The purpose of this proposal is to further understanding of the prevalence, characteristics and predictors of the psychosocial health status, health risk behaviors and neurological sequelae of long-term survivors of childhood cancer. The research proposed in this application will make use of the Childhood Cancer Survivor Study, a multi-institutional collaborative project that has established and followed a retrospectively-ascertained cohort of long-term survivors of childhood cancer and 6,000 sibling controls. This is the largest sample of well-characterized childhood cancer survivors and sibling controls known to date. Previous work suggests that certain subsets of childhood cancer survivors are vulnerable to a variety of physical and psychosocial problems, but the generalizability of these findings are limited by small sample sizes, data derived from single institutions, and lack of a control group. Furthermore, study in this field has yet to identify critical variables that influence (1) long-term survivors' psychosocial problems, but the generalizability of these findings are limited by small sample sizes, data derived from single institutions, and lack of a control group. Furthermore, study in this field has yet to identify critical variables that influence (1) long-term survivors' psychosocial status/quality of life, including their experiences with pain, and (2) behaviors that place them at risk for future health problems. The work to be conducted during the period of this functioning, and health behaviors. Physical, psychological, social and neurological factors that potentially influence these outcomes will be investigated. Specific hypotheses related to these outcomes are proposed and potentially moderating and mediating factors will be investigated. Psychosocial support interventions throughout a continuum of care- from diagnosis through treatment and into long-term survivorship-will be suggested. Plans for intervention research will be forthcoming.
