PURPOSE: Auditory complications are potential side effects from childhood cancer treatment. Yet, limited evidence exists about the impact of auditory complications-particularly tinnitus-on health-related quality of life (HRQoL) among childhood cancer survivors (CCS). We determined the prevalence of hearing loss and tinnitus in the European PanCareLIFE cohort of CCS and examined its effect on HRQoL. METHODS: We included CCS from four European countries who were diagnosed at age ≤ 18 years; survived ≥ 5 years; and aged 25-44 years at study. We assessed HRQoL (Short Form 36), hearing loss, and tinnitus using questionnaires. We used multivariable linear regression to examine associations between these two auditory complications and HRQoL adjusting for socio-demographic and clinical factors. RESULTS: Our study population consisted of 6,318 CCS (53% female; median age at cancer diagnosis 9 years interquartile range [IQR] 5-13 years) with median age at survey of 31 years (IQR 28-35 years). Prevalence was 7.5% (476/6,318; confidence interval [CI]: 6.9-8.2) for hearing loss and 7.6% (127/1,668; CI: 6.4-9.0) for tinnitus. CCS with hearing loss had impaired physical (coefficient [coef.] -4.3, CI: -7.0 to -1.6) and mental (coef. -3.2, CI: -5.5 to -0.8) HRQoL when compared with CCS with normal hearing. Tinnitus was associated with impaired physical (coef. -8.2, CI: -11.8 to -4.7) and mental (coef. -5.9, CI: -8.8 to -3.1) HRQoL. CONCLUSION: We observed reduced HRQoL among CCS with hearing loss and tinnitus. Our findings indicate timely treatment of hearing loss and tinnitus may contribute to quality of life of survivors. IMPLICATIONS FOR CANCER SURVIVORS: CCS who experience auditory complications should be counseled about possible therapeutic and supportive measures during follow-up care.

Bavarian Care and Nursing Authority Amberg Germany

Boyne Research Institute Drogheda Ireland

CANSEARCH Research Platform in Pediatric Oncology and Hematology Department of Pediatrics Gynecology and Obstetrics University of Geneva Geneva Switzerland

Department for Phoniatrics and Pedaudiology University Hospital Münster Westphalian Wilhems University Münster Germany

Department of BioMedical Research University of Bern Bern Switzerland

Department of Pediatric Endocrinology Diabetology and Metabolism Inselspital Bern University Children's Hospital University of Bern Bern Switzerland

Department of Pediatric Hematology and Oncology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Pediatric Hematology and Oncology University Hospital Bonn Bonn Germany

Department of Pediatric Hematology and Oncology University Hospital Saint Étienne France

Department of Pediatric Oncology and Hematology University Hospital for Children and Adolescents Lübeck Germany

Department of Pediatrics Inselspital Bern University Hospital University of Bern Bern Switzerland

Division of Childhood Cancer Epidemiology German Childhood Cancer Registry Institute of Medical Biostatistics Epidemiology and Informatics University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany

Division of Pediatric Hematology Oncology Department of Pediatrics Inselspital Bern University Hospital University of Bern Bern Switzerland

Graduate School for Health Sciences University of Bern Bern Switzerland

Institute of Social and Preventive Medicine University of Bern Mittelstrasse 43 3012 Bern Switzerland

Lyon University Jean Monnet University INSERM U 1059 Sainbiose Saint Étienne France

University Hospital Brno and International Clinical Research Center Masaryk University Brno Czech Republic

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