Surviving a childhood cancer: impact on education and employment

Abstract

Long-term consequences of childhood cancer encompass adverse psychosocial effects that may severely limit the opportunity to live a satisfying and productive life. We assessed the social integration of adults cured of a cancer in their first 14 years of life by record linkage between the population-based Childhood Cancer Registry of Piedmont and the Turin Longitudinal Study. We compared education and employment outcomes within the cohort of survivors and between the cohort of survivors and their peers in the general population through logistic regression. Individuals cured of a childhood tumour have a higher risk of not obtaining educational qualifications [odds ratio (OR) 0.67 (95% confidence interval 0.40-1.11) for compulsory school, OR 0.81 (0.61-1.07) for higher education] or employment, OR 0.66 (0.45-0.98), than the general population. This problem is particularly severe for individuals cured of a central nervous system neoplasm: OR 0.56 (0.31-1.01) for higher education and OR 0.28 (0.13-0.58) for employment. Within-cohort comparisons show that men are less likely to obtain educational goals than women, OR 0.72 (0.40-1.29), but more likely to be employed, OR 2.18 (0.90-5.28); parental education (university qualifications) is positively associated with the success of the child's education, OR 9.54 (2.60-35.02), but not with their employment status, OR 1.02 (0.21-4.85). Strategies should be put in place to mitigate the risk of adverse psychosocial effects from the beginning of treatment to cure and beyond to offer those suffering a cancer at a young age the possibility of full integration into society.

Educational Attainment and Employment Outcome of Survivors of Pediatric CNS Tumors in Switzerland—A Report from the Swiss Childhood Cancer Survivor Study

“…Results from the CCSS support this finding, where CCS treated with cranial radiotherapy, intrathecal methotrexate or a combination did significantly more often not complete high school or college compared to siblings [3]. Our results underline the positive effect of parental education on CCS' educational attainments, similar to other studies [6,17]. More CCS diagnosed with a CNS tumor needed special schooling compared to survivors with and without CNS-directed treatment.…”

A systematic review of the educational experiences and needs of children with cancer returning to school

“…Therefore, these challenges caused children to experience academic struggles throughout their school-life and interfered, and arguably in many cases, with the realization of their educational rights (United Nations General Assembly, 1990). These challenges could also have a negative impact on the long-term quality of life, learning and employment opportunities, as highlighted in recent studies (Brauer et al, 2017;Dumas et al, 2016;Maule et al, 2017).…”

“…Currently, although the aetiology considerably differs between several regions, leukaemia, lymphomas and tumours of the central nervous system (CNS) are the most common childhood cancers (Steliarova-Foucher et al, 2017). Technological and medical advances in diagnostic and therapeutic strategies have improved life expectancy and the wellbeing of childhood cancer survivors (Maule et al, 2017). Consequently, childhood cancer is now considered a chronic condition (National Cancer Institute, 2020a; Smith et al, 2019) and survivorship begins at diagnosis and continues beyond (National Cancer Institute, 2020b).…”

Age‐stratified distress thermometers with Worry and Learning problem domains for the paediatric oncology population: Development and validation

“…7 Without timely intervention, psychosocial problems can directly impact longer-term quality of life (QOL). 5,[7][8][9] Over 40% of childhood cancer survivors also experience significant neuro-cognitive late effects, 10 typically brain tumour and acute lymphoblastic leukaemia populations. 11,12 Significant problems, slower rates of learning, emotional regulation difficulties and deficits in attention and memory.…”

“…This population has a greater tendency to have low self‐confidence, self‐esteem problems and anger difficulties 7 . Without timely intervention, psychosocial problems can directly impact longer‐term quality of life (QOL) 5,7–9 …”