1
|
Hernádfői MV, Koch DK, Kói T, Imrei M, Nagy R, Máté V, Garai R, Donnet J, Balogh J, Kovács GT, Párniczky A, Hegyi P, Garami M. Burden of Childhood Cancer and the Social and Economic Challenges in Adulthood: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024; 178:548-566. [PMID: 38619829 PMCID: PMC11019450 DOI: 10.1001/jamapediatrics.2024.0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/31/2024] [Indexed: 04/16/2024]
Abstract
Importance Significant advancements in pediatric oncology have led to a continuously growing population of survivors. Although extensive research is being conducted on the short-, medium-, and long-term somatic effects, reports on psychosocial reintegration are often conflicting; therefore, there is an urgent need to synthesize the evidence to obtain the clearest understanding and the most comprehensive answer. Objective To provide a comprehensive review and analysis of the socioeconomic attainment of childhood cancer survivors (CCSs) compared with their unaffected peers. Data Sources A systematic review and meta-analysis was conducted using data obtained from a comprehensive search of MEDLINE (via PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases on October 23, 2021; the search was updated until July 31, 2023. Study Selection Eligible articles reported on educational attainment, employment, family formation, quality of life (QoL), or health-risk behavior-related outcomes of CCSs, and compared them with their unaffected peers. Study selection was performed in duplicate by 4 blinded independent coauthors. Data Extraction and Synthesis Data extraction was performed in duplicate by 4 independent authors following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcome measures were odds ratios (ORs) and mean differences with 95% CIs; data were pooled using a random-effects model. Results The search identified 43 913 articles, 280 of which were eligible for analysis, reporting data on a total of 389 502 survivors. CCSs were less likely to complete higher levels of education (OR, 0.69; 95% CI, 0.40-1.18), had higher odds of health-related unemployment (OR, 2.94; 95% CI, 1.90-4.57), and showed lower rates of marriage (OR, 0.72; 95% CI, 0.63-0.84) and parenthood (OR, 0.60; 95% CI, 0.49-0.74) compared with population-based controls. Conclusion and Relevance Study findings suggest that CCSs face several socioeconomic difficulties; as a result, the next goal of pediatric oncology should be to minimize adverse effects, as well as to provide lifelong survivorship support aimed at maximizing social reintegration.
Collapse
Affiliation(s)
- Márk Viktor Hernádfői
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Bethesda Children’s Hospital, Budapest, Hungary
| | - Dóra Kornélia Koch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Mathematics, Department of Stochastics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Marcell Imrei
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Rita Nagy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Vanda Máté
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Réka Garai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Jessica Donnet
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - József Balogh
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | | | - Andrea Párniczky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Pediatric Center, Semmelweis University, Budapest, Hungary
| |
Collapse
|
2
|
Bejarano-Quisoboni D, Panjo H, Fresneau B, El-Fayech C, Doz F, Surun A, de Vathaire F, Pelletier-Fleury N. Excess healthcare expenditure in adults treated for solid cancer in childhood: a cohort study in France. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:513-523. [PMID: 37344685 DOI: 10.1007/s10198-023-01606-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Due to late effects, childhood cancer survivors (CCS) are more likely to have multiple chronic conditions than the general population. However, little is known about the economic burden of care of CCS in the long term. OBJECTIVES To estimate excess healthcare expenditure for long-term CCS in France compared to the general population and to investigate the associated factors. METHODS We included 5353 5-year solid CCS diagnosed before the age of 21 years before 2000 from the French CCS cohort and obtained a random reference sample from the general population for each CCS, matched on age, gender and region of residence. We used the French national health data system to estimate annual healthcare expenditure between 2011 and 2018 for CCS and the reference sample, and computed the excess as the net difference between CCS expenditure and the median expenditure of the reference sample. We used repeated-measures linear models to estimate associations between excess healthcare expenditure and CCS characteristics. RESULTS Annual mean (95% CI) excess healthcare expenditure was €3920 (3539; 4301), mainly for hospitalization (39.6%) and pharmacy expenses (17%). Higher excess was significantly associated with having been treated before the 1990s and having survived a central nervous system tumor, whereas lower excess was associated with CCS who had not received treatment with radiotherapy. CONCLUSIONS Of the variables that influence excess healthcare expenditure, a lever for action is the type of treatment administered. Future research should focus on addressing the long-term cost-effectiveness of new approaches, especially those related to radiotherapy.
Collapse
Affiliation(s)
- Daniel Bejarano-Quisoboni
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France.
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France.
- Department of Research, Gustave Roussy, Villejuif, France.
| | - Henri Panjo
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
| | - Brice Fresneau
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - Chiraz El-Fayech
- Department of Research, Gustave Roussy, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, France
| | - François Doz
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Aurore Surun
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Florent de Vathaire
- Radiation Epidemiology Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Nathalie Pelletier-Fleury
- Primary Care and Prevention Team, CESP, Inserm, U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
| |
Collapse
|
3
|
Law K, McCabe MG, van der Veer SN, Yorke J. The development and validation of a needs assessment tool for use with YOUng adult survivors of a CentrAl Nervous system tumor (YOU-CAN). Neurooncol Pract 2024; 11:205-215. [PMID: 38496913 PMCID: PMC10940824 DOI: 10.1093/nop/npad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background Adolescent and young adult (AYA) survivors of a central nervous system (CNS) tumor represent a vulnerable group who can experience: social isolation, low rates of employment, and achieving independence can be compromised, leading to poorer quality of life compared with survivors of other cancer types. The aim of this study is to develop and evaluate the validity of a needs assessment tool (NAT) for AYA survivors of a CNS tumor. Methods Items generated using data from 29 qualitative studies and cognitive interviews (n = 8) produced NAT V1.1 (49 items). 128 of 316 eligible participants attending neuro-oncology clinics at 4 NHS sites between June 2022 and March 2023 completed the NAT V1.1 to allow for item reduction and refinement and to evaluate reliability and validity. A pilot study (n = 6) using YOU-CAN in routine follow-up concluded the study. Results Hierarchical analysis and Rasch analysis identified 18- and 15-items for removal, respectively. YOU-CAN, comprised of the remaining 16 items, demonstrates excellent test-retest reliability (intra-class correlation coefficient, 0.901, n = 40) and sufficient correlation with the European Quality of Life questionnaire and Supportive Care Needs Survey (Pearson r = 0.433 and 0.590, respectively). Pilot testing showed YOU-CAN triggered discussions of unmet needs in consultations and highlighted the importance of multidisciplinary support. Conclusions YOU-CAN is a valid and reliable instrument containing items related to concerns about physical and emotional health; family and relationships; self-acceptance; and independence. Future efforts should examine YOU-CAN's feasibility, and develop guidance for managing unmet needs. Routine use of YOU-CAN may improve the identification of otherwise undiscussed unmet needs and opportunities to deliver personalized support.
