Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peers
Article first published online: 28 JUN 2008
© 2008 The Authors. Journal compilation © 2008 Society for the Study of Addiction
Volume 103, Issue 7, pages 1139–1148, July 2008
How to Cite
Lown, E. A., Goldsby, R., Mertens, A. C., Greenfield, T., Bond, J., Whitton, J., Korcha, R., Robison, L. L. and Zeltzer, L. K. (2008), Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peers. Addiction, 103: 1139–1148. doi: 10.1111/j.1360-0443.2008.02242.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Submitted 23 August 2007; initial review completed 3 December 2007; final version accepted 12 March 2008
- Alcohol consumption;
- childhood cancer survivor;
- long-term follow-up care;
- quality of life;
- risky drinking;
Aims This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described.
Design, setting and participants Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774).
Measurement Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured.
Findings Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8–1.0] and heavy drinkers (ORadj = 0.8; CI 0.7–0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18–21 years (ORadj = 2.0; 95% CI 1.5–2.6), male (ORadj = 2.1; 95% CI 1.8–2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7–4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4–10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective.
Conclusions Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking.