Educational and occupational outcomes of childhood cancer survivors 30 ă years after diagnosis: a French cohort study
Résumé
Background: Although survival from childhood cancer has increased, ă little is known on the long-term impact of treatment late effects on ă occupational attainment or work ability. ă Methods: A total of 3512 five-year survivors treated before the age of ă 19 years in 10 French cancer centres between 1948 and 2000 were ă identified. Educational level, employment status and occupational class ă of survivors were assessed by a self-reported questionnaire. These ă outcome measures were compared with sex-age rates recorded in the French ă population, using indirect standardisation. Paternal occupational class ă was also considered to control for the role of survivors' socioeconomic ă background on their achievement. Multivariable analyses were conducted ă to explore clinical characteristics associated with the outcomes. ă Results: A total of 2406 survivors responded to the questionnaire and ă survivors aged below 25 years were included in the current analysis. ă Compared with national statistics adjusted on age and sex, male ă survivors were more likely to be college graduates (39.2% vs 30.9% ă expected; P<0.001). This higher achievement was not observed either for ă leukaemia or central nervous system (CNS) tumour survivors. ă Health-related unemployment was higher for survivors of CNS tumour ă (28.1% vs 4.3%; P<0.001) but not for survivors of other diagnoses. ă Survivors of non-CNS childhood cancer had a similar or a higher ă occupational class than expected. ă Conclusions: Survivors treated for CNS tumour or leukaemia, especially ă when treatment included cranial irradiation, might need support ă throughout their lifespan.