Screening for mental health problems in childhood cancer survivorship: a systematic review

Abstract

Many survivors of childhood cancer suffer from psychological late effects. Therefore, regular psychological screening is strongly advised. Experts recommend screening for mental disorders and symptoms for all survivors at every follow-up visit, regardless of age. However, there is little practical guidance on screening for mental health problems in childhood cancer survivorship care. The aims of this systematic review were to (a) collect comprehensive information on available screening tools, (b) determine which health care professionals performed the screening, and (c) identify practical considerations regarding the timing of screening. The databases PubMed, PsycINFO, and CINAHL were systematically searched for peer-reviewed publications concerning childhood cancer, mental health problems, survivorship, and screening published between January 1990 and January 2023. The search yielded 2268 potentially relevant articles, of which 32 were included in the narrative synthesis. We found that (a) many suitable screening tools are available for the target population, of which the Distress Thermometer, Brief Symptom Inventory-18, Symptom Checklist-90, and Pediatric Quality of Life Inventory were the most commonly used in all studies; (b) professionals of different disciplines were involved in screening, and examples include clinical nurse specialists and psychologists; and (c) early onset, regular, and long-term screening are recommended if resources are available. In conclusion, selecting a screening tool in a clinical setting depends on various factors such as time and cost. However, many brief screening tools can be easily implemented without a large investment of resources. Furthermore, professionals from various disciplines can perform the screening. If they have no background in psychology, training is recommended to give them confidence in dealing with mental health issues. In conclusion, consistent and regular mental health screening is crucial for childhood cancer survivors, and we believe that the benefits outweigh the costs.