Auditory complications among childhood cancer survivors and health-related quality of life: a PanCareLIFE study.

Purpose: Auditory complications are potential side effects from childhood cancer treatment. Yet, limited evidence exists about the impact of auditory complications-particularly tinnitus-on health-related quality of life (HRQoL) among childhood cancer survivors (CCS). We determined the prevalence of hearing loss and tinnitus in the European PanCareLIFE cohort of CCS and examined its effect on HRQoL.
Methods: We included CCS from four European countries who were diagnosed at age ≤ 18 years; survived ≥ 5 years; and aged 25-44 years at study. We assessed HRQoL (Short Form 36), hearing loss, and tinnitus using questionnaires. We used multivariable linear regression to examine associations between these two auditory complications and HRQoL adjusting for socio-demographic and clinical factors.
Results: Our study population consisted of 6,318 CCS (53% female; median age at cancer diagnosis 9 years interquartile range [IQR] 5-13 years) with median age at survey of 31 years (IQR 28-35 years). Prevalence was 7.5% (476/6,318; confidence interval [CI]: 6.9-8.2) for hearing loss and 7.6% (127/1,668; CI: 6.4-9.0) for tinnitus. CCS with hearing loss had impaired physical (coefficient [coef.] -4.3, CI: -7.0 to -1.6) and mental (coef. -3.2, CI: -5.5 to -0.8) HRQoL when compared with CCS with normal hearing. Tinnitus was associated with impaired physical (coef. -8.2, CI: -11.8 to -4.7) and mental (coef. -5.9, CI: -8.8 to -3.1) HRQoL.
Conclusion: We observed reduced HRQoL among CCS with hearing loss and tinnitus. Our findings indicate timely treatment of hearing loss and tinnitus may contribute to quality of life of survivors.
Implications for Cancer Survivors: CCS who experience auditory complications should be counseled about possible therapeutic and supportive measures during follow-up care.
Competing Interests: Declarations. The authors declare that there is no relevant financial or non-financial interests to disclose. Ethics approval: PanCareLIFE is a multinational collaborative research project that has harmonized and combined data from regional and national cohorts across Europe. Data collection and analysis for each cohort was approved by the responsible ethics committee in each participating country. For Germany this is the Ethics Committee of the Medical Association of Westphalia-Lippe and the Medical faculty of the Westphalian Wilhelms University (2012-530-f-S), for Switzerland the Cantonal Ethics Committee of the Canton of Bern (KEK-BE: 166/2014; 2021 − 01462), for the Czech Republic the Ethics Committee for Multi-Centric Clinical Trials of the University Hospital Motol (EK-1723/13) and the Multi-Centric Ethics Committee of the University Hospital Brno (approval date: 2014/10/22), and for France the Personal Protection Committee South East 1 (CPP: 2015-23). Consent to participate: All data contributed to PanCareLIFE were pseudonymized. All survivors provided either written informed consent or implied consent or assent by returning the questionnaire. Consent to publish: Consent to publish was not applicable, as this publication does not contain individual person’s data in any form. Conflict of interest: The authors declare no conflict of interest.
(© 2023. The Author(s).)