Surviving childhood cancer: a systematic review of studies on risk and determinants of adverse socioeconomic outcomes

Abstract

Substantial improvements in childhood cancer survival have resulted in a steadily increasing population of childhood cancer survivors. Whereas somatic late effects have been assessed in many studies, less is known about the impact of childhood cancer on socioeconomic outcomes in survivors. The aim of this article was to evaluate and summarise the evidence on the socioeconomic conditions of childhood cancer survivors and to identify survivors at particular risk of adverse socioeconomic outcomes. An extensive literature search of three electronic databases was conducted. Of 419 articles identified, 52 met the inclusion criteria. All the selected articles were appraised for quality, and findings were summarised in a narrative synthesis. Childhood cancer survivors were at higher risk of adverse socioeconomic outcomes with regard to educational achievement, income and social security benefits than the general population or a sibling comparison group. The risks for unemployment and a lower occupational position were significantly increased only for survivors of a central nervous system tumour. Notably, survivors of central nervous system tumours, survivors treated with cranial radiotherapy and those diagnosed at younger age independent of cancer type were determinants of particular adverse socioeconomic outcomes. Given the increasing population of childhood cancer survivors, targeted follow-up interventions and support strategies addressing not only the somatic and psychiatric late effects but also the socioeconomic difficulties that some childhood cancer survivors face is of high importance to reduce social inequity, and ensure a high quality of life after childhood cancer.

The impact of childhood cancer on parents' socio‐economic situation—A systematic review

“…This may have resulted in biased responses caused by social desirability with parents tending to present a more favourable image . Finally, the explanatory power of the NOS for appraising study quality is limited as sample size is not considered . This aspect is critical to identify characteristics associated with parents' socio‐economic situation as smaller studies may be underpowered.…”

“…and F.E.) using the Newcastle‐Ottawa Quality Assessment Scale (NOS) as recently used in a review addressing childhood cancer survivors (Table S1). NOS evaluates the quality of nonrandomised studies with a star rating system (maximum nine stars) based on three criteria: selection (four items, max.…”

Trends of National and Subnational Incidence of Childhood Cancer Groups in Iran: 1990–2016

“…Moreover, since children are dependent on their adult caregivers, many symptoms may be mistaken or neglected that could result in delayed referral for diagnosis and treatment abandonment (1,(3)(4)(5). Finally, survivors of childhood cancers are predisposed to future socioeconomic difficulties, which are concerning the public health gravely (6,7).…”

Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population

“…[ 4 12 ] Even many years after diagnosis, survivors remain at high risk for relapse and second malignancies 13 as well as treatment-related late effects, including psychosocial difficulties. [ 2 14 15 ] Those complications and uncertainties may continue to burden parents socially, financially, and mentally. [ 16 17 ] Little is known on parents’ stress symptoms many years after their child's diagnosis and treatment when survivors are grown up.…”