Psychosocial late effects of childhood cancer survivors in China: a scoping review

Survival outcomes for childhood cancer in China have improved significantly; nevertheless, long-term psychosocial consequences among childhood cancer survivors (CCSs) remain poorly delineated. A comprehensive synthesis is needed to guide survivorship practice and policy. This scoping review synthesized evidence on psychosocial late outcomes among CCSs in China, outlining outcome domains, study features, geographic distribution, and methodological gaps. Chinese and English databases were searched for studies published between 2015 and October 2025 using terms related to childhood cancer and psychosocial outcomes. Two reviewers independently conducted title/abstract and full-text screening, with disagreements resolved by a third reviewer. Studies involving survivors diagnosed before age 18 were included. Data were extracted using a predefined framework covering study design, population characteristics, cancer type, treatment, and psychosocial outcomes. Thirty-six studies met the inclusion criteria. Most were cross-sectional and geographically concentrated in more developed regions, with small samples and short follow-up periods. Psychological outcomes were most frequently reported, particularly anxiety and depression, followed by cognitive difficulties involving attention, memory, and executive functioning. Across six domains identified in the review—cognitive outcomes, psychological outcomes, social adaptation, post-traumatic stress symptoms, resilience, and fear of cancer recurrence substantial psychosocial challenges were reported. Leukemia was the most frequently studied diagnosis, with chemotherapy the most commonly reported treatment. The evidence was limited by short follow-up, small sample sizes, restricted representation of cancer diagnoses, and underrepresentation of rural populations. CCS in China experience psychosocial challenges extending beyond active treatment across six domains: cognitive outcomes, psychological outcomes, social adaptation, post-traumatic stress symptoms, resilience, and fear of cancer recurrence. These experiences may be influenced by contextual factors, including educational demands, sociocultural expectations, and regional disparities, and should be considered within the broader context of survivors’ developmental stages. However, younger children remain underrepresented in the existing evidence, and the limited availability of age-stratified analyses constrains the ability to draw definitive conclusions regarding developmental variations in psychosocial outcomes. Future research should prioritize longitudinal, multicenter studies incorporating standardized and developmentally appropriate assessment tools, prespecified age-stratified analyses, and broader geographic representation. Such efforts should be complemented by comprehensive, survivor-centered psychosocial care tailored to the evolving developmental and psychosocial needs of CCSs. Novelty and Impact:sfsd First scoping review of psychosocial late effects among Chinese CCSs Anxiety, depression, and cognitive impairment are most frequently reported Evidence is largely cross-sectional and geographically concentrated in developed regions Findings support integrating psychosocial care in pediatric oncology