Educational trajectories after childhood cancer: When illness experience matters

Abstract

With the increase in survival from childhood cancer, research has increasingly focused on the educational and professional achievements of childhood cancer survivors. Yet, if large-scale studies provide an acute description of the current situation of childhood cancer survivors, little is known about their trajectories and the social processes shaping these trajectories. Using a qualitative methodology, drawing from a life course perspective, this study sought to describe the role of childhood cancer and its side effects in educational trajectories, as perceived by the participants. We investigated related processes of social adjustment to cancer, that is to say, choices or decisions that survivors related to the illness in the making of their career plans. Eighty long-term French childhood cancer survivors participating in the Euro2K longitudinal study were interviewed through in-depth, face-to-face interviews undertaken in 2011-2012. There were various types of impact described by respondents of the diagnosis of cancer on their trajectories. These varied according to gender. In women, childhood cancer tended to result in poor educational achievement, or in steering the individual towards a health care or child care occupation. This was justified by a desire to return the support that had been offered to them as patients. In men, however, childhood cancer led to a shift in career plans, because of physical sequelae, or because of concerns about their future health. Paradoxically, this limitation had a positive impact in their occupational achievement, as most of these men disregarded blue-collar jobs and chose more qualified white-collar occupations. Overall, findings suggest that childhood cancer influenced educational trajectories and, thus, socioeconomic status in adulthood, through mechanisms embedded in gender norms. These mechanisms could explain gender inequalities in educational achievement after childhood cancer reported in large-scale cohort studies.

Educational and occupational outcomes of childhood cancer survivors 30 years after diagnosis: a French cohort study

“…Different mechanisms between men and women in the selection of a career could partly explain this finding, as suggested by a qualitative study based on 80 interviews with childhood cancer survivors randomly selected from the French cohort. In this study, 16% of male survivors said they had disregarded a typically blue-collar career choice during adolescence or young adulthood and had chosen an educational path leading to white-collar occupations, because of physical sequelae, or because of concerns about their future health, as compared with 5% of females ( Dumas et al , 2015 ).…”

Early Education and Employment Outcomes After Cancer in Adolescents and Young Adults

“…For example, in a qualitative French study, young female cancer survivors had lower educational attainment than expected but often chose occupations in child care or healthcare, which fulfilled their desire to reciprocate the care they had received. 35 Future longitudinal studies should aim to acquire more holistic understanding of the issues influencing educational and vocational pathways, the transition from education to employment after cancer during the AYA years, and effective interventions that facilitate the return to school and work after cancer treatment.…”

Prospective Validation of the Decalogue, a Set of Doctor-Patient Communication Recommendations to Improve Patient Illness Experience and Mood States within a Hospital Cardiologic Ambulatory Setting

“…It was also found that the effect on the patient illness experience was positively associated with female gender and negatively associated with age, socioeconomic status, and education level. The effects of age and gender differences on the trajectories of individual illness experiences have been widely recognized, with most analyses showing a greater reactivity of women and younger subjects [ 32 – 37 ]. Discrepancies in the illness experience related to socioeconomic, racial, and cultural factors were also reported in a number of pathophysiological conditions [ 38 – 43 ].…”