A related Q&A on this topic can be read here.

Studies have shown that survivors of pediatric and adolescent and young adult (AYA) cancers have a higher risk of psychiatric disorders compared with individuals without cancer.

In one study, 89.2% of cancer patients aged 5 to 12 years met diagnostic criteria for at least 1 psychiatric disorder.1 In another study, 48% of children and adolescents with cancer met criteria for depressive disorders, anxiety disorders, or both in the 12 months after diagnosis.2 Researchers have also found elevated rates of psychiatric disorders in long-term survivors of pediatric and AYA cancers.3-6 

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“Multiple studies have now shown that, while many survivors have good mental health, a substantial subgroup do suffer from adverse mental health outcomes for years after their cancer treatment, and their risk is higher than that of the general population,” said Sumit Gupta, MD, PhD, of the Hospital for Sick Children and the Institute for Health Policy, Management and Evaluation at the University of Toronto in Ontario, Canada.

Increased Risk in Young Cancer Survivors

In a study published in Lancet Psychiatry, Frederiksen et al3 examined the long-term risk of psychiatric disorders in 5-year survivors of childhood cancer diagnosed before age 20 years (n=18,621) as compared with their siblings (n=24,775) and matched individuals from the general population (n=88,630) in Denmark, Finland, and Sweden.

The results revealed a higher relative risk of psychiatric hospital contact among survivors compared with siblings (hazard ratio [HR], 1.39; 95% CI, 1.31-1.48) and matched individuals (HR, 1.34; 95% CI, 1.28-1.39), and the risk remained elevated in survivors at 50 years of age.

In a population-based cross-sectional study published in Cancers, the prevalence of a probable major depressive episode in survivors of childhood and adolescent cancers was approximately 2 times greater than that in a normative sample.4

In a 2020 meta-analysis of 3 studies, Dr Gupta and colleagues observed an elevated risk of mood disorders (odds ratio [OR], 1.36; 95% CI, 1.19-1.55; I2=31%) and anxiety disorders (OR, 1.16; 95% CI, 1.05-1.28; I2=0%) in 5-year survivors of AYA cancers compared with cancer-free control individuals.7

A 2018 review by Brinkman et al also showed a higher risk of anxiety and depression, as well as an increased risk of post-traumatic stress symptoms and suicidal ideation, in childhood cancer survivors compared with siblings and control individuals.5

In a 2013 study, Brinkman et al investigated patterns of psychological distress over time among adult survivors of childhood cancer.6

“While the majority of survivors in this study reported few or no symptoms, there was a subset of survivors who reported mental health issues that persisted over time or even emerged several decades postdiagnosis,” noted Katharine R. Lange, MD, a pediatric hematologist and oncologist and director of the Children’s Cancer Survivor Program at Children’s Minnesota in Minneapolis.