Prevalence

The occurrence of PTSD was assessed in 19 studies and ranged from 0%31 to 34.8%.36 This prevalence range was narrowed to 0.77%–20.5% when three studies that used DSM-III criteria31,32,36 and three studies that measured the occurrence of “likely” PTSD, as determined by clinically significant PTSS scores and/or which did not include functional impairment, were excluded.21,24,35


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Further excluding one study in which no survivors reported cancer-related traumatic events,17 the prevalence ranged from 8%20 to 20.5%.23

The prevalence of PTSS was assessed in 18 studies. Two studies reported the prevalence of intrusion and avoidance symptoms among young adult cancer survivors, as measured by the IES; clinically significant avoidance symptoms ranged from 6%–16.7%, while clinically significant intrusion symptoms ranged from 4.4%–9%.23,26

Five studies reported the prevalence of the three PTSS clusters identified in the DSM-IV using the PTSD-RI, PTSDI, and PCL-C: 40%24 to 75.3%26 of young adults, 23.638 to 73.3%20 of adolescents, and 50% of children and adolescents reported re-experiencing symptoms; 14.7%33 to 25.8%26 of young adults, 14.3%38 to 16.1%20 of adolescents, and 16.7%20 of children and adolescents experienced avoidance symptoms; and 31%33 to 55.5%24 of young adults, 20%38 to 41.3%20 of adolescents, and 28.8%20 of children and adolescents reported experiencing arousal symptoms.

Moderate to severe PTSS scores were reported in 7.7%23 to 36%31 of AYA survivors when using the PTSD-RI and 39%–44%35 (depending on the time at assessment) of AYA survivors when using the PSD. PTSS that amounted to “partial PTSD” (eg, endorsing at least one, but not all, PTSD symptom clusters) were observed in 4.8%28 to 35.2%29 of participants when the symptom threshold was two, and 7%17 to 78%32 when the symptom threshold was one.

Clinically significant PTSS scores on the PTSDI, PCL-C, and PDS (ie, exceeding clinical cutoff scores and/or meeting all three symptom cluster criteria without functional impairment) ranged from 4.1%21 to 13.3%27 among survivors of all ages, and they ranged from 7.5%28 to 13.3%27 among AYA survivors. Two studies reported no significant difference between AYA cancer survivors and comparison group levels of PTSS.21,34