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1. Neurologic morbidity and functional independence in adult survivors of childhood cancer

Author

Vuotto, Stefanie C., primary, Wang, Mingjuan, additional, Okcu, M. Fatih, additional, Bowers, Daniel C., additional, Ullrich, Nicole J., additional, Ness, Kirsten K., additional, Li, Chenghong, additional, Srivastava, Deo Kumar, additional, Howell, Rebecca M., additional, Gibson, Todd M., additional, Leisenring, Wendy M., additional, Oeffinger, Kevin C., additional, Robison, Leslie L., additional, Armstrong, Gregory T., additional, Kull, Kevin R., additional, and Brinkman, Tara M., additional

Published
2023
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2. Social‐epigenetic mediators for racial disparities in pulmonary impairment among childhood cancer survivors

Author

Song, Nan, primary, Dong, Qian, additional, Chen, Cheng, additional, Li, Qian, additional, Mulder, Heather, additional, Plyler, Emily, additional, Easton, John, additional, Walker, Emily, additional, Olson, Scott, additional, Neale, Geoffrey, additional, Krull, Kevin R., additional, Srivastava, Deo Kumar, additional, Ness, Kirsten K., additional, Zhang, Jinghui, additional, Hudson, Melissa M., additional, Robison, Leslie L., additional, Huang, I‐Chan, additional, and Wang, Zhaoming, additional

Published
2022
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3. A randomized double‐blind placebo‐controlled trial of the effectiveness of melatonin on neurocognition and sleep in survivors of childhood cancer

Author

Lubas, Margaret M., primary, Mandrell, Belinda N., additional, Greene, William L., additional, Howell, Carrie R., additional, Christensen, Robbin, additional, Kimberg, Cara I., additional, Li, Chenghong, additional, Ness, Kirsten K., additional, Srivastava, Deo Kumar, additional, Hudson, Melissa M., additional, Robison, Leslie L., additional, Krull, Kevin R., additional, and Brinkman, Tara M., additional

Published
2021
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4. Primary hypothyroidism in childhood cancer survivors: Prevalence, risk factors, and long‐term consequences

Author

Chemaitilly, Wassim, primary, Li, Zhenghong, additional, Brinkman, Tara M., additional, Delaney, Angela, additional, Huang, Sujuan, additional, Bjornard, Kari L., additional, Lam, Catherine G., additional, Wilson, Carmen L., additional, Barnes, Nicole, additional, Clark, Karen L., additional, Krasin, Matthew J., additional, Metzger, Monika L., additional, Sheyn, Anthony, additional, Bishop, Michael W., additional, Sabin, Noah D., additional, Howell, Rebecca M., additional, Helmig, Sara, additional, Shulkin, Barry L., additional, Triplett, Brandon M., additional, Pui, Ching‐Hong, additional, Gajjar, Amar, additional, Srivastava, Deo Kumar, additional, Green, Daniel M., additional, Armstrong, Gregory T., additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, Ness, Kristen K., additional, Sklar, Charles A., additional, and Krull, Kevin R., additional

Published
2021
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5. Cardiac remodeling after anthracycline and radiotherapy exposure in adult survivors of childhood cancer: A report from the St Jude Lifetime Cohort Study

Author

Jefferies, John L., primary, Mazur, Wojciech M., additional, Howell, Carrie R., additional, Plana, Juan C., additional, Ness, Kirsten K., additional, Li, Zhenghong, additional, Joshi, Vijaya M., additional, Green, Daniel M., additional, Mulrooney, Daniel A., additional, Towbin, Jeffrey A., additional, Martinez, Hugo R., additional, Goldberg, Jason F., additional, Howell, Rebecca M., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Armstrong, Gregory T., additional

Published
2021
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7. Prevalence and predictors of cancer‐related worry and associations with health behaviors in adult survivors of childhood cancer

Author

McDonnell, Glynnis A., primary, Brinkman, Tara M., additional, Wang, Mingjuan, additional, Gibson, Todd M., additional, Heathcote, Lauren C., additional, Ehrhardt, Matthew J., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Alberts, Nicole M., additional

Published
2021
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9. Cardiac biomarkers and association with subsequent cardiomyopathy and mortality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort

