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Health-related quality of life in survivors of childhood cancer: the role of chronic health problems

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Abstract

Introduction

The influence of specific health problems on health-related quality of life (HRQoL) in childhood cancer survivors is unknown. We compared HRQoL between survivors of childhood cancer and their siblings, determined factors associated with HRQoL, and investigated the influence of chronic health problems on HRQoL.

Methods

Within the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976–2005 aged <16 years. Siblings received similar questionnaires. We assessed HRQoL using Short Form-36 (SF-36). Health problems from a standard questionnaire were classified into overweight, vision impairment, hearing, memory, digestive, musculoskeletal or neurological, and thyroid problems.

Results

The sample included 1,593 survivors and 695 siblings. Survivors scored significantly lower than siblings in physical function, role limitation, general health, and the Physical Component Summary (PCS). Lower score in PCS was associated with a diagnosis of central nervous system tumor, retinoblastoma or bone tumor, having had surgery, cranio-spinal irradiation, or bone marrow transplantation. Lower score in Mental Component Summary was associated with older age. All health problems decreased HRQoL in all scales. Most affected were survivors reporting memory problems and musculoskeletal or neurological problems. Health problems had the biggest impact on physical functioning, general health, and energy and vitality.

Conclusions

In this study, we showed the negative impact of specific chronic health problems on survivors’ HRQoL.

Implications for Cancer Survivors

Therapeutic preventive measures, risk-targeted follow-up, and interventions might help decrease health problems and, consequently, improve survivors’ quality of life.

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Acknowledgements

We thank all survivors and their families for participating in our survey, the study team of the Swiss Childhood Cancer Survivor Study (Fabienne Liechti, Julia Koch, and Laura Wengenroth), the Clinical Research Associates of the Swiss Paediatric Oncology Group (Verena Stahel, Nadine Beusch, Heike Markiewicz, Claudia Giezendanner, Franziska Hochreutener, Genevieve Perrenoud, Rosa-Emma Garcia, and Nadia Lanz), and the team of the Swiss Childhood Cancer Registry (Vera Mitter, Priska Wölfli, Elisabeth Kiraly, and Marlen Spring).

Conflict of interest

No conflict of interest stated for any of the authors.

Financial support

This study was supported by the Swiss Cancer League (KLS-01605-10-2004, KLS-2215-02-2008, KLS-02783-02-2011), Cancer League Aargau, Cancer League Zurich, Swiss Bridge, and Stiftung zur Krebsbekämpfung. Gisela Michel and Claudia Kuehni were funded by the Swiss National Science Foundation (G.M.—Ambizione Fellowship grant PZ00P3_121682/1 and PZ00P3_141722; C.K.—PROSPER grant 3233-069348). The work of the Swiss Childhood Cancer Registry is supported by the Swiss Paediatric Oncology Group, Kinderkrebshilfe Schweiz, Stiftung für krebskranke Kinder Regio Basiliensis, Schweizerische Konferenz der kantonalen Gesundheitsdirektorinnen und -direktoren (GDK) and numerous other sponsors.

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Authors and Affiliations

  1. Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland

    Corina S. Rueegg, Micol E. Gianinazzi, Gisela Michel & Claudia E. Kuehni

  2. Department of Oncology/Hematology, Children’s Hospital, Cantonal Hospital Lucerne, 6000, Lucerne, Switzerland

    Johannes Rischewski

  3. Paediatric Hematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Rue de Bugnon 21, 1011, Lausanne, Switzerland

    Maja Beck Popovic

  4. Department of Pediatric Oncology and Hematology, University Children’s Hospital, Spitalstrasse 33, 4056, Basel, Switzerland

    Nicolas X. von der Weid

  5. Department of Health Sciences & Health Policy, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland

    Gisela Michel

Authors
  1. Corina S. Rueegg
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  2. Micol E. Gianinazzi
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  3. Johannes Rischewski
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  4. Maja Beck Popovic
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  5. Nicolas X. von der Weid
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  6. Gisela Michel
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  7. Claudia E. Kuehni
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Corresponding author

Correspondence to Corina S. Rueegg.

Additional information

Swiss Paediatric Oncology Group (SPOG) Scientific Committee

Prof. Dr. med. R. Ammann, Bern; Dr. med. R. Angst, Aarau; Dr. med. M. Ansari, Geneva; PD Dr. med. M. Beck Popovic, Lausanne; Dr. med. E. Bergstraesser, Zurich; Dr. med. P. Brazzola, Bellinzona; Dr. med. J. Greiner, St. Gallen; Prof. Dr. med. M. Grotzer, Zurich; Dr. med. H. Hengartner, St. Gallen; Prof. Dr. med. T. Kuehne, Basel; Prof. Dr. med. K. Leibundgut, Bern; Prof. Dr. med. F. Niggli, Zürich; PD Dr. med. J. Rischewski, Lucerne; Prof. Dr. med. N. von der Weid, Basel.

Corina S. Rueegg and Micol E. Gianinazzi contributed equally to the publication.

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Rueegg, C.S., Gianinazzi, M.E., Rischewski, J. et al. Health-related quality of life in survivors of childhood cancer: the role of chronic health problems. J Cancer Surviv 7, 511–522 (2013). https://doi.org/10.1007/s11764-013-0288-4

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  • DOI: https://doi.org/10.1007/s11764-013-0288-4

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