Psychological outcomes of siblings of cancer survivors: a report from the Childhood Cancer Survivor Study

Objective: To identify risk factors for adverse psychological outcomes among adult siblings of long‐term survivors of childhood cancer. Methods: Cross‐sectional, self‐report data from 3083 adult siblings (mean age 29 years, range 18–56 years) of 5 + year survivors of childhood cancer were analyzed to assess psychological outcomes as measured by the Brief Symptom Inventory‐18 (BSI‐18). Sociodemographic and health data, reported by both the siblings and their matched cancer survivors, were explored as risk factors for adverse sibling psychological outcomes through multivariable logistic regression. Results: Self‐reported symptoms of psychological distress, as measured by the global severity index of the BSI‐18, were reported by 3.8% of the sibling sample. Less than 1.5% of siblings reported elevated scores on two or more of the subscales of the BSI‐18. Risk factors for sibling depression included having a survivor brother (OR 2.22, 95% CI 1.42–3.55), and having a survivor with impaired general health (OR 2.15, 95% CI 1.18–3.78). Siblings who were younger than the survivor reported increased global psychological distress (OR 1.81, 95% CI 1.05–3.12), as did siblings of survivors reporting global psychological distress (OR 2.32, 95% CI 1.08–4.59). Siblings of sarcoma survivors reported more somatization than did siblings of leukemia survivors (OR 2.07, 95% CI 1.05–3.98). Conclusions: These findings suggest that siblings of long‐term childhood cancer survivors are psychologically healthy in general. There are, however, small subgroups of siblings at risk for long‐term psychological impairment who may benefit from preventive risk‐reduction strategies during childhood while their sibling with cancer is undergoing treatment. Copyright © 2010 John Wiley & Sons, Ltd.