Author

Dixon, Stephanie B., primary, Howell, Carrie R., additional, Lu, Lu, additional, Plana, Juan C., additional, Joshi, Vijaya M., additional, Luepker, Russell V., additional, Durand, Jean B., additional, Ky, Bonnie, additional, Lenihan, Daniel J., additional, Jefferies, John L., additional, Green, Daniel M., additional, Ehrhardt, Matthew J., additional, Mulrooney, Daniel A., additional, Folse, Timothy E., additional, Partin, Robyn E., additional, Santucci, Aimee K., additional, Howell, Rebecca M., additional, Srivastava, Deo Kumar, additional, Hudson, Melissa M., additional, Robison, Leslie L., additional, Ness, Kirsten K., additional, and Armstrong, Gregory T., additional

Published
2020
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11. Sleep, emotional distress, and physical health in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Author

Daniel, Lauren C., primary, Wang, Mingjuan, additional, Mulrooney, Daniel A., additional, Srivastava, Deo Kumar, additional, Schwartz, Lisa A., additional, Edelstein, Kim, additional, Brinkman, Tara M., additional, Zhou, Eric S., additional, Howell, Rebecca M., additional, Gibson, Todd M., additional, Leisenring, Wendy, additional, Oeffinger, Kevin C., additional, Neglia, Joseph, additional, Robison, Leslie L., additional, Armstrong, Gregory T., additional, and Krull, Kevin R., additional

Published
2019
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12. Social adjustment in adolescent survivors of pediatric central nervous system tumors: A report from the Childhood Cancer Survivor Study

Author

Schulte, Fiona, primary, Brinkman, Tara M., additional, Li, Chenghong, additional, Fay-McClymont, Taryn, additional, Srivastava, Deo Kumar, additional, Ness, Kirsten K., additional, Howell, Rebecca M., additional, Mueller, Sabine, additional, Wells, Elizabeth, additional, Strother, Douglas, additional, Lafay-Cousin, Lucie, additional, Leisenring, Wendy, additional, Robison, Leslie L., additional, Armstrong, Gregory T., additional, and Krull, Kevin R., additional

Published
2018
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13. Influence of fitness on health status among survivors of acute lymphoblastic leukemia

Author

Wilson, Carmen L., primary, Howell, Carrie R., additional, Partin, Robyn E., additional, Lu, Lu, additional, Kaste, Sue C., additional, Mulrooney, Daniel A., additional, Pui, Ching-Hon, additional, Lanctot, Jennifer Q., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Ness, Kirsten K., additional

Published
2018
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14. Perceptions of future health and cancer risk in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Author

Gibson, Todd M., primary, Li, Chenghong, additional, Armstrong, Gregory T., additional, Srivastava, Deo Kumar, additional, Leisenring, Wendy M., additional, Mertens, Ann, additional, Brinkman, Tara M., additional, Diller, Lisa, additional, Nathan, Paul C., additional, Hudson, Melissa M., additional, and Robison, Leslie L., additional

Published
2018
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16. Neurocognitive, psychosocial, and quality-of-life outcomes in adult survivors of childhood non-Hodgkin lymphoma

Author

Ehrhardt, Matthew J., primary, Mulrooney, Daniel A., additional, Li, Chenghong, additional, Baassiri, Malek J., additional, Bjornard, Kari, additional, Sandlund, John T., additional, Brinkman, Tara M., additional, Huang, I-Chan, additional, Srivastava, Deo Kumar, additional, Ness, Kirsten K., additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Krull, Kevin R., additional

Published
2017
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17. The role of body image dissatisfaction in the association between treatment‐related scarring or disfigurement and psychological distress in adult survivors of childhood cancer

Author

Vuotto, Stefanie C., primary, Ojha, Rohit P., additional, Li, Chenghong, additional, Kimberg, Cara, additional, Klosky, James L., additional, Krull, Kevin R., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Brinkman, Tara M., additional

Published
2017
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19. Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Author

Lown, E. Anne, primary, Hijiya, Nobuko, additional, Zhang, Nan, additional, Srivastava, Deo Kumar, additional, Leisenring, Wendy M., additional, Nathan, Paul C., additional, Castellino, Sharon M., additional, Devine, Katie A., additional, Dilley, Kimberley, additional, Krull, Kevin R., additional, Oeffinger, Kevin C., additional, Hudson, Melissa M., additional, Armstrong, Gregory T., additional, Robison, Leslie L., additional, and Ness, Kirsten K., additional

