Psychosocial Distress, Social Support, and Sexual Health Among Adult Survivors of Childhood Cancer in India: Findings From the Childhood Cancer Survivorship Program.
Advances in pediatric oncology have created a growing cohort of adult survivors of childhood cancer, but data on long-term psychological outcomes from low- and middle-income countries (LMICs) remain limited. We evaluated psychosocial outcomes among adult survivors of childhood cancer in North India and examined demographic and clinical predictors of distress, social support, self-esteem, and sexual dysfunction.
In this cross-sectional study at a tertiary care cancer center in India, 266 long-term survivors diagnosed at ≤21 years of age, aged ≥18 years at recruitment, who had completed definitive therapy and remained cancer-free for ≥2 years, underwent psychological assessment using the HADS, MSPSS, SRQ, RSS, and SDQ.
Overall, 62.1% screened positive for borderline/abnormal anxiety symptoms and 82.2% for borderline/abnormal depressive symptoms. Despite this burden, 87.9% reported high perceived social support. Mental distress and low self-esteem were reported by 16.9% and 5.9%, respectively. Among 120 sexually active respondents, 70.8% screened positive for sexual dysfunction. Female sex was independently associated with higher anxiety, higher mental distress, and lower perceived social support. Time off therapy less than 8 years was associated with lower self-esteem. Diagnosis at age ≤12 years was associated with greater sexual dysfunction.
Adult survivors of childhood cancer experience a substantial and partly hidden psychosocial burden, and their psychological journey is influenced not just by biology, but by the deep-rooted cultural norms and societal structures. The current study offers valuable evidence from India, with implications for survivorship care across LMICs.
In this cross-sectional study at a tertiary care cancer center in India, 266 long-term survivors diagnosed at ≤21 years of age, aged ≥18 years at recruitment, who had completed definitive therapy and remained cancer-free for ≥2 years, underwent psychological assessment using the HADS, MSPSS, SRQ, RSS, and SDQ.
Overall, 62.1% screened positive for borderline/abnormal anxiety symptoms and 82.2% for borderline/abnormal depressive symptoms. Despite this burden, 87.9% reported high perceived social support. Mental distress and low self-esteem were reported by 16.9% and 5.9%, respectively. Among 120 sexually active respondents, 70.8% screened positive for sexual dysfunction. Female sex was independently associated with higher anxiety, higher mental distress, and lower perceived social support. Time off therapy less than 8 years was associated with lower self-esteem. Diagnosis at age ≤12 years was associated with greater sexual dysfunction.
Adult survivors of childhood cancer experience a substantial and partly hidden psychosocial burden, and their psychological journey is influenced not just by biology, but by the deep-rooted cultural norms and societal structures. The current study offers valuable evidence from India, with implications for survivorship care across LMICs.
Authors
Sahni Sahni, Sasi Sasi, Kumar Kumar, Sharma Sharma, Vaidya Vaidya, Satapathy Satapathy, Sharma Sharma, Kumari Kumari, Sharma Sharma, Tahiliani Tahiliani, Gupta Gupta, Bagai Bagai, Sharma Sharma, Pushpam Pushpam, Khan Khan, Kumar Kumar, Agarwala Agarwala, Jain Jain, Meel Meel, Batra Batra, Ganguly Ganguly, Bakhshi Bakhshi
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