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Long-term outcomes of childhood cancer survivors in Sweden: a population-based study of education, employment, and income
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
2010 (English)In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 116, no 5, 1385-1391 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Studies of different national populations were indispensable for estimating the impact of illness-related disability on social outcomes in adult childhood cancer survivors. The effects of childhood cancer on educational attainment, employment, and income in adulthood in a Swedish setting were studied. METHODS: The study population was a national cohort of 1.46 million Swedish residents, including 1716 survivors of childhood cancer diagnosed before their 16th birthday, followed up in 2002 in registries at >25 years of age. Main outcomes were educational attainment, employment, and net income. Markers of persistent disability were considered, and outcomes were analyzed with multivariate linear and logistic regression models adjusted for age, sex, and socioeconomic indicators of the childhood households. RESULTS: Non-central nervous system (CNS) cancer survivors had similar education, employment, and income as the general population in adjusted models, whereas survivors of CNS tumors more often had no more than basic (< or =9 years) education (relative risk [RR], 1.80 [95% confidence interval (95% CI), 1.45-2.23]), less often attained education beyond secondary school (RR, 0.69 [95% CI, 0.58-0.81]), and less often were employed (RR, 0.85 [95% CI, 0.77-0.94]). Predicted net income from work was lower in CNS tumor survivors (P <.001) than in the general population, even after the exclusion of individuals who received economic disability compensation. CONCLUSIONS : CNS tumor survivors had poorer social outcomes compared with the general population, whereas outcomes for survivors of other childhood cancers were similar to the general population. Established late effects highlighted the importance of improved, safer pediatric CNS tumor treatment protocols and surveillance that identified individual needs for preventive and remedial measures.

Place, publisher, year, edition, pages
2010. Vol. 116, no 5, 1385-1391 p.
Keyword [en]
childhood cancer, central nervous system tumors, adult survivors, long-term outcomes, socioeconomic outcomes, social adjustment, disability, cohort studies, registers
National Category
Cancer and Oncology Social Sciences
URN: urn:nbn:se:uu:diva-122350DOI: 10.1002/cncr.24840ISI: 000274772300030PubMedID: 20087961OAI: oai:DiVA.org:uu-122350DiVA: diva2:309793
Available from: 2010-04-08 Created: 2010-04-08 Last updated: 2010-12-21Bibliographically approved

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Lindblad, FrankHjern, Anders
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Child and Adolescent PsychiatryDepartment of Women's and Children's Health
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