Psychological Outcomes and Health Beliefs in Adolescent and Young Adult Survivors of Childhood Cancer and Controls
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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.
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A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and/or depressive symptoms at a clinically relevant level.
“A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support.”
From Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial (2017) · cites this paper as [7]
The Introduction reports that approximately 10%–20% of pediatric cancer survivors score in the clinical range on psychological measures, and the Discussion identifies those diagnosed during adolescence as a higher-risk group. But the Age at Diagnosis results report higher post-traumatic stress symptoms—not clinically elevated anxiety or depression—in that group; Table 3 shows no significant age-at-diagnosis differences in anxiety or depression. The cited paper therefore supports concern about a vulnerable subgroup, but not the claim's specific symptoms and clinical threshold for that subgroup. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAdolescent and young adult cancer survivors report more psychological distress and fewer positive health beliefs than younger pediatric or older adult cancer patients.
“AYA cancer survivors report greater psychological distress and fewer positive health beliefs than younger pediatric or older adult counterparts.6”
From Promoting resilience in adolescents and young adults with cancer: Results from the PRISM randomized controlled trial (2018) · cites this paper as [6]
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- Authors
- Kazak, A. E., DeRosa, B. W., Schwartz, L. A., Hobbie, W., Carlson, C., Ittenbach, R. F., Mao, J. J., & Ginsberg, J. P.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Corresponding author
- Kazak, Anne E.
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2010-04-20
- Volume
- 28
- Issue
- 12
- Pages
- 2002-2007
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC2860405
- OpenAlex
- W2156212268
- Cited by
- 290
- References
- 31
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 11 · 2023: 11 · 2022: 36 · 2021: 17 · 2020: 16 · 2019: 23 · 2018: 18 · 2017: 14 · 2016: 17 · 2015: 26 · 2014: 18 · 2013: 25 · 2012: 16
- FWCI
- 18.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA106928, R01CA106928)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- childhood cancer survivors, adolescent and young adult cancer survivors, psychological distress, health-related quality of life, health beliefs, age at diagnosis, anxiety, psychosocial adjustment, health problems, patient-reported outcomes
- MeSH terms
- Adaptation, Psychological, Adolescent, Adolescent Behavior, Psychology, Adolescent, Adult, Age Factors, Anxiety, Culture, Depression, Drug Therapy, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Neoplasms, Perception, Quality of Life, Surveys and Questionnaires, Radiotherapy, Risk Factors, Stress, Psychological, Surgical Procedures, Operative, Health Behavior, Case-Control Studies, Survivors, Risk Assessment, Young Adult
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