Altered self-perception in adult survivors treated for a CNS tumor in childhood or adolescence: population-based outcomes compared with the general population

• Published in: Neuro-oncology (Charlottesville, Va.) Vol. 17; no. 5; pp. 733 - 740
• Main Authors: Hörnquist, Lina, Rickardsson, Jenny, Lannering, Birgitta, Gustafsson, Göran, Boman, Krister K
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-05-2015
• Subjects: Adult; adult survivors; Body Image - psychology; Central Nervous System Neoplasms - psychology; childhood CNS tumors; Clinical Investigations; Cohort Studies; Female; Humans; late effects; Male; Medicin och hälsovetenskap; Pediatrics; Pediatrik; Quality of Life; Self Concept; self-esteem; self-identity; Survivors - psychology; Sweden; Young Adult; Sweden; self-esteem; childhood CNS tumors; adult survivors; late effects; self-identity
• ISSN: 1522-8517; 1523-5866; 1523-5866
• DOI: 10.1093/neuonc/nou289

Survivors of pediatric CNS tumors are at risk for persistent tumor/treatment-related morbidity, physical disability and social consequences that may alter self-perception, vital for self-identity, mental health and quality of survival. We studied the long-term impact of childhood CNS tumors and their treatment on the self-perception of adult survivors and compared outcomes with those of the general population.
The cohort included 697 Swedish survivors diagnosed with a primary CNS tumor during 1982-2001. Comparison data were randomly collected from a stratified general population sample. Survivors and general population individuals were compared as regards self-perception in 5 domains: body image, sports/physical activities, peers, work, and family, and with a global self-esteem index. Within the survivor group, determinants of impact on self-perception were identified.
The final analyzed sample included 528 survivors, 75.8% of the entire national cohort. The control sample consisted of 995, 41% of 2500 addressed. Survivors had significantly poorer self-perception outcomes in domains of peers, work, body image, and sports/physical activities, and in the global self-perception measure, compared with those of the general population (all P < .001). Within the survivor group, female gender and persistent visible physical sequelae predicted poorer outcomes in several of the studied domains. Tumor type and a history of cranial radiation therapy were associated with outcomes.
An altered self-perception is a potential late effect in adult survivors of pediatric CNS tumors. Self-perception and self-esteem are significant elements of identity, mental health and quality of survival. Therefore, care and psychosocial follow-up of survivors should include measures for identifying disturbances and for assessing the need for psychosocial intervention.