Introduction
Childhood and adolescent/young adult (AYA) cancer survivors report chronic health conditions, such as cardiovascular disease,1 and emotional distress, including depressive symptoms,2 at higher rates compared to peers. Some, but not all, of these outcomes are explained by cancer treatments, which remain necessary to achieve cure.3 Therefore, it is critical to identify and target modifiable risk factors to reduce sub-optimal outcomes.
Adverse Childhood Experiences (ACEs) are traumatic events that occur prior to age 18, and they can undermine a person’s sense of safety, stability, and bonding.4 ACEs have been associated with increased rates of chronic health conditions,5poor mental health,6 and substance misuse5 for the general population. However, resilience, defined as harnessing resources to sustain well-being during adversity, can mitigate the effects of ACEs.7,8Resilience can be cultivated, providing a target for intervention to improve health outcomes of those with ACEs.
To date, the impact of ACEs on health outcomes of childhood and AYA cancer patients and survivors has not been investigated. The influence of resilience on ACEs and health outcomes has also not been explored for these populations. Therefore, the purpose of this pilot study was to evaluate the feasibility and acceptance of assessing the sensitive subjects of ACEs and resilience in childhood and AYA cancer patients. We also described the occurrence of ACEs, resilience, and poor health outcomes (such as chronic health conditions, mental health issues, and substance misuse) in our cohort.