Collapse
Affiliation(s)
- Kate Law
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Martin G McCabe
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- The Christie Hospital NHS Foundation Trust, Manchester, UK
| |
Collapse
|
4
|
Law K, Harris E, McCabe MG, Yorke J, van der Veer SN. Measurement Properties of Patient-Reported Outcome Measures for Adolescent and Young Adult Survivors of a Central Nervous System Tumor: A Systematic Review. J Adolesc Young Adult Oncol 2024; 13:40-54. [PMID: 37307017 PMCID: PMC10877386 DOI: 10.1089/jayao.2023.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Purpose: To identify and evaluate patient-reported outcome measures (PROMs) for assessing survivorship-related concepts for adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors. Methods: We searched five electronic databases. Two researchers independently screened all titles for inclusion and used consensus-based standards for the selection of health measurement instruments (COSMIN) guidance to grade the quality of evidence for each measurement property. Results: Four studies met eligibility criteria: single-item pain thermometer; single-item fatigue thermometer; 37-item pediatric functional assessment of cancer therapy-brain tumor survivors, measuring quality of life; and 12-item Perceived Barriers Scale to assess barriers to employment. The Perceived Barrier Scale showed high-quality evidence for internal consistency and moderate quality evidence for construct and structural validity. Evidence for the measurement properties of the other PROMs was low-to-moderate quality. Conclusion: We found one PROM with sufficient evidence for good measurement properties to support its use. This warrants development and evaluation of further PROMs to inform ongoing supportive care for this population. Implications for Cancer Survivors: The Perceived Barriers Scale is sufficiently validated and could be considered to guide support for AYA survivors of CNS tumors to achieve their employment goals.
Collapse
Affiliation(s)
- Kate Law
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Emily Harris
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Martin G. McCabe
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Sabine N. van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
5
|
Ehrhardt MJ, Krull KR, Bhakta N, Liu Q, Yasui Y, Robison LL, Hudson MM. Improving quality and quantity of life for childhood cancer survivors globally in the twenty-first century. Nat Rev Clin Oncol 2023; 20:678-696. [PMID: 37488230 DOI: 10.1038/s41571-023-00802-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 07/26/2023]
Abstract
The contributions of cooperative groups to performing large-cohort clinical trials and long-term survivorship studies have facilitated advances in treatment, supportive care and, ultimately, survival for patients with paediatric cancers. As a result, the number of childhood cancer survivors in the USA alone is expected to reach almost 580,000 by 2040. Despite these substantial improvements, childhood cancer survivors continue to have an elevated burden of chronic disease and an excess risk of early death compared with the general population and therefore constitute a large, medically vulnerable population for which delivery of high-quality, personalized care is much needed. Data from large survivorship cohorts have enabled the identification of compelling associations between paediatric cancers, cancer therapy and long-term health conditions. Effectively translating these findings into clinical care that improves the quality and quantity of life for survivors remains an important focus of ongoing research. Continued development of well-designed clinical studies incorporating dissemination and implementation strategies with input from patient advocates and other key stakeholders is crucial to overcoming these gaps. This Review highlights the global progress made and future efforts that will be needed to further increase the quality and quantity of life-years gained for childhood cancer survivors.
Collapse
Affiliation(s)
- Matthew J Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nickhill Bhakta
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Global Paediatric Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Qi Liu
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| |
Collapse
|
6
|
Altherr A, Bolliger C, Kaufmann M, Dyntar D, Scheinemann K, Michel G, Mader L, Roser K. Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors-A Systematic Review. Curr Oncol 2023; 30:8720-8762. [PMID: 37887531 PMCID: PMC10604989 DOI: 10.3390/curroncol30100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/28/2023] Open
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15-39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.
Collapse
Affiliation(s)
- Aurelia Altherr
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Michaela Kaufmann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Daniela Dyntar
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Cancer Registry of Central Switzerland, 6000 Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Division of Hematology & Oncology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
- Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Luzius Mader
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland;
- Cancer Registry Bern-Solothurn, University of Bern, 3008 Bern, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| |
Collapse
|
7
|
Bonanno M, Bourque CJ, Robichaud LA, Levesque A, Lacoste-Julien A, Rondeau É, Dubé É, Leblanc M, Bertrand MC, Provost C, Desjardins L, Sultan S. Prioritizing Solutions and Improving Resources among Young Pediatric Brain Tumor Survivors: Results of an Online Survey. Curr Oncol 2023; 30:8586-8601. [PMID: 37754538 PMCID: PMC10527929 DOI: 10.3390/curroncol30090623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Pediatric Brain Tumor Survivors (PBTS) often experience social, academic and employment difficulties during aftercare. Despite their needs, they often do not use the services available to them. Following a previous qualitative study, we formulated solutions to help support PBTS return to daily activities after treatment completion. The present study aims to confirm and prioritize these solutions with a larger sample. We used a mixed-methods survey with 68 participants (43 survivors, 25 parents, PBTS' age: 15-39 years). Firstly, we collected information about health condition, and school/work experience in aftercare. Then, we asked participants to prioritize the previously identified solutions using Likert scales and open-ended questions. We used descriptive and inferential statistics to analyze data, and qualitative information to support participants' responses. Participants prioritized the need for evaluation, counseling, and follow-up by health professionals to better understand their post-treatment needs, obtain help to access adapted services, and receive information about resources at school/work. Responses to open-ended questions highlighted major challenges regarding the implementation of professionals' recommendations at school/work and the need for timely interventions. These results will help refine solutions for PBTS and provide key elements for future implementation. Translating these priorities into action will need further work involving professionals and decision makers.
Collapse
Affiliation(s)
- Marco Bonanno
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | | | - Lye-Ann Robichaud
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Levesque
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| | - Ariane Lacoste-Julien
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émélie Rondeau
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Émilie Dubé
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Michelle Leblanc
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
| | - Marie-Claude Bertrand
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Carole Provost
- Hematology-Oncology Department, Sainte-Justine University Hospital Center, Montreal, QC H3T 1C5, Canada
| | - Leandra Desjardins
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- CHU Sainte-Justine Research Centre, Montreal, QC H3T 1C5, Canada
| | - Serge Sultan
- Psycho-Oncology Center (CPO), Sainte-Justine University Hospital Research Center, Montreal, QC H3T 1C5, Canada (L.D.); (S.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
| |
Collapse
|
8
|
Baughan N, Pell JP, Mackay DF, Clark D, King A, Fleming M. Educational outcomes in childhood cancer survivors: A Scotland-wide record-linkage study of 766,217 schoolchildren. PLoS One 2023; 18:e0286840. [PMID: 37494295 PMCID: PMC10370705 DOI: 10.1371/journal.pone.0286840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/24/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND A cancer diagnosis during childhood greatly disrupts the lives of those affected, causing physical and psychological challenges. We aim to investigate educational outcomes among schoolchildren with a previous cancer diagnosis compared to their peers. METHODS Individual records from four national education databases and three national health databases were linked to construct a cohort of all singleton schoolchildren born in Scotland attending Scottish local-authority schools between 2009-2013. Pupils previously diagnosed with any cancer, haematological cancers, and central nervous system (CNS) cancers, were compared to their unaffected peers with respect to five educational outcomes: special educational need (SEN), absenteeism, school exclusion, academic attainment, and unemployment. Analyses were adjusted for sociodemographic and maternity factors and chronic conditions. RESULTS Of 766,217 pupils, 1,313 (0.17%) had a previous cancer diagnosis. Children with any cancer had increased odds of SEN (OR 3.26, 95% CI 2.86-3.71), absenteeism (IRR 1.82, 95% CI 1.70-1.94), and low attainment (OR 2.15, 95% CI 1.52-3.03) compared to their peers. Similar findings were observed for haematological (SEN OR 2.62, 95% CI 2.12-3.24; absenteeism IRR 2.04, 95% CI 1.85-2.25; low attainment OR 2.17, 95% CI 1.31-3.61) and CNS (SEN OR 6.44, 95% CI 4.91-8.46; absenteeism IRR 1.75, 95% CI 1.51-2.04; low attainment OR 3.33, 95% CI 1.52-7.30) cancers. Lower exclusions were observed among children with any cancer (IRR 0.51, 95% CI 0.31-0.83) and CNS cancer (IRR 0.20, 95% CI 0.06-0.61). No associations were observed with unemployment. CONCLUSIONS This study highlights the wider impacts of childhood cancer on educational outcomes. These children need to be supported, as poor educational outcomes can further impact later health.
