Psychosocial Wellbeing of Young Adult Survivors of Childhood and Adolescent Cancer: An Integrative Review

Background & Purpose: Advancements in cancer treatment have increased the number of childhood and adolescent cancer survivors significantly. The majority of childhood and adolescent cancer survivors will proceed to young adulthood. However, due to late effects of treatment, survivors experience a wide range of physical and psychological sequelae that impede their ability to meet the psychosocial demands of young adulthood. Therefore, the purpose of this integrative review is to understand the prevalence and magnitude of psychological and social sequelae that survivors of childhood and adolescent cancer experience during young adulthood.

Theoretical Framework: Psychological and Social-wellbeing domains from the Quality of Life model by Ferrell & Hassey Dow (1997) was used to guide the review.

Methods: A systematic literature search was conducted on three databases (CINAHL, MEDLINE, PsycINFO) spanning from January 1999 to April 2017. A combination of keywords and MeSH terms related to the review purpose were used (e.g. child, survivors, neoplasms, social, psychological, depression, marriage, employment…). The search was limited to primary source articles published in English. Both quantitative and qualitative studies were included in the integrative review if the study sample consisted of young adult survivors of childhood and adolescent cancer between the age of 19-39 years and at least one of the psychological and/or social wellbeing domains was reported in the study.

Results: 1,915 articles were identified from the initial search of the three databases after removing the duplicates. After title and abstract review, 1,585 articles were removed for the following reasons: sample are not young adult childhood cancer survivors (n=768), no psychosocial outcome variables reported (n=419), other types of publications (n=79), review articles (n=319). The full text of the remaining 330 articles was evaluated to determine if they meet the inclusion criteria.

Preliminary analysis of national and international studies indicates that a subset of young adult survivors are at risk for experiencing psychological problems, and are less likely to fulfill their social roles compared to the general population. Disparities in relation to their non-affected peers were found in areas of employment, military service, family/marital relationships, and mental health. Further analysis is in progress to identify further themes and patterns in the data and to identify the final number of articles that will be included in the review.

Conclusions & Implications: The psychosocial life of survivors of childhood and adolescent cancer is affected considerably during young adulthood by their cancer experience. Careful and early assessment and interventions are needed to improve psychosocial functioning for childhood cancer survivors transitioning to their adulthood.