Prevalence and predictors of cancer‐related worry and associations with health behaviors in adult survivors of childhood cancer. Issue 15 (12th April 2021)

• Record Type: Journal Article
• Authors: McDonnell, Glynnis A.; Brinkman, Tara M.; Wang, Mingjuan; Gibson, Todd M.; Heathcote, Lauren C.; Ehrhardt, Matthew J.; Srivastava, Deo Kumar; Robison, Leslie L.; Hudson, Melissa M.; Alberts, Nicole M.
• Is Part Of: Cancer. Volume 127:Issue 15(2021)
• Page Start: 2743
• Page End: 2751
• Publication Date: 2021-04-12
• Subjects: cancer survivors -- childhood cancer -- health behavior -- health care utilization -- worry; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.33563
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : Background: Cancer‐related worry (CRW) is common among cancer survivors; however, little is known about factors associated with CRW or its impact on health behaviors in adult survivors of childhood cancer. Methods: Survivors in the St. Jude Lifetime Cohort Study (n = 3211; 51% male; mean age, 31.2 years [SD, 8.4 years]; mean time after diagnosis, 22.8 years [SD, 8.3 years]) underwent medical evaluations and completed ratings of CRW, psychological symptoms, and health behaviors. Multivariable modified Poisson regression models examined associations between CRW and treatment exposures, chronic health conditions, psychological symptoms, and health behaviors. Results: Sixty‐four percent of survivors (95% confidence interval [CI], 62.6‐65.9) reported worry about subsequent malignancy, 45% (95% CI, 43.5‐46.9) reported worry about physical problems related to cancer, and 33% (95% CI, 31.2‐34.4) reported worry about relapse. Multiple psychological symptoms, treatment exposures, and chronic conditions significantly increased the risk of CRW. Survivors reporting CRW were at increased risk for substance use, inadequate physical activity, and increased health care utilization after adjustments for chronic conditions. For example, with adjustments for chronic conditions, those who endorsed CRW were more likely to have ≥5 cancer‐related physician visits, ≥5 physician visits related to cancer, and ≥5 calls to a physician's office in the previous 2 years in comparison with survivors who were not worried. CRW was also associated with an increased risk of current tobacco use, past marijuana use, and current marijuana use. Conclusions: A substantial proportion of adult survivors of childhood cancer reported CRW associated with increased health care utilization. CRW may serve as an intervention target to promote well‐being and adaptive health behaviors. Abstract : Cancer‐related worry is common among long‐term survivors of childhood cancer. It is associated with treatment exposures, chronic medical conditions, psychological and somatic symptoms, and maladaptive health behaviors. Cancer‐related worry is a modifiable construct that can be targeted via psychosocial interventions.