Collapse
Affiliation(s)
- Nicholas Baughan
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Daniel F Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - David Clark
- Public Health Scotland, Edinburgh, United Kingdom
| | - Albert King
- ScotXed, Scottish Government, Edinburgh, United Kingdom
| | - Michael Fleming
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
9
|
Oh S, Lee H, Kim S, Kim S, Lyu CJ, Park CG, Kang HJ. Development and psychometric properties of the social adjustment scale for youth cancer survivors in South Korea. Asia Pac J Oncol Nurs 2023; 10:100241. [PMID: 37435599 PMCID: PMC10331412 DOI: 10.1016/j.apjon.2023.100241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/04/2023] [Indexed: 07/13/2023] Open
Abstract
Objective We developed a new scale-the Social Adjustment Scale for Youth Cancer Survivors-and examined its psychometric properties. Methods In the scale's development stage, preliminary items were constructed based on the results of a concept analysis of the hybrid model, literature review, and interviews. These items were then reviewed through content validity and cognitive interviews. In the validation stage, 136 survivors were recruited from two children's cancer centers in Seoul, South Korea. An exploratory factor analysis was performed to identify a set of constructs, and validity and reliability were tested. Results Starting with 70 items constructed through literature review and interviews with youth survivors, the final scale comprised 32 items. The exploratory factor analysis identified four domains-namely, role achievement in one's present position, harmony in relationships, disclosure and acceptance of cancer history, and preparation and expectation for future roles. Correlations with quality of life indicated good convergent validity (r = 0.82, P < 0.001). The Cronbach's α of the overall scale was 0.95, indicating excellent internal consistency; and the intraclass correlation coefficient was 0.94 (P < 0.001), suggesting high test-retest reliability. Conclusions The Social Adjustment Scale for Youth Cancer Survivors exhibited acceptable psychometric properties in measuring the social adjustment of youth cancer survivors. It can be used to identify youths facing difficulty in adjusting to society after treatment and to investigate the effect of interventions implemented to promote social adjustment among youth cancer survivors. Future research is needed to examine the applicability of the scale in patients across diverse cultural backgrounds and healthcare systems.
Collapse
Affiliation(s)
- Sumi Oh
- College of Nursing, Health and Nursing Research Institute, Jeju National University, Jeju Special Self-Governing Province, South Korea
| | - Hyejung Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sue Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sanghee Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Chuhl Joo Lyu
- Division of Pediatric Hemato-oncology, Yonsei University Health System, College of Medicine, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois, Chicago, USA
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, South Korea
| |
Collapse
|
10
|
覃 李, 麦 惠. [Recent research on cognitive impairment in children with acute lymphoblastic leukemia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:315-320. [PMID: 36946169 PMCID: PMC10032075 DOI: 10.7499/j.issn.1008-8830.2210063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/12/2023] [Indexed: 03/23/2023]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common malignant neoplastic disease in children. With the continuous improvement in diagnosis and treatment, there has been an increasing number of ALL children who achieve long-term survival after complete remission; however, a considerable proportion of these children have cognitive impairment, which has a serious adverse impact on their learning, employment, and social life. This article reviews the latest research on cognitive impairment in children with ALL from the aspects of the influencing factors, detection techniques, and prevention/treatment methods for cognitive impairment.
Collapse
|
11
|
Lönnerblad M, Åberg M, Blomgren K, Berglund E. Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study. Cancers (Basel) 2022; 15:cancers15010255. [PMID: 36612254 PMCID: PMC9818516 DOI: 10.3390/cancers15010255] [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: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988-1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time.
Collapse
Affiliation(s)
- Malin Lönnerblad
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, 75185 Uppsala, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
- Correspondence: ; Tel.:+46-734697279
| | - Maria Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, 40530 Gothenburg, Sweden
- Regionhälsan, Region Västra Götaland, 40583 Gothenburg, Sweden
| | - Klas Blomgren
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Pediatric Oncology, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
| |
Collapse
|
12
|
Pickering L, Main KM, Feldt-Rasmussen U, Sehested A, Mathiasen R, Klose M, Ibsen R, Kjellberg J, Jennum P. Survival and long-term socioeconomic consequences of childhood and adolescent onset of brain tumours. Dev Med Child Neurol 2022. [PMID: 36451275 DOI: 10.1111/dmcn.15467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 12/05/2022]
Abstract
AIM To evaluate survival distributions, long-term socioeconomic consequences, and health care costs in patients with childhood and adolescent onset of brain tumours in a Danish nationwide prospective cohort study. METHOD A search of national registries identified 2283 patients (1198 males, 1085 females; mean age 9 years 6 months [SD 5 years 7 months]) diagnosed with a brain tumour between 1980 and 2015 and aged no older than 18 years at diagnosis. These were compared with sex-, age-, and residency-matched comparison individuals. Patients with malignant tumours were compared with those with benign tumours. Survival distributions were estimated by the Kaplan-Meier method and hazard ratio by the Cox proportional hazard model. Socioeconomic data at age 20 and 30 years were assessed. RESULTS The probability of mortality was highest during the first year after tumour diagnosis. In young adulthood, the patients were generally less likely to be married, had lower grade-point averages, educational levels, and income, were less likely to be in employment, and had higher health care costs than comparison individuals. Patients with malignant tumours had worse outcomes with respect to education, employment, and health care costs than those with benign tumours. INTERPRETATION A diagnosis of brain tumour in childhood and adolescence adversely affects survival and has negative long-term socioeconomic consequences, especially in patients with malignant tumours. These patients require continuous social support.
