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Childhood injury after a parental cancer diagnosis
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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2015 (Engelska)Ingår i: eLIFE, E-ISSN 2050-084X, Vol. 4, artikel-id e08500Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

A parental cancer diagnosis is psychologically straining for the whole family. We investigated whether a parental cancer diagnosis is associated with a higher-than-expected risk of injury among children by using a Swedish nationwide register-based cohort study. Compared to children without parental cancer, children with parental cancer had a higher rate of hospital contact for injury during the first year after parental cancer diagnosis (hazard ratio [HR]=1.27, 95% confidence interval [CI]=1.22-1.33), especially when the parent had a comorbid psychiatric disorder after cancer diagnosis (HR=1.41, 95% CI=1.08-1.85). The rate increment declined during the second and third year after parental cancer diagnosis (HR=1.10, 95% CI=1.07-1.14) and became null afterwards (HR=1.01, 95% CI=0.99-1.03). Children with parental cancer also had a higher rate of repeated injuries than the other children (HR=1.13, 95% CI= 1.12-1.15). Given the high rate of injury among children in the general population, our findings may have important public health implications.

Ort, förlag, år, upplaga, sidor
eLife Sciences Publications Ltd , 2015. Vol. 4, artikel-id e08500
Nationell ämneskategori
Annan medicin och hälsovetenskap Pediatrik
Forskningsämne
Biologi
Identifikatorer
URN: urn:nbn:se:oru:diva-47206DOI: 10.7554/eLife.08500ISI: 000373886800001PubMedID: 26519735Scopus ID: 2-s2.0-84955264959OAI: oai:DiVA.org:oru-47206DiVA, id: diva2:889218
Forskningsfinansiär
Vetenskapsrådet, SIMSAM 340-2013-5867 SIMSAM 80748301Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2012-0498Svenska Sällskapet för Medicinsk Forskning (SSMF)
Anmärkning

Funding Agencies:

China Scholarship Council 20126100002

Karolinska Institutet

Tillgänglig från: 2015-12-22 Skapad: 2015-12-22 Senast uppdaterad: 2018-07-23Bibliografiskt granskad
Ingår i avhandling
1. Parental cancer and children’s well-being: understanding the potential role of psychological stress
Öppna denna publikation i ny flik eller fönster >>Parental cancer and children’s well-being: understanding the potential role of psychological stress
2017 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Early life stress has a major influence on one’s health through the life course. During childhood, early experience may not only affect the normal brain development, but also influence the susceptibility to mental and physical disorders. A cancer diagnosis in a parent may cause substantial distress in the children, who may have to confront and adapt to short- and long-term changes in their lives and subsequently experience a higher risk of physical and psychosocial problems. Therefore, the first aim of this thesis was to examine whether parental cancer is associated with physical and mental health problems in the affected children using data from the Swedish national registers. Further, to explore the potential mechanism determining the impact of stress on children’ health, we focused on the brain development in childhood and investigated the association between stress biomarkers and brain morphology, using data from a Dutch population-based cohort.

In Study I, we assessed the association between parental cancer and risk of injury in a large representative sample of Swedish children. We found that parental cancer was associated with a higher risk of hospital contacts for injury, particularly during the first year after the cancer diagnosis and when the parent experienced a psychiatric illness after the cancer diagnosis. The risk increment reduced during the second and third years and became null afterwards.

Given the observed higher risk of adverse physical health in terms of injury, we further investigated the influence of parental cancer on adverse mental health in terms of psychiatric disorders among children. In Study II, we constructed a matched cohort, and separately examined the associations between parental cancer diagnosed during pregnancy or after birth and clinical diagnoses of psychiatric disorders or use of prescribed psychiatric medications. Paternal but not maternal cancer during pregnancy appeared to be associated with a higher risk of psychiatric disorders, primary among girls. Parental cancer after birth conferred a higher risk of clinical diagnoses of psychiatric disorders, particularly stress reaction and adjustment disorders. The affected children also experienced a higher risk of use of prescribed psychiatric medications, particularly anxiolytics. The latter associations were most pronounced for parental cancer with poor expected survival and for parental death after cancer diagnosis.

In Study III, we focused on other domains of mental and physical health affected by parental cancer. We examined the associations of parental cancer with intellectual performance, stress resilience, and physical fitness among boys that underwent the compulsory military conscription examination during early adulthood. We observed positive associations of parental cancer with low stress resilience and low physical fitness, with stronger associations noted for parental cancer with poor expected survival and for a loss of parent through death after cancer diagnosis. No overall association was observed between parental cancer and intellectual performance, but the parental cancer with poor expected survival or resulting in a death of the parent was associated with a higher risk of low intellectual performance.

Ort, förlag, år, upplaga, sidor
Stockholm: Karolinska Institutet, 2017. s. 53
Nationell ämneskategori
Psykiatri
Identifikatorer
urn:nbn:se:oru:diva-67304 (URN)978-91-7676-652-1 (ISBN)
Disputation
2017-04-28, Hörsal Atrium, Nobels väg 12B, Stockholm, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-06-19 Skapad: 2018-06-19 Senast uppdaterad: 2018-06-19Bibliografiskt granskad

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