Published
2016
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20. Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study

Author

Gibson, Todd M., primary, Liu, Wei, additional, Armstrong, Gregory T., additional, Srivastava, Deo Kumar, additional, Hudson, Melissa M., additional, Leisenring, Wendy M., additional, Mertens, Ann C., additional, Klesges, Robert C., additional, Oeffinger, Kevin C., additional, Nathan, Paul C., additional, and Robison, Leslie L., additional

Published
2015
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21. Treatment-induced hearing loss and adult social outcomes in survivors of childhood CNS and non-CNS solid tumors: Results from the St. Jude Lifetime Cohort Study

Author

Brinkman, Tara M., primary, Bass, Johnnie K., additional, Li, Zhenghong, additional, Ness, Kirsten K., additional, Gajjar, Amar, additional, Pappo, Alberto S., additional, Armstrong, Gregory T., additional, Merchant, Thomas E., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Gurney, James G., additional

Published
2015
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22. Genetic and clinical factors associated with obesity among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort

Author

Wilson, Carmen L., primary, Liu, Wei, additional, Yang, Jun J., additional, Kang, Guolian, additional, Ojha, Rohit P., additional, Neale, Geoffrey A., additional, Srivastava, Deo Kumar, additional, Gurney, James G., additional, Hudson, Melissa M., additional, Robison, Leslie L., additional, and Ness, Kirsten K., additional

Published
2015
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24. Validity of anthropometric measurements for characterizing obesity among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study

Author

Karlage, Robyn E., primary, Wilson, Carmen L., additional, Zhang, Nan, additional, Kaste, Sue, additional, Green, Daniel M., additional, Armstrong, Gregory T., additional, Robison, Leslie L., additional, Chemaitilly, Wassim, additional, Srivastava, Deo Kumar, additional, Hudson, Melissa M., additional, and Ness, Kirsten K., additional

Published
2015
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26. Lifestyle and metabolic syndrome in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study

Author

Smith, Webb A., primary, Li, Chenghong, additional, Nottage, Kerri A., additional, Mulrooney, Daniel A., additional, Armstrong, Gregory T., additional, Lanctot, Jennifer Q., additional, Chemaitilly, Wassim, additional, Laver, Joseph H., additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Ness, Kirsten K., additional

Published
2014
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28. Dexamethasone exposure and memory function in adult survivors of childhood acute lymphoblastic leukemia: A report from the SJLIFE cohort

Author

Edelmann, Michelle N., primary, Ogg, Robert J., additional, Scoggins, Matthew A., additional, Brinkman, Tara M., additional, Sabin, Noah D., additional, Pui, Ching-Hon, additional, Srivastava, Deo Kumar, additional, Robison, Leslie L., additional, Hudson, Melissa M., additional, and Krull, Kevin R., additional

Published
2013
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30. Psychoactive medication use and neurocognitive function in adult survivors of childhood cancer: A report from the childhood cancer survivor study

Author

Brinkman, Tara M., primary, Zhang, Nan, additional, Ullrich, Nicole J., additional, Brouwers, Pim, additional, Green, Daniel M., additional, Srivastava, Deo Kumar, additional, Zeltzer, Lonnie K., additional, Stovall, Marilyn, additional, Robison, Leslie L., additional, and Krull, Kevin R., additional

Published
2012
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35. Prospective medical assessment of adults surviving childhood cancer: Study design, cohort characteristics, and feasibility of the St. Jude Lifetime Cohort Study

Author

Hudson, Melissa M., primary, Ness, Kirsten K., additional, Nolan, Vikki G., additional, Armstrong, Gregory T., additional, Green, Daniel M., additional, Morris, E. Brannon, additional, Spunt, Sheri L., additional, Metzger, Monika L., additional, Krull, Kevin R., additional, Klosky, James L., additional, Srivastava, Deo Kumar, additional, and Robison, Leslie L., additional

Published
2010
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38. Rapid immune reconstitution after a reduced-intensity conditioning regimen and a CD3-depleted haploidentical stem cell graft for paediatric refractory haematological malignancies

