Browse Theses

Since the 1970s, cancer in children and young people has become both increasingly common and more survivable. Whilst physical late effects of cancer are well documented, less is known about long-term mental health. A systematic review highlighted increased mental ill health amongst childhood and young adult cancer survivors. However, few studies included clinician-diagnosed mental health problems, and no population-based studies were found. The Yorkshire Specialist Register of Cancer in Children and Young People was used to identify 7253 long-term survivors of early-life cancer. Records from routinely collected mental health data sets were used to identify individuals who had had contact with specialist mental health services, or who had a recorded mental health condition during an inpatient hospital stay. These were compared with population rates of specialist mental health services use and recorded mental health conditions, and standardised incidence ratios were calculated. Logistic regression was used to identify sub-groups at increased risk of mental health difficulties. Cancer survivors were 73.7% more likely than the general population to have a recorded contact with specialist mental health services, but no more likely to have a recorded mental health diagnosis during an inpatient stay. Teenagers and young adults treated on specialist teenage and young adult units had more specialist mental health services contacts than those treated on standard wards. The increased risk of mental health services use amongst cancer survivors should prompt clinicians to routinely enquire about mental health during contacts with this cohort. The increased risk amongst teenagers and young adults treated on specialist units was surprising, and it is unclear whether this represents a true increase in prevalence of mental ill health, or simply improved access to specialist services. Further work to understand the reasons behind increased mental health services use is essential, and should include analysis of primary care records.