Abstract
The purpose of this correlational study was to examine factors related to cognitive late effects of treatment that may be predictors of decision making and risk behaviors for cancer-surviving adolescents. A convenience sample of 52 survivors (ages 14-19 years, disease-free for 5 years, no treatment for 2 years, and with all types of cancer except primary brain tumors) participated in this study at two regional survivor follow-up clinics. A medical record review, a semistructured interview with the teen, and intelligence testing on a separate day were used to collect data. A history of cancer therapy threatening cognitive function (defined as >=18 gy of radiotherapy, intrathecal or high-dose systemic methotrexate, or both) was a marginally significant predictor of poorer-quality decision making in the first regression model. Poorer-quality decision making was a significant predictor of one or more risk behaviors in the second model. Younger age at initial treatment and lower cognitive ability (full-scale IQ) were not significant predictors for either of the models. There were no significant differences for the Wechsler IQ subtests related to abstract and analytic ability by cognitive threat status. Post hoc analysis indicated that lack of sensitivity to change of the Wechsler IQ measure may have affected outcomes. Abstract and/or analytic ability may be important links for decision making and risk behaviors of teen survivors, thus warranting further examination within a larger sample. Intervention to improve decision making needs to be provided for teen survivors; this may be true especially when there is a history of therapy threatening cognitive function.