Psychosocial Distress, Social Support, and Sexual Health Among Adult Survivors of Childhood Cancer in India: Findings From the Childhood Cancer Survivorship Program.
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BACKGROUND: Advances in pediatric oncology have created a growing cohort of adult survivors of childhood cancer, but data on long-term psychological outcomes from low- and middle-income countries (LMICs) remain limited. We evaluated psychosocial outcomes among adult survivors of childhood cancer in North India and examined demographic and clinical predictors of distress, social support, self-esteem, and sexual dysfunction. PROCEDURE: In this cross-sectional study at a tertiary care cancer center in India, 266 long-term survivors diagnosed at ≤21 years of age, aged ≥18 years at recruitment, who had completed definitive therapy and remained cancer-free for ≥2 years, underwent psychological assessment using the HADS, MSPSS, SRQ, RSS, and SDQ. RESULTS: Overall, 62.1% screened positive for borderline/abnormal anxiety symptoms and 82.2% for borderline/abnormal depressive symptoms. Despite this burden, 87.9% reported high perceived social support. Mental distress and low self-esteem were reported by 16.9% and 5.9%, respectively. Among 120 sexually active respondents, 70.8% screened positive for sexual dysfunction. Female sex was independently associated with higher anxiety, higher mental distress, and lower perceived social support. Time off therapy less than 8 years was associated with lower self-esteem. Diagnosis at age ≤12 years was associated with greater sexual dysfunction. CONCLUSIONS: Adult survivors of childhood cancer experience a substantial and partly hidden psychosocial burden, and their psychological journey is influenced not just by biology, but by the deep-rooted cultural norms and societal structures. The current study offers valuable evidence from India, with implications for survivorship care across LMICs.