Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors

ABSTRACT

Long-term sequelae of cancer and its treatment render childhood cancer (CC) survivors vulnerable to cognitive and behavioural difficulties and likely affect their quality of life (QoL). Our aim was to compare levels of cognition, psychosocial functioning, and health-related QoL of CC survivors to healthy controls and examine the associations between these three domains. Seventy-eight CC survivors (age range = 7–16 years, ≥ one year since cancer treatment) and 56 healthy controls were included. Cognition (i.e., fluid intelligence, executive functions, memory, processing speed, and selective attention), psychosocial functioning, and health-related QoL were assessed using standardized tests and questionnaires. The cognitive performance, parent-reported psychosocial behaviour, and health-related QoL of the CC survivors were within the normative range. However, working memory was significantly poorer in survivors than controls, and visuospatial working memory below the normative range was more commonly observed among survivors than among controls. Processing speed significantly predicted survivors’ performance in executive functions. Among survivors, greater peer problems were significantly associated with poorer cognitive functions and health-related QoL. Despite the evidence for good intellectual functioning, which might point towards adequate reserves, in some survivors, domain-specific difficulties may emerge years after cancer relating to psychosocial development and QoL.

KEYWORDS:

• Pediatric cancer survivors
• Cognitive late effects
• Psychosocial functioning
• Executive functions
• Cognitive reserve

Acknowledgments

This work was supported by the Fondation Gaydoul (Churerstrasse 47, 8808 Pfäffikon SZ), the Swiss Cancer Research foundation under Grant KFS-3705-08-2015; KFS-4708-02-2019, the Dietmar Hopp Stiftung GmbH (Walldorf, Germany), the Hans & Annelies Swierstra Stiftung (Meggen, Switzerland), and the Berner Stiftung für krebskranke Kinder und Jugendliche, 3010 Bern. In addition, we thank the staff of the Swiss Childhood Cancer Registry for their support, the participating parents, and their children. The funding sources had no role in the design of the study, and no role during its execution, analyses, interpretation of the data, or decision to submit results. We are grateful to our postgraduate students and research assistants for their support in performing assessments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data of this study are available upon reasonable request after signing a confidentiality statement and a data sharing agreement.

Additional information

Funding

This work was supported by the Fondation Gaydoul (Churerstrasse 47, 8808 Pfäffikon SZ), the Swiss Cancer Research foundation [grant number KFS-3705-08-2015; KFS-4708-02-2019], the Dietmar Hopp Stiftung GmbH (Walldorf, Germany), the Hans & Annelies Swierstra Stiftung (Meggen, Switzerland), the Berner Stiftung für krebskranke Kinder und Jugendliche, 3010 Bern; and the Krebsstiftung Thun-BernerOberland, 3600 Thun.