Collapse
Affiliation(s)
- Line Pickering
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction and EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Clinical Medicine, University of Copenhagen, Denmark.,Department of Medical Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sehested
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - René Mathiasen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Marianne Klose
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Jakob Kjellberg
- VIVE - The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| |
Collapse
|
13
|
Milner S, Feltbower RG, Absolom K, Glaser A. Identifying the important social outcomes for childhood cancer survivors: an e-Delphi study protocol. BMJ Open 2022; 12:e063172. [PMID: 36410830 PMCID: PMC9680166 DOI: 10.1136/bmjopen-2022-063172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Optimising the health of childhood cancer survivors is important given the high long-term survival rate coupled with a significant late effects burden. Included within the WHO's definition of 'Health' are social outcomes. These are of interest given their impact on adult functioning within society, complex interactions with physical and mental health outcomes and potential for cross generational effects. Categories included within the definition of social outcomes are ill defined leading to potential gaps in research and service provision which could affect the ability of survivors to achieve their maximal potential. An e-Delphi study will be used to achieve expert consensus on the most important social outcomes for childhood cancer survivors to inform future research and ultimately, service provision. METHODS AND ANALYSIS A heterogeneous sample of at least 48 panel members will be recruited across four groups chosen to provide different perspectives on the childhood cancer journey: childhood cancer survivors, health professionals, social workers and teachers. Purposive sampling from a UK, regional long-term follow-up clinic will be used to recruit a representative sample of survivors. Other panel members will be recruited through local channels and national professional working groups. Opinions regarding breakdown and relevance of categories of social outcome will be collected through 3-5 rounds of questionnaires using an e-Delphi technique. Open ended, 7-point Likert scale and ranking questions will be used. Each round will be analysed collectively and per group to assess inter-rater agreement. Agreement and strength of agreement will be indicated by a median score of 6 or 7 and mean absolute deviation from the median, respectively. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by Regional Ethics Committee 4, West of Scotland (ID 297344). Study findings will be disseminated to involved stakeholders, published in a peer-reviewed journal and presented at conferences.
Collapse
Affiliation(s)
- Sarah Milner
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Richard G Feltbower
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - Kate Absolom
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
| | - Adam Glaser
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| |
Collapse
|
14
|
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.
Collapse
|
15
|
Barbati M, Kicinski M, Suciu S, Mazingue F, Vandecruys E, Plat G, Uyttebroeck A, Paillard C, Dresse M, Simon P, Pluchart C, Minckes O, Ferster A, Freycon C, Millot F, Van Der Werff ten Bosch J, Chantrain C, Paulus R, de Schaetzen G, Rossi G, Rohrlich P, Benoit Y, Piette C. Socio-economic outcomes among long-term childhood acute lymphoblastic leukaemia survivors enrolled between 1971 and 1998 in EORTC CLG studies: Results of the 58LAE study. Eur J Cancer Care (Engl) 2022; 31:e13755. [PMID: 36284405 PMCID: PMC9787328 DOI: 10.1111/ecc.13755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/09/2022] [Accepted: 10/09/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the socio-economic outcomes of survivors of childhood acute lymphoblastic leukaemia (ALL). METHODS Childhood ALL adult survivors, enrolled in EORTC trials between 1971 and 1998 in France and Belgium, were invited to fill out a questionnaire with information about their socio-economic situation (living with a partner, having a university degree, having a job, working part time and history of having a paid job). The outcomes were compared with two matched control populations. RESULTS Among 1418 eligible patients, 507 (35.8%) participated, including 39 (8%) and 61 (12%) patients who received a haematopoietic stem cell transplantation (HSCT) and a cranial radiotherapy (CRT), respectively. The median time to follow-up was 20 years, and median age was 25 years. Survivors showed a socio-economic level at least as good as controls. HCST and CRT were associated with a higher probability of not obtaining a bachelor degree (respectively OR = 3.49, 95% CI: 1.46-8.35 and OR = 2.31, 95% CI: 1.04-5.15), HSCT was associated with unemployment (OR = 2.89, 95% CI: 1.09-7.65) and having a relapse was associated with a higher probability of not having a partner (OR = 1.88, 95% CI: 1.01-3.51) adjusting for confounders. CONCLUSION Childhood ALL survivors showed a high level of socio-economic participation. HCST and CRT were associated with poorer functioning.
Collapse
Affiliation(s)
- Melissa Barbati
- Department of Pediatric Hematology‐OncologyCHRU LilleLilleFrance
| | | | - Stefan Suciu
- Statistics DepartmentEORTC HeadquartersBrusselsBelgium
| | | | - Els Vandecruys
- Department of Pediatric Hematology‐OncologyGhent University HospitalGhentBelgium
| | | | - Anne Uyttebroeck
- Department of Pediatric Hemato‐OncologyUniversity Hospital LeuvenLeuvenBelgium
| | - Catherine Paillard
- Department of Pediatric Hematology‐OncologyCHRU StrasbourgStrasbourgFrance
| | | | | | - Claire Pluchart
- Department of Pediatric Haematology and OncologyCHU ReimsReimsFrance
| | - Odile Minckes
- Department of Pediatric Hematology‐OncologyCHU CaenCaenFrance
| | - Alina Ferster
- Department of Hemato‐OncologyHUDERF (ULB)BrusselsBelgium
| | - Claire Freycon
- Department of Pediatric Hematology‐OncologyCHU GrenobleGrenobleFrance
| | - Frederic Millot
- Department of Pediatric Hematology‐OncologyCHU PoitiersPoitiersFrance
| | | | | | | | | | - Giovanna Rossi
- Medical DepartmentEORTC HeadquartersBrusselsBelgium,Present address:
R&D DepartmentBreast International Group (BIG)BrusselsBelgium
| | | | - Yves Benoit
- Department of Pediatric Hematology‐OncologyGhent University HospitalGhentBelgium
| | - Caroline Piette
- Department of PaediatricsUniversity Hospital Liège and University of LiègeLiègeBelgium
| | | |
Collapse
|
16
|
Employment among Childhood Cancer Survivors: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14194586. [PMID: 36230516 PMCID: PMC9559689 DOI: 10.3390/cancers14194586] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
To date, there are heterogeneous studies related to childhood cancer survivors’ (CCS) employment rates. Given the importance of this topic, we aimed to perform a systematic review and meta-analysis to investigate the prevalence of employment among CCS and to examine its association with socio-demographic and clinical factors. We followed the PRISMA guidelines to search for pertinent articles in relevant electronic databases. Eighty-nine articles comprising 93 cohorts were included. The overall prevalence of employment was 66% (CI: 95% 0.63–0.69). Subgroup meta-analyses showed that lower rates were found for central nervous system tumor survivors (51%, CI: 95% 0.43–0.59), and for CCS treated with cranial-radiotherapy (53%, CI: 95% 0.42–0.64) or haematopoietic stem-cell transplantation (56%, CI: 95% 0.46–0.65). The studies conducted in Asia highlighted employment rates of 47% (CI: 95%, 0.34–0.60). Univariate meta-regressions identified the following socio-demographic factors associated with higher rates of employment: a female gender (p = 0.046), a higher mean age at the time of investigation (p = 0.00), a longer time since diagnosis (p = 0.00), a higher educational level (p = 0.03), and a married status (p = 0.00). In conclusion, this systematic review and meta-analysis provides evidence that two-thirds of CCS are employed worldwide. Identifying vulnerable groups of CCS may allow for the design of multidisciplinary support strategies and interventions to promote employment in this population.
