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Güney Yılmaz G, Tanrıverdi M, Şahin S, Çakır FB. Cross-cultural adaptation, reliability, and validity of the Turkish Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQL TM-CFS) in children with cancer. Child Neuropsychol 2024:1-15. [PMID: 38832834 DOI: 10.1080/09297049.2024.2364205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
The Pediatric Quality of Life Inventory-Cognitive Functioning Scale (PedsQLTM-CFS) was developed as a brief, general, symptom-specific tool to measure cognitive function. The 6-item PedsQL™ Cognitive Functioning Scale and PedsQL 3.0 Cancer Module answered 369 parents and 330 children with 5-18 years. Parents also completed Behavior Rating Inventory of Executive Function (BRIEF). The PedsQL™ Cognitive Functioning Scale evidenced excellent reliability (parent proxy-report α = 0.980/Fleiss Kappa: 0.794; children self-report α = 0.963/Fleiss Kappa: 0.790). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with all parent-report BRIEF summary and subscale scores (p < .05). Both child self-report and parent proxy-report PedsQL™ Cognitive Functioning Scale scores exhibited significant correlations with PedsQL 3.0 Cancer Module total score and subscale scores (p < .05). The PedsQLTM-CFS can be used in high-risk populations with substantial to perfect reliability, both in regards to total/subcategory scores as well as in children with cancer.
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Affiliation(s)
- Güleser Güney Yılmaz
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Türkiye
| | - Müberra Tanrıverdi
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bezmialem Vakıf University, İstanbul, Türkiye
| | - Sedef Şahin
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Türkiye
| | - Fatma Betül Çakır
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Bezmialem Vakıf University, İstanbul, Türkiye
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2
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Önal G, Davutoğlu C, Şahin S. Investigation of cognitive functions in children with bone tumours and lymphoma in treatment process. Child Care Health Dev 2024; 50:e13139. [PMID: 37269221 DOI: 10.1111/cch.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/17/2023] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Neurocognitive sequelae are among the most debilitating effects of cancer observed in children. Yet we know very little about the impact on neurocognitive functioning, especially cancer types that develop outside the central nervous system. This study aimed to assess and compare the cognitive functions (CoF) of children with bone tumours and lymphoma in the treatment process. METHODS The CoF of children with bone tumours (n = 44), lymphoma (n = 42) and their non-cancer peers (n = 55) were assessed with Dynamic Occupational Therapy Assessment for Children. The CoF of children with cancer were compared with their non-cancer peers. Then, children with bone tumours and lymphoma were compared in binary. RESULTS One-hundred forty-one children aged 6-12 years with a mean age of 9.4 (SD = 1.5) were included in this study. The orientation and visuomotor construction functions of children with bone tumours and orientation, praxis and visuomotor construction functions of children with lymphoma performed worse than their non-cancer peers (pk < 0.001). While orientation, spatial perception, visuomotor construction and thinking operations functions of children with bone tumours and lymphoma were similar (pk > 0.016), praxis functions of children with lymphoma were found to be worse than children with bone tumours (pk < 0.016). CONCLUSIONS Our findings show that children with bone tumours and lymphoma in the process of treatment are at risk for impairment of their CoF. The findings highlight the importance of assessing CoF in children with bone tumours and lymphoma and considering specific differences between groups. It is essential to assess CoF and develop early intervention plans in these children.
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Affiliation(s)
- Gözde Önal
- Faculty of Health Sciences, Department of Occupational Therapy, Ankara Medipol University, Ankara, Turkey
| | - Ceren Davutoğlu
- Faculty of Health Science, Department of Occupational Therapy, Erzurum Technical University, Erzurum, Turkey
| | - Sedef Şahin
- Faculty of Health Sciences, Department of Occupational Therapy, Hacettepe University, Ankara, Turkey
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3
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Childhood lymphoma treatment impacts educational outcomes: a registry study from Sweden. J Cancer Surviv 2022:10.1007/s11764-022-01266-0. [DOI: 10.1007/s11764-022-01266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
Abstract
Purpose
This study aimed to explore educational outcomes in individuals diagnosed with lymphoma in childhood concerning school grade year 9 and attendance in high school and post-compulsory education. Whether sex or age at diagnosis affected the assessed variables was also explored.
