Adult psychosocial outcomes in long-term survivors of acute lymphoblastic leukaemia and Wilms' tumour: a controlled study

Background Variability in methods and deficits in design have contributed t o conflicting findings about adult psychosocial functioning after childhood cancer. We did a controlled study of psychosocial outcomes in adult surviv ors of childhood acute lymphoblastic leukaemia (ALL) and Wilms' tumour to a ddress previous methods limitations. Methods We assessed 102 survivors of childhood ALL and Wilms' tumour, who h ad been free from relapse for 5 years and were aged 19-30 years, and 102 un related healthy controls. We used standard measures of adult psychiatric di sorder, interpersonal and social-role performance, and intellectual ability to assess past and current functioning. Findings Cancer survivors had no increased rates of psychiatric disorder. M ean scores of cancer survivors were significantly higher (indicating poorer functioning) than those of controls for love/sex relationships (mean diffe rence 0.87 [95% CI 0.53-1.22]), friendships (0.37 [0.07-0.67]), non-specifi c social contacts (0.40 [0.20-0.60]), and day-to-day coping (0.35 [0.14-0.5 7]). Cancer survivors were more likely than controls to have a combination of deficits in love/sex relationships and friendships (ALL survivors odds r atio 10.83 [95% CI 3.87-30.82], Wilms' tumour survivors 4.85 [1.43-16.47]), which was associated with more recent treatment (p=0.005). Poor coping was associated with lower intellectual ability scores (p=0.018). Interpretation Childhood ALL and Wilms' tumour have longterm effects on int erpersonal functioning and coping, probably mediated by different mechanism s. Prospective studies with each of these tumour groups are needed with sim ilar adolescent and adult outcome measures.