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Childhood cancer survivors at higher risk of mental health events


Childhood cancer survivors are at a significantly higher risk of a severe mental health event requiring an emergency department (ED) visit or hospitalization, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and The Hospital for Sick Children (SickKids).

In the study published today in Cancer, researchers examined data representing 4,117 childhood cancer survivors and 20,269 controls, and observed that rates of mental healthcare visits to family physicians and psychiatrists as well as the risk for a severe mental health event were significantly increased in survivors.

“While previous research has shown that childhood cancer survivors have an elevated risk of physical health issues later in life, our study shows that these same survivors are also at risk for mental health challenges,” says Dr. Sumit Gupta, co-author of the study, adjunct scientist at ICES and staff oncologist and clinician investigator at SickKids. “In particular, survivors of adolescent cancer have a higher rate of mental health visits and survivors of cancer diagnosed prior to age five have a markedly elevated risk of severe mental health events.”

The researchers found that childhood cancer survivors who were diagnosed before the age of five are at the highest risk for a severe mental health event: by age 28, 16 per cent of these adults will have had an ED visit or hospitalization for mental health reasons.

The researchers found childhood cancer survivors had a 34 per cent higher rate of medical visits for a mental health complaint compared to the general population and most visits were to family physicians and psychiatrists. ED visits and hospitalizations were less common but survivors still had a 13 per cent increase in their risk for a severe mental health event. Risk was driven by sociodemographic factors such as female gender and lower income, not cancer type or treatment.

“Our study shows that female survivors of adolescent cancers are at the highest risk of seeing a family doctor or psychiatrist for a mental health issue,” says Dr. Paul Nathan, co-author on the study, adjunct scientist at ICES, staff oncologist, clinician investigator and the director of the Aftercare program in the Division of Haematology/Oncology at SickKids. “Our results show that aftercare programs should be screening childhood cancer survivors for mental health issues just as we screen for physical complications of treatment.”

“Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer,” was published today in Cancer.

Author block: Nathan PC, Nachman A, Sutradhar R, Kurdyak P, Pole JD, Lau C, Gupta S.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized child and family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).


Deborah Creatura
Media Advisor, ICES
[email protected]
(o) 416-480-4780 or (c) 647-406-5996

Jessamine Luck
The Hospital for Sick Children (SickKids)
[email protected]
416-813-7654 ext 201436

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