# Health-Related Quality of Life and Social Outcomes in Adolescents and Young Adult Survivors of Childhood Cancer: A Single-Center Case–Control Study from Crete, Greece

## TL;DR

This study compares health and social outcomes in young cancer survivors and their healthy peers, finding that survivors generally have similar quality of life but face challenges related to cancer type and late effects.

## Contribution

The study provides insights into HRQoL and social outcomes specific to AYA CCSs in a single-center setting in Greece.

## Key findings

- CCSs show no significant deviation in HRQoL from healthy peers.
- Late effects and cancer type significantly impact physical and mental health scores.
- Healthy lifestyle behaviors correlate with better mental health outcomes.

## Abstract

Background: Recent advances in childhood cancer treatment and increased survival rates have led to a growing number of adolescents and young adults (AYAs) who are survivors of childhood cancer (CCSs). This study aimed to examine health status, health-related quality of life (HRQoL), and social outcomes in AYA CCSs. Methods: Sixty-two AYAs who were CCSs (treated within the same tertiary Pediatric Hematology–Oncology Department in Crete, Greece) were enrolled in the study. Self-reported HRQoL was assessed using the Short-Form Health Survey (SF-36). Sixty-five never-ill peers constituted the control group. Results: CCSs reach adolescence and young adulthood without significant deviations in HRQoL from their healthy peers. The presence and severity of late effects were significantly correlated with lower scores in physical health. The cancer type seems to play a pivotal role: Langerhans cell histiocytosis survivors displayed significantly lower scores in mental health, and brain tumor survivors scored substantially lower scores in physical functioning. Acute lymphoblastic leukemia survivors reported the highest scores in mental health. Age at diagnosis of neoplasia was negatively correlated with physical functioning. No significant sex differences were identified. Adherence to multiple healthy lifestyle behaviors (regular exercise, abstaining from alcohol consumption and smoking, and using sun protection) and active employment were correlated with significantly higher scores in mental health. Conclusions: Appropriate therapy and regular follow-up after treatment have led to improved clinical and social outcomes, as assessed by CCSs. More efforts are needed to increase awareness of avoiding harmful behaviors that raise the risk of late effects in this specific group.