Author

Chen, Xiaohua, primary, Hale, Gregory A., additional, Barfield, Raymond, additional, Benaim, Ely, additional, Leung, Wing H., additional, Knowles, James, additional, Horwitz, Edwin M., additional, Woodard, Paul, additional, Kasow, Kimberly, additional, Yusuf, Usman, additional, Behm, Frederick G., additional, Hayden, Randall T., additional, Shurtleff, Sheila A., additional, Turner, Victoria, additional, Srivastava, Deo Kumar, additional, and Handgretinger, Rupert, additional

Published
2006
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42. Testing the stress‐response sequence model in paediatric oncology nursing

Author

Hinds, Pamela S., primary, Sanders, C. Ben, additional, Srivastava, Deo Kumar, additional, Hickey, Sherry, additional, Jayawardene, Deepthi, additional, Milligan, Mary, additional, Olson, Mary Sue, additional, Puckett, Patty, additional, Quargnenti, Alice, additional, Randall, Elizabeth A., additional, and Tyc, Vida, additional

Published
1998
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44. Primary hypothyroidism in childhood cancer survivors: Prevalence, risk factors, and long-term consequences.

Author

Chemaitilly W, Li Z, Brinkman TM, Delaney A, Huang S, Bjornard KL, Lam CG, Wilson CL, Barnes N, Clark KL, Krasin MJ, Metzger ML, Sheyn A, Bishop MW, Sabin ND, Howell RM, Helmig S, Shulkin BL, Triplett BM, Pui CH, Gajjar A, Srivastava DK, Green DM, Armstrong GT, Robison LL, Hudson MM, Ness KK, Sklar CA, and Krull KR

Subjects
Adolescent, Adult, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Prevalence, Quality of Life, Retrospective Studies, Risk Factors, Cancer Survivors psychology, Hypothyroidism epidemiology, Leukemia, Myeloid, Acute complications
Abstract

Background: Data on primary hypothyroidism and its long-term impact on the health, cognition, and quality of life (QOL) of childhood cancer survivors are limited. This study examined the prevalence of and risk factors for primary hypothyroidism and its associations with physical, neurocognitive, and psychosocial outcomes., Methods: This was a retrospective study with a cross-sectional health outcome analysis of an established cohort comprising 2965 survivors of childhood cancer (52.8% male; median current age, 30.9 years, median time since cancer diagnosis, 22.3 years). Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between primary hypothyroidism and cancer-related risk factors, cardiovascular disease risk factors, frailty, neurocognitive and QOL outcomes, social attainment, and subsequent thyroid carcinoma. Associations between serum free thyroxine and thyrotropin levels at assessment and health outcomes were explored., Results: The prevalence of primary hypothyroidism was 14.7% (95% CI, 13.5%-16.0%). It was more likely in females (OR, 1.06; 95% CI, 1.03-1.08), was less likely in non-Whites (OR, 0.96; 95% CI, 0.93-0.99), was associated with thyroid radiotherapy (higher risk at higher doses), and was more common if cancer was diagnosed at an age ≥ 15.0 years versus an age < 5 years (OR, 1.05; 95% CI, 1.01-1.09). Primary hypothyroidism was associated with frailty (OR, 1.54; 95% CI, 1.05-2.26), dyslipidemia (OR, 1.52; 95% CI, 1.14-2.04), impaired physical QOL (OR, 1.66; 95% CI, 1.12-2.48), and having health care insurance (OR, 1.51; 95% CI, 1.07-2.12)., Conclusions: Primary hypothyroidism is common in survivors and is associated with unfavorable physical health and QOL outcomes. The impact of thyroid hormone replacement practices on these outcomes should be investigated further., (© 2021 American Cancer Society.)

Published
2022
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45. Cardiac biomarkers and association with subsequent cardiomyopathy and mortality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort.

Author

Dixon SB, Howell CR, Lu L, Plana JC, Joshi VM, Luepker RV, Durand JB, Ky B, Lenihan DJ, Jefferies JL, Green DM, Ehrhardt MJ, Mulrooney DA, Folse TE, Partin RE, Santucci AK, Howell RM, Srivastava DK, Hudson MM, Robison LL, Ness KK, and Armstrong GT

Subjects
Adult, Biomarkers blood, Cardiomyopathies blood, Cardiomyopathies mortality, Cardiotoxicity, Child, Cohort Studies, Female, Humans, Male, Proportional Hazards Models, Young Adult, Cancer Survivors, Cardiomyopathies diagnosis, Natriuretic Peptide, Brain blood, Peptide Fragments blood, Troponin T blood
Abstract

Background: Survivors of childhood cancer exposed to cardiotoxic therapies are at significant cardiovascular risk. The utility of cardiac biomarkers for identifying the risk of future cardiomyopathy and mortality is unknown., Methods: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) were assessed in 1213 adults 10 or more years from a childhood cancer diagnosis; 786 were exposed to anthracycline chemotherapy and/or chest-directed radiation therapy (RT). NT-proBNP values above age- and sex-specific 97.5th percentiles were considered abnormal. Generalized linear models estimated cross-sectional associations between abnormal NT-proBNP and anthracycline or chest RT doses as risk ratios with 95% confidence intervals (CIs). A Poisson distribution estimated rates and a Cox proportional hazards model estimated hazard ratios (HRs) for future cardiac events and death., Results: At a median age of 35.5 years (interquartile range, 29.8-42.5 years), NT-proBNP and cTnT were abnormal in 22.5% and 0.4%, respectively. Exposure to chest RT and exposure to anthracycline chemotherapy were each associated with a dose-dependent increased risk for abnormal NT-proBNP (P for trend <.0001). Among exposed survivors with no history of Common Terminology Criteria for Adverse Events-graded cardiomyopathy and with normal systolic function, survivors with abnormal NT-proBNP had higher rates per 1000 person-years of cardiac mortality (2.93 vs 0.96; P < .0001) and future cardiomyopathy (32.10 vs 15.98; P < .0001) and an increased risk of future cardiomyopathy (HR, 2.28; 95% CI, 1.28-4.08) according to a multivariable assessment., Conclusions: Abnormal NT-proBNP values were prevalent and, among survivors who were exposed to cardiotoxic therapy but did not have a history of cardiomyopathy or current systolic dysfunction, identified those at increased risk for future cardiomyopathy. Further longitudinal studies are needed to confirm this novel finding., (© 2020 American Cancer Society.)

Published
2021
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46. Neurocognitive, psychosocial, and quality-of-life outcomes in adult survivors of childhood non-Hodgkin lymphoma.

Author

Ehrhardt MJ, Mulrooney DA, Li C, Baassiri MJ, Bjornard K, Sandlund JT, Brinkman TM, Huang IC, Srivastava DK, Ness KK, Robison LL, Hudson MM, and Krull KR

Subjects
Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Cancer Survivors psychology, Cognition, Lymphoma, Non-Hodgkin mortality, Lymphoma, Non-Hodgkin psychology, Quality of Life
Abstract

Background: Children with non-Hodgkin lymphoma (NHL) undergo treatment with central nervous system-directed therapy, the potentially neurotoxic effects of which have not been reported in NHL survivors., Methods: NHL survivors (n = 187) participating in the St. Jude Lifetime Cohort who were 10 or more years from their diagnosis and were 18 years old or older underwent neurocognitive, emotional distress (Brief Symptom Inventory 18), and health-related quality of life (HRQOL) assessments (36-Item Short Form Health Survey). Age-adjusted z scores were compared with community controls (n = 181) and normative data. Treatment exposures were abstracted from medical records. Models adjusted for the age, sex, and time from diagnosis were used to calculate the risk of impairment., Results: The mean ages at evaluation were similar for the survivors and the controls (35.7 ± 8.9 vs 35.5 ± 11.0 years; P = .86). Survivors were 25.2 ± 8.8 years from their diagnosis: 43 (23%) received cranial radiation, 70 (37%) received high-dose methotrexate, 40 (21%) received high-dose cytarabine, and 151 (81%) received intrathecal chemotherapy. Survivors' intelligence and attention were within normal limits; however, their memory, executive function, processing speed, and academics were impaired in comparison with both population norms and community controls (P values < .05). Treatment-related exposures were not associated with neurocognitive function; however, neurocognitive impairment was associated with lower educational attainment, unemployment, and occupational status (P values < .03). Slower processing speed and worse self-reported executive function were associated with symptoms of depression (P values ≤ .003) and poorer HRQOL (P values < .05)., Conclusions: Adult survivors of childhood NHL experience impaired neurocognitive function, which is associated with lower social attainment and poor HRQOL. Early-detection and intervention strategies are recommended. Cancer 2017. © 2017 American Cancer Society., (© 2017 American Cancer Society.)

