Originally published as JCO Early Release 10.1200/JCO.2008.21.1458 on February 17 2009

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Social Outcomes in the Childhood Cancer Survivor Study Cohort

From the Department of Pediatrics and University of Michigan Comprehensive Cancer Center; School of Social Work, University of Michigan, Ann Arbor, MI; St Jude Children's Research Hospital, Memphis, TN; Yale University School of Medicine, New Haven, CT; Oregon Health & Science University, Portland, OR; The Hospital for Sick Children, Toronto, Ontario, Canada; and the Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA.

Corresponding author: James G. Gurney, PhD, Department of Pediatrics, University of Michigan, 300 N Ingalls St, Room 6D22, Ann Arbor, MI 48109; e-mail: jamegurn{at}umich.edu.

Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects.

Supported in part by grant No. CA 55727 from the National Institutes of Health.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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