealand. They found higher proportions of survivors who were not worried about late effects (57%) and subsequent neoplasms (60%) compared to our results for reported levels of concern in the North American Childhood Cancer Survivor Study, but certainly both studies highlight the fact that a substantial subgroup of survivors have low levels of concern about their future health. We would like to reiterate here that the goal of survivorship education and care should be to provide survivors with an understanding of the potential late effects associated with childhood cancer and treatments and to foster an appropriate level of concern, which may not be uniform for all survivors. Therefore, it is important to consider survivors' treatment history and risk profile when evaluating their reported levels of concern. Ultimately, some degree of concern may be beneficial if it motivates at-risk survivors to take an active role in their health care and follow established survivorship care guidelines. Accordingly, we were very interested to see the data from Signorelli et al. from their analyses of associations between perceptions of risk or degree of worry and engagement with follow-up care. However, it is important to note that their analysis was based on cross-sectional data. Because survivors reported their current follow-up engagement at the same time they reported their risk perceptions and levels of worry, it is impossible to determine the direction of their reported associations. Levels of perceived risk and frequency of worries may influence follow-up engagement, but it is also plausible that survivors exposed to more follow-up care have different perceptions and worries as a result. We faced similar issues in our analysis, where we were only able to examine self-reported screening behaviors in a subgroup of survivors with longitudinal data. Additional studies are warranted that can prospectively examine the impact that survivors' levels of concern or worry may have on their future behaviors. We fundamentally agree with Signorelli et. al. in their assertion that the key objective of future efforts should be maximizing survivors' understanding of their personal health risks, promoting risk

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Perceptions of future health and cancer risk in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Cited by 28 publications

References 43 publications

Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Minding the Gap for Survivors of Childhood Cancer

Reply to Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

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