Collapse
|
17
|
Dionisi-Vici M, Godono A, Castiglione A, Gatti F, Fortunati N, Clari M, Conti A, Zucchetti G, Biasin E, Varetto A, Pira E, Fagioli F, Brignardello E, Felicetti F. Work Placement and Job Satisfaction in Long-Term Childhood Cancer Survivors: The Impact of Late Effects. Cancers (Basel) 2022; 14:cancers14163984. [PMID: 36010976 PMCID: PMC9406576 DOI: 10.3390/cancers14163984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Late effects of cancer and its treatments during childhood or adolescence can impact work placement and increase the risk of unemployment. The aim of this study is to describe the work placement and the perceived job and economic satisfaction of long-term childhood cancer survivors (CCS). Jobs have been categorized according to the International Standard Classification of Occupations version 08 (ISCO-08), and satisfaction has been evaluated through the Satisfaction Profile (SAT-P). Out of 240 CCS (female = 98) included: 53 were students, 46 were unemployed and 141 were employed. Within unemployed survivors, 89.13% were affected by late effects (n = 41). The presence of at least one severe late effect was significantly associated with the probability of unemployment (OR 3.21; 95% CI 1.13−9.12, p < 0.050), and having any late effect was inversely related to the level of satisfaction of the financial situation of unemployed CCS (b −35.47; 95% CI −59.19, −11.74, p = 0.004). Our results showed that being a survivor with severe comorbidities has a significantly negative impact on occupation and worsens the perception of satisfaction of economic situations. Routinary follow-up care of CCS should include the surveillance of socioeconomic development and provide interventions, helping them to reach jobs suitable for their health.
Collapse
Affiliation(s)
- Margherita Dionisi-Vici
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Anna Castiglione
- Unit of Clinical Epidemiology, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Filippo Gatti
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Nicoletta Fortunati
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Marco Clari
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Alessio Conti
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Zucchetti
- Division of Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Eleonora Biasin
- Division of Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Antonella Varetto
- Clinical Psychology Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Enrico Pira
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Franca Fagioli
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
- Division of Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Enrico Brignardello
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital, 10126 Turin, Italy
- Correspondence: ; Tel.: +39-0116336431
| |
Collapse
|
18
|
Nguyen NAT, Auquier P, Beltran Anzola A, d'Oiron R, Biron-Andréani C, Lienhart A, Rauch A, Baumstarck K, Boucekine M, Milien V, Rosso-Delsemme N, Tabele C, Giraud N, Sannié T, Chambost H, Resseguier N. Occupational integration of adults with severe haemophilia (INTHEMO): A study based on the FranceCoag registry. Haemophilia 2022; 28:962-976. [PMID: 35858674 DOI: 10.1111/hae.14620] [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: 02/09/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Health of people with severe haemophilia (PwSH) improves thanks to the advancements in haemophilia care, giving them more opportunities in occupational integration. However, there is little literature on the occupational integration of PwSH. OBJECTIVES The main objective of our study was to assess the occupational integration of PwSH and to compare it with that of the general population. The secondary objective was to study the association between individual characteristics (sociodemographic, clinical and psycho-behavioural) and occupational integration of PwSH. METHODS A multicentre, non-interventional, cross-sectional study was conducted in 2018-2020 on PwSH, aged over 18 and under 65 years and included in the FranceCoag registry. Measurements included indicators of occupational integration, sociodemographic, clinical and psycho-behavioural characteristics. The indicators of occupational integration were compared with those of the general population, using indirect standardization. The data of the general population were available from the National Institute of Statistics and Economic Studies (INSEE). Determinants of occupational integration were explored using structural equation modelling. RESULTS Of 1262 eligible people, 588 were included. PwSH had a lower employment rate than the general population (standardized ratio, .85; 95% CI, .77-.94). There were more PwSH at tertiary education level than expected (standardized ratio, 1.38; 95% CI, 1.17-1.61). HIV infection, poor physical health and mental health concerns were associated with a higher risk of unemployment in PwSH. CONCLUSION Employment rate of PwSH is lower than that of the general population despite their higher education level. Target interventions focusing on determinants of difficult occupational integration could be helpful for PwSH.
Collapse
Affiliation(s)
- Ngoc Anh Thu Nguyen
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
| | - Pascal Auquier
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Any Beltran Anzola
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
| | - Roseline d'Oiron
- Haemophilia Treatment Centre, Bicêtre Hospital, University Hospital of Paris (APHP), Kremlin-Bicêtre, France
| | | | - Anne Lienhart
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Bron, France
| | - Antoine Rauch
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Karine Baumstarck
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Mohamed Boucekine
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Vanessa Milien
- FranceCoag Network, Marseille, France.,Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Natacha Rosso-Delsemme
- Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Clemence Tabele
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,FranceCoag Network, Marseille, France
| | - Nicolas Giraud
- Association française des hémophiles (AFH), Paris, France
| | - Thomas Sannié
- Association française des hémophiles (AFH), Paris, France
| | - Hervé Chambost
- FranceCoag Network, Marseille, France.,Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Noémie Resseguier
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
| | | |
Collapse
|
19
|
Bejarano-Quisoboni D, Pelletier-Fleury N, Allodji RS, Lacour B, GrosClaude P, Pacquement H, Doz F, Berchery D, Pluchart C, Bondiau PY, Nys J, Jackson A, Demoor-Goldschmidt C, Dumas A, Thomas-Teinturier C, Vu-Bezin G, Valteau-Couanet D, Haddy N, Fresneau B, de Vathaire F. Health care expenditures among long-term survivors of pediatric solid tumors: Results from the French Childhood Cancer Survivor Study (FCCSS) and the French network of cancer registries (FRANCIM). PLoS One 2022; 17:e0267317. [PMID: 35617253 PMCID: PMC9135272 DOI: 10.1371/journal.pone.0267317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 04/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Childhood cancer survivors (CCS) may require lifelong medical care due to late effects of cancer treatments. Little is known about of their healthcare utilization and expenditures at long-term especially in publicly funded health care system. We aim to estimate and describe the health care expenditures among long-term CCS in France. Methods A total of 5319 five-year solid CCS diagnosed before the age of 21 between 1945 and 2000 in France were identified in the French Childhood Cancer Survivors Study cohort (FCCSS) and the French cancer registry. Information about health care expenditure was taken from the French national health data system between 2011 and 2016, and was described according to survivors’ characteristics. Generalized linear models were used to determine associations between health care expenditures and survivors’ characteristics. Results Mean annual amount of healthcare expenditures was € 4,255. Expenditures on hospitalizations and pharmacy represents 60% of total expenditures. Mean annual of healthcare expenditures were higher at increasing age, among women survivors (€ 4,795 vs € 3,814 in men) and in central nervous system (CNS) tumor survivors (€ 7,116 vs € 3,366 in lymphoma and € 3,363 in other solid tumor survivors). Conclusions Childhood cancer survivorship is associated with a substantial economic burden in France. We found that female gender and CNS primary cancer were associated with increased healthcare expenditures.
