Cross-sectional study of 266 adult survivors of childhood cancer (diagnosed ≤21 years, cancer-free ≥2 years) at a tertiary care center in North India, assessing psychosocial outcomes — anxiety, depression, mental distress, self-esteem, perceived social support, and sexual dysfunction — using validated tools (HADS, MSPSS, SRQ, RSS, SDQ).
62.1% screened positive for borderline/abnormal anxiety and 82.2% for borderline/abnormal depression; 70.8% of 120 sexually active survivors screened positive for sexual dysfunction. Female sex independently predicted higher anxiety, higher mental distress, and lower social support; diagnosis at ≤12 years predicted greater sexual dysfunction.
Cross-sectional design prevents causal inference. Single-center North India sample limits generalizability across LMICs. Sexual dysfunction data available only for the 120 sexually active respondents (~45% of cohort), introducing selection bias.
Routine psychosocial screening — especially for anxiety, depression, and sexual dysfunction — should be embedded in survivorship care for childhood cancer survivors, with heightened attention to female survivors and those diagnosed at younger ages. Programs in LMICs should address cultural barriers that may mask distress despite high reported social support.
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