Prognostic Models for Optimal and Improved Health-Related Quality-of-Life Among Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

PURPOSE: Predictors of optimal or improved health-related quality-of-life (HRQOL) in adult survivors of childhood cancer are understudied. METHODS: This cohort study used data from 4,755 survivors in the Childhood Cancer Survivor Study who completed baseline (T0) and two follow-up surveys (T1, T2) between 1992 and 2016. HRQOL was assessed using SF-36 Physical and Mental Component Summaries (PCS; MCS), classified as optimal (≥40) or suboptimal (<40), with improvement being suboptimal at T1 to optimal at T2. RESULTS: At T1, 88.4% and 82.5% had optimal physical and mental HRQOL; among those suboptimal, 51.3% and 63.9% improved by T2. Higher education, physical activity, income, mental health, and absence of chronic conditions predicted optimal or improved HRQOL using multivariable logistic regression with backward selection. Model performance was acceptable for optimal PCS (0.81), MCS (0.72), and improved models (0.69 each). CONCLUSION: Findings may inform targeted interventions addressing education, lifestyle, mental health, and chronic conditions to enhance well-being in childhood cancer survivors.