Published
2018
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47. The role of body image dissatisfaction in the association between treatment-related scarring or disfigurement and psychological distress in adult survivors of childhood cancer.

Author

Vuotto SC, Ojha RP, Li C, Kimberg C, Klosky JL, Krull KR, Srivastava DK, Robison LL, Hudson MM, and Brinkman TM

Subjects
Adolescent, Adult, Child, Cohort Studies, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Quality of Life, Young Adult, Adult Survivors of Child Adverse Events psychology, Anxiety, Body Image psychology, Cancer Survivors psychology, Cicatrix psychology, Depression, Neoplasms psychology, Stress, Psychological psychology
Abstract

Objective: To examine the potential mediating role of body image dissatisfaction on the association between treatment-related scarring/disfigurement and psychological distress in adult survivors of childhood cancer., Methods: Participants included 1714 adult survivors of childhood cancer (mean [SD] age at evaluation = 32.4 [8.0] years, time since diagnosis = 24.1 [8.1] years) enrolled in the St. Jude Lifetime Cohort Study. Survivors completed measures of body image, emotional distress, and posttraumatic stress symptoms (PTSS). Body image dissatisfaction (BID) was categorized into 2 groups (cancer-related and general) based on factor analysis. Using causal mediation analysis, we estimated the proportion of psychological distress associated with treatment-related scarring/disfigurement that could be eliminated by resolving BID through a hypothetical intervention., Results: Among survivors with scarring/disfigurement of the head, a sizable proportion of the relative excess of psychological distress could be eliminated if BID was successfully treated (males: [cancer-related BID: depression: 63%; anxiety: 100%; PTSS: 52%]; [general BID: depression: 70%; anxiety: 100%; PTSS: 42%]; females: [cancer-related BID: depression: 20%; anxiety; 36%; PTSS: 23%]; [general BID: depression: 32%; anxiety: 87%; PTSS: 38%]). The mediating effect of BID was less pronounced for the association between scarring/disfigurement of the body and psychological distress for both males and females., Conclusions: Body image dissatisfaction mediates the association treatment-related scarring/disfigurement and psychological distress among adult survivors of childhood cancer, particularly among survivors with scarring/disfigurement of the head and male survivors. Successful treatment of body image dissatisfaction has the potential to eliminate a substantial proportion of psychological distress related to scarring/disfigurement among adult survivors of childhood cancer., (Copyright © 2017 John Wiley & Sons, Ltd.)

Published
2018
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48. Predictors of health care utilization in adult survivors of childhood cancer exposed to central nervous system-directed therapy.

Author

Kimberg CI, Klosky JL, Zhang N, Brinkman TM, Ness KK, Srivastava DK, Robison LL, Hudson MM, and Krull KR

Subjects
Adolescent, Adult, Central Nervous System, Cognition physiology, Executive Function physiology, Female, Health Status, Humans, Intelligence physiology, Male, Neoplasms therapy, Surveys and Questionnaires, Young Adult, Cognitive Dysfunction psychology, Dental Care statistics & numerical data, Neoplasms mortality, Patient Acceptance of Health Care psychology
Abstract

Background: Survivors of childhood cancer treated with central nervous system (CNS)-directed therapy may be at risk for poor health care utilization because of neurocognitive deficits. This study examined associations between neurocognitive function and adherence to routine and risk-based medical evaluations in adult survivors exposed to CNS-directed therapy., Methods: Neurocognitive function and health care utilization were assessed in 1304 adult survivors of childhood cancer enrolled in the St. Jude Lifetime Cohort Study. Adherence to recommended care was defined as meeting guidelines published by the Children's Oncology Group. Multivariate models were used to evaluate associations between neurocognitive function and health screenings. Established predictors of health care utilization were included as covariates. Odds ratios (ORs) or prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated for variables maintained in the final models., Results: Adherence to recommended medical care was higher for routine care (general physician care, 57.6%; dental care, 49.1%) versus specialized care (survivor-focused care, 21.9%; echocardiogram, 19.9%). Higher intelligence was predictive of general physician care (OR, 1.74; 95% CI, 1.41-2.15) and survivor-focused care (OR, 1.44; 95% CI, 1.13-1.83) in comparison with no care, whereas better executive function skills were associated with reduced dental care (PR, 0.94; 95% CI, 0.91-0.98). Echocardiogram monitoring was not associated with neurocognition. Possible late effects of cancer treatment (pain and reduced cardiorespiratory fitness) were associated with an increased likelihood of receiving specialized medical care., Conclusions: Survivors with reduced global cognition are at risk for poor health care utilization. Educational practices regarding recommended health care should be personalized to ensure comprehension by survivors with neurocognitive impairment., (© 2014 American Cancer Society.)

