{"id":4667,"date":"2018-02-22T00:00:00","date_gmt":"2018-02-22T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer\/"},"modified":"2023-06-14T19:59:50","modified_gmt":"2023-06-14T23:59:50","slug":"adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer\/","title":{"rendered":"Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; The elevated risk for physical late effects in childhood cancer survivors (CCS) is well documented, but their risk for mental health problems is less well described.<\/p>\n<p><strong>Methods <\/strong>&#x2014; We assembled a cohort of all five-year CCS diagnosed before age 18 years and treated in an Ontario pediatric cancer center between 1987-2008. Patients were matched to population controls, and linked to health administration databases. We calculated rates of mental healthcare visits (family physician, psychiatrist, emergency department [ED], hospitalization) and risk for a severe mental health event (ED, hospitalization, suicide). Outcomes were compared using recurrent event and survival analyses.<\/p>\n<p><strong>Results<\/strong> &#x2014; Compared to 20,269 controls, 4,117 CCS had a higher rate of mental health visits (Adjusted relative rate [RR] 1.34, 95% CI 1.12-1.52). Higher rates were associated with female gender (RR 1.39, CI 1.10-1.75; p=0.006) and age 15-17.9 years at diagnosis (compared to age 0-4 years, RR 1.81, CI 1.17-2.80 p=0.008). Cancer type, treatment intensity, and treatments targeting the CNS were not significant predictors. Survivors were at increased risk of a severe event compared to controls (adjusted hazard ratio 1.13, 95% CI 1.00-1.28; p=0.045). CCS diagnosed with cancer at &#x2264;4 years were at greatest risk; 16.3% (95% CI 13.2-19.8%) experienced a severe event by age 28.<\/p>\n<p><strong>Conclusion <\/strong>&#x2014; CCS experience higher rates of mental health visits and a greater risk for a severe event than the general population. Survivors of adolescent cancer have a higher rate of mental health visits overall, while survivors of cancer prior to age 4 have a markedly elevated risk of severe events.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; The elevated risk for physical late effects in childhood cancer survivors (CCS) is well documented, but their risk for mental health problems is less well described. Methods &#x2014; We assembled a cohort of all five-year CCS diagnosed before age 18 years and treated in an Ontario pediatric cancer center between 1987-2008. Patients were [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-4667","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Nathan PC, Nachman A, Sutradhar R, Kurdyak P, Pole JD, Lau C, Gupta S. <em>Cancer.<\/em> 2018; 124(9):2045-57. Epub 2018 Feb 22.","source_url":"","ices_scientist":[1302,1370,1098,1152,1239],"site":[6733],"research_program":[6741],"news_release":[7944],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9478],"video":[],"downloads":null,"links":null,"sitecore_item_id":"87263727-BDE5-4676-B1AA-BCB6FBBA8609","sitecore_item_name":"Adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer","sitecore_field_values":"{\n  \"__Valid from\": \"20180226T112324\",\n  \"Title\": \"Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer\",\n  \"Short title\": \"Adverse mental health outcomes\",\n  \"Summary\": \"Childhood cancer survivors experience higher rates of mental health visits and a greater risk for a severe event than the general population.\",\n  \"Citation\": \"<p>Nathan PC, Nachman A, Sutradhar R, Kurdyak P, Pole JD, Lau C, Gupta S. <em>Cancer.<\/em> 2018; 124(9):2045-57. Epub 2018 Feb 22.<\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; The elevated risk for physical late effects in childhood cancer survivors (CCS) is well documented, but their risk for mental health problems is less well described.<\/p>n<p><strong>Methods <\/strong>&mdash; We assembled a cohort of all five-year CCS diagnosed before age 18 years and treated in an Ontario pediatric cancer center between 1987-2008. Patients were matched to population controls, and linked to health administration databases. We calculated rates of mental healthcare visits (family physician, psychiatrist, emergency department [ED], hospitalization) and risk for a severe mental health event (ED, hospitalization, suicide). Outcomes were compared using recurrent event and survival analyses.<\/p>n<p><strong>Results<\/strong> &mdash; Compared to 20,269 controls, 4,117 CCS had a higher rate of mental health visits (Adjusted relative rate [RR] 1.34, 95% CI 1.12-1.52). Higher rates were associated with female gender (RR 1.39, CI 1.10-1.75; p=0.006) and age 15-17.9 years at diagnosis (compared to age 0-4 years, RR 1.81, CI 1.17-2.80 p=0.008). Cancer type, treatment intensity, and treatments targeting the CNS were not significant predictors. Survivors were at increased risk of a severe event compared to controls (adjusted hazard ratio 1.13, 95% CI 1.00-1.28; p=0.045). CCS diagnosed with cancer at &le;4 years were at greatest risk; 16.3% (95% CI 13.2-19.8%) experienced a severe event by age 28.<\/p>n<p><strong>Conclusion <\/strong>&mdash; CCS experience higher rates of mental health visits and a greater risk for a severe event than the general population. Survivors of adolescent cancer have a higher rate of mental health visits overall, while survivors of cancer prior to age 4 have a markedly elevated risk of severe events.<\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{26914DE7-C67E-4326-AAFE-E0BC7A893323}|{56BF24FA-D81E-4114-BF1F-4715A424E26C}|{F5F3AB6E-CD96-4F14-BDD6-206C43AC2DD3}|{B5C574DB-2952-4976-9299-A6F54F1757FA}|{92701820-E853-436C-8AD9-173545BA0A7D}\",\n  \"Posted Date\": \"20180222T000000\",\n  \"Show on Publications Landing Page\": \"1\",\n  \"In The News\": \"{78EDA5FF-728E-40AC-ABFD-AA3B040B96B4}\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2018\/February\/Adverse-mental-health-outcomes-in-a-population-based-cohort-of-survivors-of-childhood-cancer"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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