Collapse
Affiliation(s)
- Daniel Bejarano-Quisoboni
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Primary care and Prevention Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Nathalie Pelletier-Fleury
- Primary care and Prevention Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
| | - Rodrigue S. Allodji
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Brigitte Lacour
- EPICEA, CRESS, INSERM UMR 1153, Université de Paris, Paris, France
- Registre National des Tumeurs Solides de l’Enfant, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | | | | | - Hélène Pacquement
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
| | - François Doz
- SIREDO Center (Care, Research, Innovation in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- University of Paris, Paris, France
| | | | | | | | - Julie Nys
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Angela Jackson
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | | | - Agnès Dumas
- Université de Paris, ECEVE, UMR1123, Inserm, Paris, France
| | - Cécile Thomas-Teinturier
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Service d’Endocrinologie et Diabétologie Pédiatrique AP-HP, Université Paris Saclay, Gif-sur-Yvette, France
| | - Giao Vu-Bezin
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | | | - Nadia Haddy
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
| | - Brice Fresneau
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Florent de Vathaire
- Radiation Epidemiology Team, CESP, Inserm U1018, Villejuif, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France
- Department of Research, Gustave Roussy, Villejuif, France
- * E-mail:
| |
Collapse
|
20
|
Devine KA, Christen S, Mulder RL, Brown MC, Ingerski LM, Mader L, Potter EJ, Sleurs C, Viola AS, Waern S, Constine LS, Hudson MM, Kremer LCM, Skinner R, Michel G, Gilleland Marchak J, Schulte FSM. Recommendations for the surveillance of education and employment outcomes in survivors of childhood, adolescent, and young adult cancer: A report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Cancer 2022; 128:2405-2419. [PMID: 35435238 PMCID: PMC9321726 DOI: 10.1002/cncr.34215] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
Educational achievement and employment outcomes are critical indicators of quality of life in survivors of childhood, adolescent, and young adult (CAYA) cancer. This review is aimed at providing an evidence-based clinical practice guideline (CPG) with internationally harmonized recommendations for the surveillance of education and employment outcomes in survivors of CAYA cancer diagnosed before the age of 30 years. The CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of 4 existing CPGs, the authors performed a systematic literature search through February 2021. They screened articles for eligibility, assessed quality, and extracted and summarized the data from included articles. The authors formulated recommendations based on the evidence and clinical judgment. There were 3930 articles identified, and 83 of them, originating from 17 countries, were included. On a group level, survivors were more likely to have lower educational achievement and more likely to be unemployed than comparisons. Key risk factors for poor outcomes included receiving a primary diagnosis of a central nervous system tumor and experiencing late effects. The authors recommend that health care providers be aware of the risk of educational and employment problems, implement regular surveillance, and refer survivors to specialists if problems are identified. In conclusion, this review presents a harmonized CPG that aims to facilitate evidence-based care, positively influence education and employment outcomes, and ultimately minimize the burden of disease and treatment-related late adverse effects for survivors of CAYA cancers. LAY SUMMARY: A multidisciplinary panel has developed guidelines for the surveillance of education and employment outcomes among survivors of childhood, adolescent, and young adult cancer. On the basis of evidence showing that survivors are at risk for lower educational achievement and unemployment, it is recommended that all survivors receive regular screening for educational and employment outcomes.
Collapse
Affiliation(s)
- Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Salome Christen
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.,Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom
| | - Lisa M Ingerski
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Luzius Mader
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | - Adrienne S Viola
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | | | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York.,Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom.,Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Gisela Michel
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | |
Collapse
|
21
|
Baecklund F, Alexanderson KAE, Mittendorfer-Rutz E, Chen L. Sickness absence and disability pension trajectories in childhood cancer survivors and references- a Swedish prospective cohort study. PLoS One 2022; 17:e0265827. [PMID: 35363802 PMCID: PMC8975138 DOI: 10.1371/journal.pone.0265827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Childhood cancer survivors are at high risk of chronic health conditions. We aimed to explore future long-term sickness absence and disability pension in young adult childhood cancer survivors and matched references. Methods We performed a prospective cohort study using microdata from five Swedish nationwide registers. Among all individuals born 1976–1998 and living in Sweden, we included 3632 childhood cancer survivors and 17,468 matched references that could be followed-up for 15, 10, or 5 years, respectively. A group-based trajectory model was applied to identify trajectories of mean annual sickness absence and/or disability pension days (SADP) in each sub-cohort, with 95% confidence intervals (CI). Potential risk factors for trajectory belonging were explored using χ2 test and multinomial logistic regression. Results Most young adult childhood cancer survivors (90.2–96.5%) and references (97.4–98.8%) followed a No SADP trajectory. A larger proportion of childhood cancer survivors than references followed a Moderate (33–102 days/year) or High (115–260 days/year) SADP trajectory (15-year follow-up cohorts: Moderate 4.6% versus 1.2%; High 5.1% versus 1.5%). Childhood cancer survivors of central nervous system (CNS) tumors were at higher risk of the High SADP trajectory than childhood cancer survivors of hematological or non-CNS solid tumors (hematological versus CNS: odds ratio = 2.30, 95% CI 1.23–4.30; hematological versus non-CNS: odds ratio = 0.32, 95% CI 0.13–0.79). Conclusions Although most young adult childhood cancer survivors had no SADP during follow-up, 9.7% experienced moderate or high numbers of SADP days/year throughout the 15-year follow-up; compared to 2.7% among references. CNS tumor survivors were at particular risk of SADP long-term and need extra attention in their future work prospect.
Collapse
Affiliation(s)
- Fredrik Baecklund
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Pediatric Oncology Unit, Karolinska University Hospital, Stockholm, Sweden
- * E-mail:
| | - Kristina A. E. Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
22
|
Otth M, Wyss J, Scheinemann K. Long-Term Follow-Up of Pediatric CNS Tumor Survivors—A Selection of Relevant Long-Term Issues. CHILDREN 2022; 9:children9040447. [PMID: 35455491 PMCID: PMC9029633 DOI: 10.3390/children9040447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022]
Abstract
Introduction: Survivors of pediatric central nervous system (CNS) tumors are at high risk for late effects and long-term morbidity. The quality of survival became increasingly important, as advances in diagnostics, multimodal treatment strategies, and supportive care have led to significant increases in long-term survival. Aim: This review aims to provide a global overview of the potential late effects and long-term follow-up care of CNS tumor survivors, directed to trainees and practitioners with less targeted training in pediatric oncology. Late effects in CNS tumor survivors: A specific focus on CNS tumor survivors relies on cognitive and psychosocial late effects, as they may have an impact on education, professional career, independent living, and quality of life. Further important late effects in CNS tumor survivors include endocrine, metabolic, cardiovascular, and cerebrovascular diseases. Conclusions: Comprehensive long-term follow-up care is essential for pediatric CNS tumor survivors to improve their quality of survival and quality of life. An individualized approach, taking all potential late effects into account, and carried out by an interdisciplinary team, is recommended, and should continue into adulthood. Existing recommendations and guidelines on long-term follow-up care guide the multidisciplinary teams.
