Adult Siblings of Childhood Cancer Survivors Are Heavy Drinkers: Which Siblings are at Risk? A Report from the Childhood Cancer Survivor Study

Objective: Little is known about alcohol consumption among siblings of childhood cancer survivors, though recent research has documented considerable distress among this under-researched population. This study describes alcohol consumption patterns among the siblings of long-term survivors of pediatric cancer compared to survivors and healthy peers and evaluates demographic, mental health and severity of the cancer experience to explain associated risks for heavy drinking among siblings. Methods: Data were collected from 3,034 adult siblings of pediatric cancer survivors, 10,398 survivors, and 5,712 controls from a national survey. National data were weighted to reflect the distribution of siblings by gender, age and ethnicity to increase comparability of the samples. Results: Controlling for demographic variables, compared to healthy peers, siblings were more likely to be current drinkers (ORadj=2.0; 95% CI 1.7-2.3), risky drinkers (ORadj=1.3; 1.1-1.6), and heavy drinkers (ORadj=1.3; 1.0-1.6). Compared to survivors, siblings were again more likely to be current drinkers (OR=1.7), risky drinkers (OR=1.5) and heavy drinkers (OR=1.5;1.3-1.8). Factors associated with heavy sibling drinking include younger age, being male, lower education, and drinking initiation at a young age. Depression and general psychological distress were associated with heavy sibling drinking. Conclusions: Adult siblings of childhood cancer exhibit higher rates of current, risky and heavy alcohol consumption compared to both peers and survivors. Screening for alcohol consumption should be instituted for siblings as well as for survivors. Cancer related stresses from the survivor's diagnosis and treatment do not explain the heavier drinking. Family factors should be explored in future studies.