Risk taking and decision making of adolescent long-term survivors of cancer

Late effects of multi-modal treatments for long-term survivors of childhood cancer may affect their ability to make decisions related to risk behaviors. Adolescent survivors may be at greater risk than those in the general population because of late effects of organ compromise and oncogenesis. The purposes of this study were to (1) describe the prevalence of risk behaviors among adolescent long-term survivors of cancer; (2) describe these survivors' perceptions of the quality of their decision making; (3) test the hypothesis that the poorer the decision-making quality, the more risk behaviors exhibited by an adolescent long-term survivor; and (4) examine the effects of central nervous system (CNS) prophylactic leukemia therapy and academic achievement problems on quality of decision making and risk behaviors. In this descriptive study, a semi-structured interview was used at the time of the yearly clinic visit. The sample consisted of 36 long-term survivors who were disease-free for five years, had no medical treatment for two years, and were 14-19 years of age. The major conclusions drawn regarding adolescent long-term survivors were that (1) although there was a trend toward higher experimental use of some risk behaviors, essentially, the prevalence rates were comparable to those of the general population; (2) some were good decision makers; however, quality decision-making skills were poorly practiced by the majority; (3) with better decision-making quality, fewer risk behaviors were exhibited; and (4) prior CNS prophylactic leukemia therapy and academic achievement problems may be associated with poor quality decision making.