Collapse
Affiliation(s)
- Maria Otth
- Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau AG, 5001 Aarau, Switzerland; (J.W.); (K.S.)
- Department of Oncology, Hematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children’s Hospital Zurich—Eleonore Foundation, 8032 Zurich, Switzerland
- Correspondence:
| | - Johanna Wyss
- Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau AG, 5001 Aarau, Switzerland; (J.W.); (K.S.)
- Division of Oncology and Hematology, University Children’s Hospital Basel (UKBB), 4056 Basel, Switzerland
| | - Katrin Scheinemann
- Division of Oncology-Hematology, Department of Pediatrics, Kantonsspital Aarau AG, 5001 Aarau, Switzerland; (J.W.); (K.S.)
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
- Department of Pediatrics, McMaster University Hamilton, Hamilton, ON L8S 4K1, Canada
| |
Collapse
|
23
|
Otth M, Michel G, Gerber NU, Guerreiro Stücklin AS, von Bueren AO, Scheinemann K. Educational Attainment and Employment Outcome of Survivors of Pediatric CNS Tumors in Switzerland-A Report from the Swiss Childhood Cancer Survivor Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030411. [PMID: 35327783 PMCID: PMC8947698 DOI: 10.3390/children9030411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/03/2022]
Abstract
Background: Childhood cancer survivors diagnosed with a central nervous system (CNS) tumor are at risk for educational and vocational challenges. This study compared educational attainment and employment outcome in survivors of CNS tumors to survivors of other malignancies. Methods: The questionnaire-based Swiss Childhood Cancer Survivor Study (SCCSS) included cancer patients diagnosed between 1976 and 2010, aged ≤20 years, who survived ≥5 years after diagnosis. We classified participants aged ≥16 years into three groups: CNS tumor and non-CNS malignancy with and without CNS-directed treatment. We analyzed educational attainment, employment outcome and special schooling. Subgroup analyses included survivors aged ≥25 years. Results: We analyzed 2154 survivors, including 329 (15%) CNS tumor survivors, 850 (40%) non-CNS tumor survivors with and 975 (45%) without CNS-directed treatment. Fewer CNS tumor survivors aged ≥25 years reached tertiary education (44%) compared to those without CNS-directed treatment (51%) but performed similar to survivors with CNS-directed treatment (42%). Among CNS tumor survivors, 36 (14%) received special schooling. Higher parental education was associated with higher levels in survivors. Employment outcome did not significantly differ between the three diagnostic groups. A higher proportion of CNS tumor survivors received disability pension or were unemployed. Conclusions: Our findings suggest that CNS tumor survivors need more time to achieve their highest educational level. This should influence clinical care of these survivors by offering vocational counseling.
Collapse
Affiliation(s)
- Maria Otth
- Department of Pediatrics, Division of Oncology-Hematology, Kantonsspital Aarau AG, 5001 Aarau, Switzerland;
- Department of Oncology, Hematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children’s Hospital Zurich—Eleonore Foundation, 8032 Zurich, Switzerland; (N.U.G.); (A.S.G.S.)
- Correspondence:
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland;
| | - Nicolas U. Gerber
- Department of Oncology, Hematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children’s Hospital Zurich—Eleonore Foundation, 8032 Zurich, Switzerland; (N.U.G.); (A.S.G.S.)
| | - Ana S. Guerreiro Stücklin
- Department of Oncology, Hematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children’s Hospital Zurich—Eleonore Foundation, 8032 Zurich, Switzerland; (N.U.G.); (A.S.G.S.)
| | - André O. von Bueren
- Department of Pediatrics, Obstetrics and Gynecology, Division of Pediatric Hematology and Oncology, University Hospital of Geneva, 1205 Geneva, Switzerland;
| | - Katrin Scheinemann
- Department of Pediatrics, Division of Oncology-Hematology, Kantonsspital Aarau AG, 5001 Aarau, Switzerland;
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland;
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
| | | |
Collapse
|
24
|
Frederiksen LE, Pedersen C, Mogensen H, Mader L, Bautz A, Talbäck M, Hirvonen E, Norsker FN, Hasle H, Malila N, Madanat-Harjuoja L, Feychting M, Erdmann F, Winther JF. Employment status and occupational positions of childhood cancer survivors from Denmark, Finland and Sweden: A Nordic register-based cohort study from the SALiCCS research programme. THE LANCET REGIONAL HEALTH. EUROPE 2021; 12:100258. [PMID: 34901911 PMCID: PMC8640515 DOI: 10.1016/j.lanepe.2021.100258] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND A childhood cancer diagnosis and late effects of treatment may affect survivors' possibilities of employment or highly skilled occupations later in life. In this study, we compared the employment and occupational status of childhood cancer survivors with population comparisons and siblings. METHODS In a cohort study based on Nordic registers, we identified 10 461 survivors of childhood cancer diagnosed before age 20 years in Denmark, Finland and Sweden since 1971. Survivors were compared with 48 928 population comparisons matched to survivors by age, sex and geographical region and 12 605 siblings of survivors. Annual outcome information on employment, unemployment, health-related unemployment and occupational position was obtained from the statistical institutes between 1980-2017 and assessed in multivariate logistic regression analyses from age 30 onwards. FINDINGS By 30 years of age, 9.2% (95% CI, 8.6-9.9%) of survivors were unemployed for health reasons. Childhood cancer survivors had considerably higher odds of health-related unemployment at ages 30, 40 and 50 than population comparisons (ORage30, 2.57; 95% CI, 2.35-2.81) and siblings (ORage30, 2.50; 95% CI, 2.15-2.90). We observed no large difference in unemployment unrelated to health or in occupational position. Health-related unemployment was particularly pronounced among survivors of central nervous system tumours and survivors diagnosed below 15 years of age. INTERPRETATION Survivors at risk of health-related unemployment should be offered comprehensive survivorship care and interventions for obtaining and maintaining suitable employment. FUNDING NordForsk [76111], the Danish Childhood Cancer Foundation [2016-0293], Aarhus University [43239402], the Swedish Childhood Cancer Foundation [PR2020-0130] and [OB2019-0003], Tømrermester Jørgen Holm og Hustru Elisa F. Hansens Mindelegat [20088] and the Swiss National Science Foundation to LM [P2LUP3_175288].