Methods
Data from 174 children born 1988–1996 and diagnosed with lymphoma before age 15 were matched with approximately five controls per patient. The mean time since diagnosis to receiving school year 9 grades was 4.88 years for Hodgkin lymphoma (HL) cases (mean age at diagnosis 10.62, 11.76, and 10.05 years for all, girls, and boys, respectively) and 7.79 years for non-Hodgkin lymphoma (NHL) cases (mean age at diagnosis 7.85, 7.87, and 7.84 years for all, girls, and boys, respectively).
Results
We observed statistically significant differences between cases and controls in physical education, both for failing (p = 0.041) and the highest grade (p = 0.015). Compared with controls, HL cases were three times more likely to fail mathematics, and significantly fewer individuals in the whole lymphoma (p = 0.011) and NHL (p = 0.035) groups attended the third year of high school.
Conclusions
Educational outcomes are impacted for children treated for lymphoma, especially in physical education. Since patients with HL are treated without central nervous system-directed therapy, other factors, such as absence from school, may affect school results. Physical late complications in lymphoma survivors warrant special attention.
Implications for Cancer Survivors
The problems childhood lymphoma survivors face should be known by schools and parents, to enable their management. Children treated for lymphoma should be closely monitored and included in follow-up programs when needed, for example, to support physical activity.
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4
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Foster R, Zheng DJ, Netson-Amore KL, Kadan-Lottick NS. Cognitive Impairment in Survivors of Pediatric Extracranial Solid Tumors and Lymphomas. J Clin Oncol 2021; 39:1727-1740. [PMID: 33886354 DOI: 10.1200/jco.20.02358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rebecca Foster
- St Louis Children's Hospital, St Louis, MO.,Washington University, St Louis, MO
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5
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Foster RH, Hayashi RJ, Wang M, Liu W, Mohrmann C, Howell RM, Smith SA, Gibson TM, Srivastava D, Green DM, Oeffinger KC, Leisenring WM, Robison LL, Armstrong GT, Krull KR, Hardy KK. Psychological, educational, and social late effects in adolescent survivors of Wilms tumor: A report from the Childhood Cancer Survivor Study. Psychooncology 2020; 30:349-360. [PMID: 33113206 DOI: 10.1002/pon.5584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/31/2020] [Accepted: 10/13/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To delineate the impact of treatment exposures and chronic health conditions on psychological, educational, and social outcomes in adolescent survivors of Wilms tumor. METHODS Parent reports from the Childhood Cancer Survivor Study were analyzed for 666 adolescent survivors of Wilms tumor and 698 adolescent siblings. Adjusting for race and household income, survivors were compared to siblings on the Behavior Problems Index and educational outcomes. Multivariable modified Poisson regression estimated relative risks (RR) for therapeutic exposures and chronic health conditions (CTCAE 4.03 graded) among survivors, adjusting for sex, race, income, and age at diagnosis. RESULTS Compared to siblings, adolescent survivors of Wilms tumor were more likely to take psychoactive medication (9.4% vs. 5.1%, p < 0.001) and utilize special education services (25.5% vs. 12.6%, p < 0.001) but did not differ significantly in emotional and behavioral problems. Survivors were less likely to be friendless (7.2% vs. 10.1%, p = 0.04) but were more likely to have difficulty getting along with friends (14.5% vs. 7.8%, p < 0.001). Among survivors, use of special education services was associated with abdomen plus chest radiation (RR = 1.98, CI:1.18-3.34). Those with grade 2-4 cardiovascular conditions had higher risk for anxiety/depression (RR = 1.95, CI:1.19-3.19), headstrong behaviors (RR = 1.91, CI:1.26-2.89), and inattention (RR = 1.56, CI:1.02-2.40). CONCLUSIONS Adolescent survivors of Wilms tumor were similar to siblings with respect to mental health concerns overall but were more likely to require special education. Monitoring of psychosocial and academic problems through adolescence is warranted, especially among those treated with radiation to the abdomen plus chest or with cardiac conditions.
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Affiliation(s)
- Rebecca H Foster
- Department of Psychology, St. Louis Children's Hospital, St Louis, Missouri, USA.,Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Robert J Hayashi
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Mingjuan Wang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Wei Liu
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Caroline Mohrmann
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Rebecca M Howell
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan A Smith
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - DeoKumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Daniel M Green
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Kevin C Oeffinger
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Kristina K Hardy
- Neuropsychology Division, Children's National Health System, Washington, District of Columbia, USA.,Departments of Psychiatry & Behavioral Sciences and Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA
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6
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Tonning Olsson I, Brinkman TM, Hyun G, Banerjee P, Mulrooney DA, Huang IC, Green DM, Srivastava D, Robison LL, Hudson MM, Krull KR. Neurocognitive outcomes in long-term survivors of Wilms tumor: a report from the St. Jude Lifetime Cohort. J Cancer Surviv 2019; 13:570-579. [PMID: 31243647 DOI: 10.1007/s11764-019-00776-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/12/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE To examine prevalence and predictors of neurocognitive outcomes, social attainment, emotional distress, and health-related quality of life (HRQOL) in long-term survivors of pediatric Wilms tumor (WT). METHODS One hundred fifty-eight WT survivors (59% female; mean [SD] age 33 [9.1] years; time since diagnosis 29 [9.1] years) and 354 community controls (55.6% female; 35 [10.2] years) completed comprehensive neuropsychological testing and physical examination, including echocardiography/electrocardiography, pulmonary function tests, and endocrine evaluation. Self-report of emotional distress, HRQOL, and social attainment were collected. Impairment was defined in relation to both controls and normative data. Generalized linear models were developed to examine impact of treatment and chronic health conditions on outcomes. RESULTS WT survivors performed poorer than norms and controls in 6 of 16 cognitive variables and 1 of 8 HRQOL variables, with scores ranging from - 0.64 (mathematics) to - 0.21 (verbal fluency) standard deviations below expectations. Compared to controls, WT survivors were less likely to graduate college (odds ratio 2.23, 95% confidence interval 1.46-3.41) and had more moderate to severe neurologic conditions (18.4% vs 8.2%, p < 0.001), which were associated with poor memory (β = - 0.90, p < 0.001), attention (β = - 1.02, p < 0.001), and HRQOL general health (β = - 0.80, p = 0.0015). Treatment variables and cardiopulmonary morbidity (higher in survivors) were not associated with outcomes. CONCLUSIONS Survivors of WT demonstrate impairment in neurocognitive function and have lower social attainment during adulthood, with poorer neurocognitive function associated with neurologic morbidity. IMPLICATIONS FOR CANCER SURVIVORS Survivors of WT should be offered neurocognitive evaluations and rehabilitation. Neurologic conditions should be routinely assessed, and appropriate support offered to reduce risk for functional limitations.
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Affiliation(s)
- Ingrid Tonning Olsson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA.,Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Geehong Hyun
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
| | - Pia Banerjee
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
| | - Daniel A Mulrooney
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA.,Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
| | - Daniel M Green
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA.,Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA.,Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN, 38105-3678, USA. .,Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
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7
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Frederiksen LE, Mader L, Feychting M, Mogensen H, Madanat-Harjuoja L, Malila N, Tolkkinen A, Hasle H, Winther JF, Erdmann F. Surviving childhood cancer: a systematic review of studies on risk and determinants of adverse socioeconomic outcomes. Int J Cancer 2018; 144:1796-1823. [PMID: 30098012 DOI: 10.1002/ijc.31789] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/20/2018] [Accepted: 07/27/2018] [Indexed: 01/03/2023]
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.
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Affiliation(s)
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laura Madanat-Harjuoja
- Finnish Cancer Registry, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Anniina Tolkkinen
- Finnish Cancer Registry, Helsinki, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
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8
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Kosola S, McCarthy MC, McNeil R, Orme LM, Drew S, Sawyer SM. Early Education and Employment Outcomes After Cancer in Adolescents and Young Adults. J Adolesc Young Adult Oncol 2018; 7:238-244. [DOI: 10.1089/jayao.2017.0045] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Silja Kosola
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Maria C. McCarthy
- Murdoch Children's Research Institute, Melbourne, Australia
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | - Robyn McNeil
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Lisa M. Orme
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
- ONTrac at Peter Mac Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sarah Drew
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Susan M. Sawyer
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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9
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Andersen KK, Duun-Henriksen AK, Frederiksen MH, Winther JF. Ninth grade school performance in Danish childhood cancer survivors. Br J Cancer 2017; 116:398-404. [PMID: 28081550 PMCID: PMC5294489 DOI: 10.1038/bjc.2016.438] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/05/2016] [Accepted: 12/08/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Childhood cancer survivors can experience learning problems resulting in lower-than-expected attained education as adults. It is unclear whether learning problems manifest already during adolescence. Methods: We analysed nationwide Danish registries on school grades for Danish children during 2001–2014. Applying a matched design we compared grades of childhood cancer survivors to children without cancer at ninth grade. We estimated grade differences by subject and its correlation to cancer site and age at diagnosis. The available statistical precision allowed for an analysis of more rare cancer sites. Results: The total study population was 793 332 children (mean age 15.24 years and 49.7% girls), of whom 1320 were childhood cancer survivors. Lower rank grades were seen in children with cancer in all school subjects but differed substantially according to cancer site. Most affected were survivors of central nervous system (CNS) tumours, neuroblastoma, lymphoma, leukaemia, other malignant neoplasm and germ-cell tumours. Survivors from other cancer types did not obtain lower grades. Lower rank grades were associated with young age at diagnosis. Conclusions: The effect of childhood cancer differed substantially between cancer sites. The largest effect was among survivors of CNS tumours and leukaemia diagnosed at a young age, suggesting an association with radiation therapy. However, the majority of cancer survivors fare well. Increasing awareness on children affected by cancer and special accommodations may help maximise the learning potential of those most affected.
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Affiliation(s)
- Klaus Kaae Andersen
- Unit of Statistics, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | | | - Marie Hoffmann Frederiksen
- Unit of Statistics, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - Jeanette Falck Winther
- Unit of Cancer Survivorship, Childhood Cancer Survivorship Research Group, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
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10
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Ahomäki R, Harila-Saari A, Matomäki J, Lähteenmäki PM. Non-graduation after comprehensive school, and early retirement but not unemployment are prominent in childhood cancer survivors-a Finnish registry-based study. J Cancer Surviv 2016; 11:284-294. [PMID: 27714627 DOI: 10.1007/s11764-016-0574-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND In order to assess neurocognitive and social outcomes after childhood cancer, we explored the educational and vocational attainments of Finnish survivors in comparison to matched population controls. METHODS From national registries, we identified survivors (n = 3243) born from 1960 to 1992 and aged below 16 at cancer diagnosis (years 1964-2009) as well as their controls (n = 16,215). Data on educational achievements, yearly income, employment status, and retirement were retrieved from Statistics Finland. RESULTS The median (range) age at study was 28 (17-50) years. The proportion of those with no education after comprehensive school was higher than controls for all the diagnostic groups: brain tumor (BT) (33.5 vs 23.0 %), solid tumor (ST) (25.0 vs 21.4 %), and leukemia/NHL (29.2 vs 23.1 %). Odds ratios (OR) for unemployment were not significantly elevated in any survivor group compared to controls, but OR for being retired was elevated in each survivor group (BT 14.8, ST 2.2, leukemia/NHL 4.0). Irradiation significantly increased that OR only in BT survivors. Leukemia/NHL survivors treated after 1992 had lower risk for early retirement (OR 0.6) compared to those diagnosed earlier. CONCLUSIONS Survivors had higher frequencies than controls for lacking further education after comprehensive school. Unemployment was not common, but risk for early retirement was significantly increased in each three survivor group. IMPLICATIONS FOR CANCER SURVIVORS Reassuring is that premature retirement was less common during the most recent treatment era. Screening and follow-up of psychosocial performance more effectively might be essential, and there is a need for studies on possibility for effective rehabilitation of the survivors.
