Psychiatric disorders in childhood cancer survivors in Denmark, Finland and Sweden: a registry-based cohort study from SALiCC’s research program
Background
A childhood cancer diagnosis and treatment-induced somatic late effects can affect the survivors’ mental health in the long term. We aimed to investigate whether child cancer survivors are at higher risk for psychiatric disorders later in life than their siblings and the general population.
Methods
Bargain
The study population included 18,621 surviving childhood cancers (9934 [53·3%] men and 8687 [46·7%] women), 24,775 siblings (12,594 [50·8%] men and 12 181 [49·2%]
women) and 88,630 matched individuals (47,300 [53·4%] men and 41,330 [46·6%]
honor). The cumulative incidence rate of having had a psychiatric hospital contact at the age of 30 between 1 January 1979 and 11 August 2017 was 15 · 9% (95% CI 15 · 3–16 · 5) for surviving childhood cancer, 14 · 0% (13 · 5–14 · 5) for siblings and 12 · 7% (12 · 4–12 · 9) for matched individuals. Despite a small absolute difference, survivors had a higher relative risk of any psychiatric hospital contact than their siblings (1 · 39, 1 · 31–1 · 48) and matched individuals (hazard ratio 1 · 34, 95% CI 1 · 28– 1 · 39). The higher risk persisted at age 50. Survivors had a higher burden of recurrent psychiatric hospital contacts and had more hospital contacts for various psychiatric disorders than their siblings and the matched individuals.
Interpretation
Child cancer survivors are at higher risk for psychiatric disorders than their siblings and matched individuals from the general population. To improve mental health and the overall quality of life after childhood cancer, survivor care should include a focus on early signs of mental health problems, especially among high-risk groups of survivors.
Financing
NordForsk, Aarhus University, the Swedish Childhood Cancer Foundation, the Danish Health Foundation and the Swiss National Science Foundation.