Collapse
Affiliation(s)
- Line Elmerdahl Frederiksen
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark,Corresponding author: Line Elmerdahl Frederiksen, PhD, Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen.
| | - Camilla Pedersen
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Andrea Bautz
- The Danish Clinical Quality Program – National Clinical Registries, Frederiksberg, Denmark
| | - Mats Talbäck
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - Laura Madanat-Harjuoja
- Finnish Cancer Registry, Helsinki, Finland,Dana Farber Cancer Institute/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark,Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
25
|
[Consequences of childhood cancer in the quest for first job in the Grand Ouest inter-region: A mixed-method study designed from the Grand Ouest Cancer de l'Enfant (GOCE) organization in childhood cancer survivors and professionals]. Bull Cancer 2021; 109:318-330. [PMID: 34656299 DOI: 10.1016/j.bulcan.2021.06.015] [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: 12/15/2020] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The professional situation of patients treated for childhood cancer differs from country to country. The aim of the study is to study, with the French sociocultural specificities, the first professional integration of these young people. METHODS A sequential quantitative-qualitative mixed approach associates 16 individual interviews and responses to a self-questionnaire of 254 young cancer survivors (sex-ratio=1, median age 23.5 years diagnosed between 2000 and 2010; 68% leukemia) to 30 individual and collective interviews of professionals. Results They seem to have had fewer difficulties than the general population to find their first job (33% vs. 44%). Young women had more difficulties, young people thought they had stopped studying too early and those who mentioned their sequelae (mainly psychological and neurocognitive). The qualitative phase shows that, in this context, the information provided during the job interview plays an important role in access to the first job. DISCUSSION The study showed a need for information, communication and training for all actors whose main axes could be: i) for young people: learn to introduce themselves and adapt speeches and postures, be aware of their non-obligation to reveal a situation relating to health and to the handicap; ii) for the medical profession: to promote communication and to find spaces for exchanges between specialists, generalists, occupational physicians; iii) for employers: better know the disease and the laws to adapt their eyes and practices.
Collapse
|
26
|
Meuleman MS, Guilmin-Crépon S, Hummel A, Daugas E, Dumas A, Leye F, Dantal J, Rigothier C, Provot F, Chauveau D, Burtey S, Hertig A, Dahan K, Durrbach A, Dossier C, Karras A, Guerrot D, Esnault V, Rémy P, Massy ZA, Tostivint I, Morin MP, Zaoui P, Fritz O, Le Quintrec M, Wynckel A, Bourmaud A, Boyer O, Sahali D, Alberti C, Audard V, Mellerio H. Long-term health-related quality of life outcomes of adults with pediatric onset of frequently relapsing or steroid-dependent nephrotic syndrome. J Nephrol 2021; 35:1123-1134. [PMID: 34224090 DOI: 10.1007/s40620-021-01111-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Long-term psychosocial outcomes and health-related quality of life (HRQOL) in adults with pediatric onset of frequently relapsing or steroid-dependent idiopathic nephrotic syndrome (FRNS or SDNS) remain to be determined. METHODS In this prospective cohort study, 59 adults with pediatric onset of FRNS/SDNS and persistent active glomerular disease in adulthood completed the GEDEPAC-2 questionnaire exploring 11 well-being domains. Data were compared to the French general population (FGP) with standardized incidence ratio ([SIR]; adjusted for period, age, gender). Regression models were performed to identify predictive factors of psychosocial well-being. RESULTS In 82% of cases, the questionnaire was completed while the participants (n = 59; 47 men; median age = 32 years; median number of relapses = 13) were in complete remission (under specific therapy in 76% of cases). Participants had higher educational degree than in the FGP (SIR = 6.3; p < 0.01) and more frequently a managerial occupation (SIR = 3.1; p < 0.01). Social integration was acceptable with regard to marital status and experience of sexual intercourse, but experiences of discrimination were far more frequent (SIR = 12.5; p < 0.01). The SF-12 mental component summary (MCS) score was altered (Z-score = - 0.6; p < 0.01) and mean multidimensional fatigue inventory (MFI-20) global fatigue score appeared high (12). Transfer from pediatric to adult healthcare was followed by a period of discontinued care for 33% of participants. Multivariate analysis revealed a close relationship between MFI-20, physical health, and MCS. CONCLUSIONS This study shows that pediatric onset FRNS and SDNS may have a long-term negative impact on mental HRQOL and highlights the impact of fatigue, which is often not adequately considered in routine care.
Collapse
Affiliation(s)
- Marie-Sophie Meuleman
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France.
| | - Sophie Guilmin-Crépon
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Aurélie Hummel
- Service de Néphrologie, AP-HP, Hôpital Necker, Paris, France
| | - Eric Daugas
- Service de Néphrologie, AP-HP, Hôpital Bichat, Université de Paris, INSERM U1149, Paris, France
| | - Agnès Dumas
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France
| | - Fallou Leye
- Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Jacques Dantal
- Service de Néphrologie Immunologie Clinique Transplantation, Centre de Recherche en Transplantation et Immunologie (CRTI), Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France
| | - Claire Rigothier
- Service de Néphrologie Transplantation, Dialyse et Aphérèses, CHU de Bordeaux, Bordeaux, France
| | - François Provot
- Service de Néphrologie, Hôpital Huriez, CHU de Lille, Lille, France
| | - Dominique Chauveau
- Service de Néphrologie et Transplantation d'Organes, Hôpital de Rangueil et Centre de Référence Maladies Rénales Rares, CHU de Toulouse, Toulouse, France
| | - Stéphane Burtey
- APHM, INSERM, INRAe, C2VN, Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Aix Marseille University, Marseille, France
| | - Alexandre Hertig
- Service de Néphrologie et Transplantation Rénale, AP-HP, Hôpital Tenon, Paris, France
| | - Karine Dahan
- Service de Néphrologie et Dialyse, AP-HP, Hôpital Tenon, Paris, France
| | - Antoine Durrbach
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France
| | - Claire Dossier
- Service de Néphrologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Alexandre Karras
- Service de Néphrologie, AP-HP, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | | | - Vincent Esnault
- Service de Néphrologie, Hôpital Pasteur, CHU de Nice, Nice, France
| | - Philippe Rémy
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Ziad A Massy
- Service de Néphrologie, AP-HP, Hôpital Ambroise Paré, Boulogne-Billancourt, France.,INSERM U1018 CESP, UVSQ, UPS Villejuif, Villejuif, France
| | - Isabelle Tostivint
- Service de Néphrologie et Transplantation, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Marie-Pascale Morin
- Service de Néphrologie, Hôpital de Pontchaillou, CHU de Rennes, Rennes, France
| | - Philippe Zaoui
- Service de Néphrologie, Hémodialyse, Aphérèse et Transplantation Rénale, CHU de Grenoble Alpes, Université Grenoble-Alpes, Grenoble, France
| | - Olivier Fritz
- Service de Néphrologie, Centre Hospitalier (CH) La Rochelle, La Rochelle, France
| | - Moglie Le Quintrec
- Service de Néphrologie Dialyse et Transplantation Rénale, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France
| | | | - Aurélie Bourmaud
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Olivia Boyer
- