Risk of mental health visits up in childhood cancer survivors

(HealthDay)—Survivors of adolescent cancer have higher rates of adverse mental health outcomes than the general population, according to a study published online Feb. 22 in Cancer.

Paul C. Nathan, M.D., from the Hospital for Sick Children in Toronto, identified all five-year childhood cancer survivors diagnosed before age 18 years and treated in an Ontario pediatric cancer center from 1987 to 2008. They matched 4,117 patients to 20,269 population controls in order to compare rates of mental health care visits (family physician, psychiatrist, emergency department, hospitalization) and the risk for a severe mental health event (emergency department, hospitalization, or suicide).

The researchers found that, compared with controls, childhood cancer survivors had a higher rate of mental health visits (adjusted relative rate [RR], 1.34). Female gender (RR, 1.39) and being diagnosed at ages 15 to 17.9 years (compared with ages 0 to 4 years: RR, 1.81) were associated with higher rates of mental health visits. However, cancer type, treatment intensity, and treatments targeting the central nervous system were not significant predictors of mental health visits. Compared with controls, survivors were at increased risk for a severe event (adjusted hazard ratio, 1.13). Childhood cancer survivors diagnosed with cancer at age 4 years or younger were at greatest risk for a severe event by age 28 years (16.3 percent).

"Survivors of adolescent cancer have a higher rate of mental health visits overall, whereas survivors of cancer before age 4 years have a markedly elevated risk of severe events," the authors write.

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