Childhood Cancer and Psychiatric Problems
Brain Cancer Survivors Have More Problems, but Other Survivors Don't
Aug. 13, 2003 -- It's no surprise that childhood cancer can cause significant stress in survivors. But there's some good news. With the exception of brain tumor survivors, survivors of childhood cancers appear no more likely to develop psychological problems later in life.
Researchers from the Danish Cancer Society report that the adults in their study who survived childhood brain cancers had twice the expected number of admissions to psychiatric hospitals. But survivors of childhood leukemias and other cancers were no more likely to have serious psychiatric disorders later in life than the general population.
The research included more than 3,700 childhood or adolescent cancer survivors in Denmark who were followed for an average of 15 years. The findings are reported in the Aug. 14 issue of TheNew England Journal of Medicine.
Remarkable Progress, but With a Price
Forty years ago, the survival rate for children who got cancer was close to zero, but today roughly three out of four survive to adulthood. This remarkable progress has not come without a price, however. Depending on their treatment, childhood cancer survivors may face a long list of potential health concerns as adults, including an increased risk for secondary cancers, infertility, and heart disease.
Only a few small studies have investigated the risk of long-term depression and other psychological illnesses following successful treatment for childhood cancers. The studies found little evidence of a link, but they were too small to be conclusive.
In this study, researcher Christoffer Johansen, MD, PhD, and Danish Cancer Society colleagues compared a national cancer registry with a registry of people admitted to psychiatric hospitals. Denmark is one of the only countries in the world to have a nationwide psychiatric hospitalization registry.
They found that childhood cancer survivors were more likely than the general population to be hospitalized with a psychiatric problem.
But the increase in risk was restricted to those with a history of brain tumors. Eighty-eight of the 973 brain tumor survivors had been admitted to psychiatric hospitals at least once -- and 51 more than once -- compared with 48 admissions expected in the general population.