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Psychological Distress Between Young Adult Female Survivors of Childhood Cancer and Matched Female Cohorts Surveyed in the Adolescent Health Study

Cantrell, Mary Ann PhD, RN; Posner, Michael A. PhD

doi: 10.1097/NCC.0000000000000105

Background: The psychological health of childhood cancer survivors is an essential treatment outcome. Female survivors are a subgroup of survivors with an increased risk for poor psychological outcomes.

Objective: This study compared psychological distress in young adult female survivors of childhood cancer with that in young adult females in the general population with no history of childhood cancer. Psychological distress was measured by assessing respondents’ subjective degree of depressive symptoms, anxiety, and somatization.

Methods: The study was a secondary data analysis. The sample was drawn from the National Longitudinal Study of Adolescent Health, which used a representative, probability-based sampling technique. The sample included 66 young adult female survivors of childhood cancer and 8186 young adult females with no history of cancer. Randomized, nonparametric testing was used to construct 10 000 different age-matched female cohort samples from the general population.

Results: Young adult female survivors of childhood cancer had more depressive symptoms (P < .05) as compared with matched cohorts with 589 of the 10 000 matched samples. There were no statistically significant differences between the cancer survivors and the matched cohort groups on anxiety and somatization symptoms.

Conclusion: Young adult female survivors of childhood cancer are at an increased risk of experiencing depression, which can decrease their psychological functioning and emotional well-being.

Implications for Practice: Healthcare professionals who care for these cancer survivors need to be aware that female survivors are at risk for depression and should screen and refer accordingly.

Author Affiliations: College of Nursing (Dr Cantrell) and Department of Mathematical Sciences (Dr Posner), Villanova University, Pennsylvania.

This study was funded by a grant from the Center for Nursing Research, College of Nursing, Villanova University. This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris and funded by a grant P01-HD31921 from the National Institute of Child Health and Human Development, with cooperativefunding from 17 other agencies.

The authors have no conflicts of interest to disclose.

Persons interested in obtaining data files from Add Health should contact Add Health, Carolina Population Center, 123 W Franklin St, Chapel Hill, NC 27516 (

Correspondence: Mary Ann Cantrell, PhD, RN, 342 Driscoll Hall, College of Nursing, Villanova University, 800 Lancaster Ave, Villanova, PA 19085 (

Accepted for publication August 26, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins