Medical and Pediatric Oncology zyx 17:46W70 zy ( 1989) Psychosocial Status of Young Adult Survivors of Childhood Cancer: A Survey Anna T. Meadows, MD, Linda McKee, MS, and Anne E. Kazak, PhD The majority of childhood cancer patients now can expect to survive into early adult- hood, cured of their cancer. Current adult survivors are a diverse group in terms zyxwvu of diagnosis, age at diagnosis, and types zyxwvut of treatment. It is estimated that by 1990, 1 in every 1,000 twenty-year-olds will have had cancer, making it important to describe the long-term psychosocial adjustment of this population. Patients who were diagnosed between 1948 and 1975 while less than 16 years of age, who were currently 18 years or older, had been off therapy for at least 5 years, and had no known brain damage were eligible for this survey and were identified through the tumor registry at the Children’s Hospital of Philadelphia (CHP). Initially, the parents were contacted by letter. Ninety-five (57%) zyxwvuts of the 167 eligible patients participated in a telephone interview, which covered educa- tional achievement, occupational status, in- terpersonal relationships, marital status, pregnancies, employee benefits and insur- ance, and medical and health behaviors. Re- spondents were not different from nonre- spondents in terms of sex, year of diagnosis, age at diagnosis, diagnoses, stage of illness, or type of treatments. There were no differ- ences in terms of education, marital status, fertility issues, or occupational status by di- agnosis group, age at diagnosis, or treat- ments. The patients were compared to sib- lings over 18 years of age in terms of education and marital status. zyxw No significant differences in sex distribution or years of education between patients and siblings were found. The siblings were, as a group, older than the patients and were more likely to be married. In general, these patients were function- ing normally, but there are many unex- plored areas of interpersonal relationships and productivity that need further study be- fore conclusions regarding psychosocial ad- justment of childhood cancer survivors can be drawn. zyxwv Key words: pediatric oncology, cancer survival, psychosocial adjustment INTRODUCTION As many as zyxwvutsrqp 213 of those diagnosed with cancer under the age of 16 can be expected to survive to early adult- hood, cured of their cancer. Some years ago, we esti- mated that by the year 1990, 1 in every 1,000 twenty- year-olds would be such a survivor [ I]. As the nurnber of survivors of childhood cancer increases, so does the diversity of this population. Those who have survived cancer range widely in initial diagnosis, age, and type of treatment received, necessitating examination of sub- groups of survivors with respect to these variables. From a psychosocial perspective, there are many dimensions of adult adjustment that can be explored (e.g., interper- sonal relationships, educational and work history, coping styles, measures of psychopathology). In the present study, we undertook to study individuals 18 years of age and over who had been treated for cancer during child- hood, utilizing a telephone interview and ascertaining information about education, employment, insurance, personal relationships, health status, and behavior. We obtained similar information regarding their siblings of comparable age and compared them to the patients in the areas of education and marital status. Previous literature in this area supports the notion that survivors of childhood cancer show overall adequate levels of psychosocial adjustment [2-41. However, in their study of 118 survivors, Koocher and O’Malley [5] report that 47% experience adjustment difficulties. These adjustment problems would be expected to affect attain- ment of developmental, personal, and professional goals. Indeed, for at least a subset of the young adult survivor population, there is evidence of significant psy- From the Department of Pediatrics (A.T.M., A.E.K.), University of Pennsylvania School of Medicine and the Division of Oncology, The Children’s Hospital of Philadelphia and the Department of Information Services (L.M.), Thomas Jefferson University, Philadelphia, Penn- sylvania. Address reprint requests to Dr. Anna T. Meadows, The Children’s Hospital of Philadelphia, Division of Oncology, Room 9093A, 34th Street and Civic Center Boulevard, Philadelphia, Pennsylvania 19104. z 0 1989 Alan R. Liss. Inc.