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Affiliation(s)
- Ritva Ahomäki
- Department of Pediatrics and Adolescence, Turku University Hospital, Tuijulankatu 24, 20540, Turku, Finland.
| | - Arja Harila-Saari
- Childhood Cancer Research Unit, Stockholm, Sweden.,Department of Pediatrics and Adolescence, Oulu University Hospital, Astrid Lindgren Children's Hospital, Turku, Finland
| | - Jaakko Matomäki
- The University of Turku, Turun Yliopisto, 20014, Turku, Finland
| | - Päivi M Lähteenmäki
- Department of Pediatrics and Adolescence, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
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11
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Educational attainment among long-term survivors of cancer in childhood and adolescence: a Norwegian population-based cohort study. J Cancer Surviv 2015; 10:87-95. [PMID: 25929213 DOI: 10.1007/s11764-015-0453-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The number of young cancer survivors has increased over the past few decades due to improvement in treatment regimens, and understanding of long-term effects among the survivors has become even more important. Educational achievements and choice of educational fields were explored here. METHODS Five-year cancer survivors born in Norway during 1965-1985 (diagnosed <19 years) were included in our analysis by linking Norwegian population-based registries. Cox regression was applied to study the educational attainment among survivors of central nervous system (CNS) tumours, those assumed to have received CNS-directed therapy, and other cancer survivors relative to the cancer-free population. Logistic regression was used to compare the choice of educational fields between the cancer survivors at undergraduate and graduate level and the cancer-free population. RESULTS Overall, a lower proportion of the cancer survivors completed intermediate (67 vs. 70 %), undergraduate (31 vs. 35 %) and graduate education (7 vs. 9 %) compared with the cancer-free population. Deficits in completion of an educational level were mainly observed among survivors of CNS-tumours and those assumed to have received CNS-directed therapy. Choices of educational fields among cancer survivors were in general similar with the cancer-free population at both undergraduate and graduate levels. CONCLUSION Survivors of CNS-tumours and those assumed to have received CNS-directed therapy were at increased risk for educational impairments compared with the cancer-free population. Choices of educational fields were in general similar. IMPLICATIONS FOR CANCER SURVIVORS Careful follow-up of the survivors of CNS-tumours and those assumed to have received CNS-directed therapy is important at each level of education.
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12
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Bonneau J, Dugas K, Louis A, Morel L, Toughza J, Frappaz D. [Educational and social outcome after childhood cancer]. Bull Cancer 2015; 102:691-7. [PMID: 25917346 DOI: 10.1016/j.bulcan.2015.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
Abstract
The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents.
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Affiliation(s)
- Jacinthe Bonneau
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France.
| | - Karyn Dugas
- CHU de Pellegrin, maison Aquitaine ressources pour les adolescents et jeunes adultes (MARADJA), 33000 Bordeaux, France
| | - Aurélien Louis
- Centre hospitalier de Chalon-sur-Saône, unité de Pédiatrie, 71321 Chalon-sur-Saone, France
| | - Laëtitia Morel
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France
| | - Jihane Toughza
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
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Huo K, Sun Y, Li H, Du X, Wang X, Karlsson N, Zhu C, Blomgren K. Lithium reduced neural progenitor apoptosis in the hippocampus and ameliorated functional deficits after irradiation to the immature mouse brain. Mol Cell Neurosci 2012; 51:32-42. [DOI: 10.1016/j.mcn.2012.07.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 06/14/2012] [Accepted: 07/06/2012] [Indexed: 02/08/2023] Open
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Abstract
Childhood cancer is rare, with an incidence of 100 new cases per million children and with renal tumours contributing 7% of cases. The introduction of multimodality treatment, surgery, radiotherapy and chemotherapy, has led to an exponential increase in the 5-year survival rate to >80%. However, this successful treatment has led to the development of late adverse effects. These treatment-related effects can cause premature deaths and increased morbidity compared with patients' peers. Radiation causes damage to tissue and organs within the radiation field, affecting growth and function, and is largely responsible for the leading cause of death, namely, second malignant neoplasms. Another important late effect is cardiac dysfunction due to anthracycline use with or without cardiac radiation. In addition, a few patients have genetic abnormalities predisposing to Wilms tumour development, which result in renal dysfunction in the long term and may be exacerbated by cancer treatment regimens. Awareness of late consequences of cancer treatment is important, as early recognition can improve outcome. When presented with a patient with a history of renal tumours, it is vital to enquire about previous treatment to understand whether it is relevant to the presenting problem.