Published
2015
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49. Suicide ideation and associated mortality in adult survivors of childhood cancer.

Author

Brinkman TM, Zhang N, Recklitis CJ, Kimberg C, Zeltzer LK, Muriel AC, Stovall M, Srivastava DK, Sklar CA, Robison LL, and Krull KR

Subjects
Adult, Case-Control Studies, Child, Cohort Studies, Female, Follow-Up Studies, Health Status, Humans, Male, Neoplasms mortality, Neoplasms therapy, Odds Ratio, Outcome Assessment, Health Care, Siblings, Stress, Psychological etiology, Suicide statistics & numerical data, Neoplasms psychology, Suicide psychology, Survivors psychology
Abstract

Background: Adult survivors of childhood cancer are at risk for suicide ideation, although longitudinal patterns and rates of recurrent suicide ideation are unknown. This study investigated the prevalence of late report (ie, after initial assessment) and recurrent suicide ideation in adult survivors of childhood cancer, identified predictors of suicide ideation, and examined associations among suicide ideation and mortality., Methods: Participants included 9128 adult survivors of childhood cancer and 3082 sibling controls enrolled in the Childhood Cancer Survivor Study who completed a survey question assessing suicide ideation on one or more occasions between 1994 and 2010. Suicide ideation was assessed using the Brief Symptom Inventory-18 instrument. Mortality data was ascertained from the National Death Index., Results: Survivors were more likely to report late (odds ratio [OR] =1.9, 95% confidence interval [CI] =1.5-2.5) and recurrent suicide ideation (OR=2.6, 95% CI=1.8-3.8) compared to siblings. Poor physical health status was associated with increased risk of suicide ideation in survivors (late report: OR=1.9, 95% CI=1.3-2.7; recurrent: OR=1.9, 95% CI=1.2-2.9). Suicide ideation was associated with increased risk for all-cause mortality (hazard ratio=1.3, 95% CI=1.03-1.6) and death by external causes (hazard ratio=2.4, 95% CI=1.4-4.1)., Conclusions: Adult survivors of childhood cancer are at risk for late-report and recurrent suicide ideation, which is associated with increased risk of mortality. Routine screening for psychological distress in adult survivors appears warranted, especially for survivors who develop chronic physical health conditions., (© 2013 American Cancer Society.)

Published
2014
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50. Statistical analysis of mixed recurrent event data with application to cancer survivor study.

Author

Zhu L, Tong X, Zhao H, Sun J, Srivastava DK, Leisenring W, and Robison LL

Subjects
Adolescent, Computer Simulation, Female, Humans, Neoplasm Recurrence, Local pathology, Neoplasms pathology, Poisson Distribution, Pregnancy, Young Adult, Models, Statistical, Neoplasm Recurrence, Local epidemiology, Neoplasms epidemiology, Regression Analysis
Abstract

Event history studies occur in many fields including economics, medical studies, and social science. In such studies concerning some recurrent events, two types of data have been extensively discussed in the literature. One is recurrent event data that arise if study subjects are monitored or observed continuously. In this case, the observed information provides the times of all occurrences of the recurrent events of interest. The other is panel count data, which occur if the subjects are monitored or observed only periodically. This can happen if the continuous observation is too expensive or not practical, and in this case, only the numbers of occurrences of the events between subsequent observation times are available. In this paper, we discuss a third type of data, which is a mixture of recurrent event and panel count data and for which there exists little literature. For regression analysis of such data, we present a marginal mean model and propose an estimating equation-based approach for estimation of regression parameters. We conduct a simulation study to assess the finite sample performance of the proposed methodology, and the results indicate that it works well for practical situations. Finally, we apply it to a motivating study on childhood cancer survivors., (Copyright © 2012 John Wiley & Sons, Ltd.)

Published
2013
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