101. Alcohol consumption behaviors and neurocognitive dysfunction and emotional distress in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study
- Author
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Brinkman, Tara M, Lown, E Anne, Li, Chenghong, Olsson, Ingrid Tonning, Marchak, Jordan Gilleland, Stuber, Margaret L, Vuotto, Stefanie, Srivastava, Deokumar, Nathan, Paul C, Leisenring, Wendy M, Armstrong, Gregory T, Robison, Leslie L, and Krull, Kevin R
- Subjects
Health Services and Systems ,Health Sciences ,Alcoholism ,Alcohol Use and Health ,Behavioral and Social Science ,Mind and Body ,Brain Disorders ,Clinical Research ,Depression ,Pediatric ,Pediatric Cancer ,Neurosciences ,Underage Drinking ,Basic Behavioral and Social Science ,Substance Misuse ,Cancer ,Mental Health ,Prevention ,2.3 Psychological ,social and economic factors ,Aetiology ,Mental health ,Good Health and Well Being ,Adult ,Adult Survivors of Child Adverse Events ,Affective Symptoms ,Alcohol Drinking ,Cancer Survivors ,Child ,Cognition Disorders ,Emotions ,Epidemiologic Methods ,Female ,Humans ,Male ,Psychological Distress ,Alcohol ,childhood cancer ,emotional distress ,late effects ,neurocognition ,survivorship ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Substance Abuse ,Public health ,Clinical and health psychology - Abstract
AimsTo estimate the level of alcohol consumption behaviors in adult survivors of childhood cancer and to test associations between alcohol consumption behaviors and symptoms of neurocognitive impairment and emotional distress.DesignRetrospective cohort study with longitudinal follow-up of self-reported health outcomes.SettingChildhood Cancer Survivor Study (CCSS), a 26-center study of ≥ 5-year survivors of childhood cancer diagnosed ≤ 21 years of age between 1970 and 1986 in the United States and Canada.ParticipantsA total of 4484 adult survivors of childhood cancer [mean (standard deviation) age at evaluation = 34.8 (6.1) years; time from diagnosis = 24.8 (4.4) years] and 1651 sibling controls who completed surveys reporting on alcohol use, neurocognitive impairment and emotional distress.MeasurementsSurvivor report of alcohol use included age at drinking initiation and quantity and frequency of alcohol consumption. Neurocognition was assessed using the CCSS Neurocognitive Questionnaire. Emotional distress symptoms were measured using the Brief Symptoms Inventory-18 and the Posttraumatic Stress Diagnostic Scale.FindingsAfter adjustment for childhood cancer treatment exposures, including cranial radiation therapy, drinking initiation prior to 18 years of age was associated with 30% increased risk of subsequent memory problems [risk ratio (RR) = 1.3; 95% confidence interval (CI) = 1.1-1.5]. Younger age at drinking initiation was associated with future risk of depression (RR = 1.3; 95% CI = 1.1-1.5), anxiety (RR = 1.6; 95% CI = 1.3-2.1), and somatization (RR = 1.2; 95% CI = 1.1-1.4). Persistent heavy/risky drinking was associated with 80% increased risk of persistent psychological distress (RR = 1.8, 95% CI = 1.4-2.3).ConclusionsDrinking initiation during adolescence is associated with modest increased risk for memory impairment and emotional distress in adult survivors of childhood cancer.
- Published
- 2019