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Affiliation(s)
- Gill Levitt
- Department of Oncology/Haematology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
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15
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Dieluweit U, Debatin KM, Grabow D, Kaatsch P, Peter R, Seitz DCM, Goldbeck L. Educational and vocational achievement among long-term survivors of adolescent cancer in Germany. Pediatr Blood Cancer 2011; 56:432-8. [PMID: 21072822 DOI: 10.1002/pbc.22806] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adolescence involves graduating from school and preparing one's professional career. The accomplishment of these tasks may be hampered by the experience of cancer. This study investigates the educational and professional achievements of German long-term survivors of adolescent cancer. PROCEDURE Adult survivors of cancer during adolescence (n = 820, age at onset between 15 and 18 years; M = 15.8, SD = 0.9 years; age at follow-up: M = 30.4, SD = 6.0 years) were recruited through the German Childhood Cancer Registry. They completed self-reports with standard items on their educational and vocational level and their current occupational situation. Outcomes were compared to an age-matched sample from the general population (German Socio-Economic Panel, n = 820, age: M = 30.4, SD = 6.7). Risk factors for educational and vocational underachievement were identified by subgroup analyses. RESULTS Compared to peers from the general population, survivors of cancer during adolescence achieved higher educational and vocational levels. A higher proportion of survivors was employed; however, survivors were significantly older when starting their first occupation. Subgroup analyses revealed that neuropsychological late effects were associated with reduced rates of graduation from university and of employment among the survivors. No such effect of neuro-cognitive late effects occurred for high school graduation. CONCLUSIONS Most German survivors of cancer during adolescence participate in school and vocational life without major difficulties. Problems particularly arise for survivors with neuropsychological sequelae. Further research should investigate whether these results can be attributed to the German support system for pediatric cancer patients or to sample effects.
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Affiliation(s)
- Ute Dieluweit
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany.
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Bonneau J, Lebreton J, Taque S, Chappe C, Bayart S, Edan C, Gandemer V. School performance of childhood cancer survivors: mind the teenagers! J Pediatr 2011; 158:135-41. [PMID: 20813381 DOI: 10.1016/j.jpeds.2010.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 05/10/2010] [Accepted: 07/06/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess school performance in an unselected group of childhood cancer survivors and study risk factors for impairment. STUDY DESIGN Rates of repeating a grade were compared for patients with cancer, their siblings, and the general population. Phone questionnaires were administered to patients about the school career of their child in remission and their siblings. Responses about cancer survivors were compared with those concerning their siblings and various registries provided by the national board of education. The primary outcome was the rate of repeating a grade. RESULTS A total of 148 children in remission with a mean age of 15 ± 5.3 years and a mean follow-up period since diagnosis of 6.3 ± 1.3 years were included. More patients than siblings repeated a grade (33% versus 21%; P = .02), with a mean delay since diagnosis of 2 years. Risk factors were an older age at diagnosis, attending a secondary school, low education level of parents, bone marrow transplantation, cerebral surgery, and physical sequelae. In multivariate analysis, risk for repeating was associated with low educational level of the father, attending secondary school at diagnosis, and requiring school-organized educational support on return to school. CONCLUSION After cancer, repeating a grade is not an exceptional occurrence, especially for teenagers; follow-up and supportive interventions before returning to school would be beneficial.
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Affiliation(s)
- Jacinthe Bonneau
- Department of Pediatric Hematology, University Hospital, Rennes, France
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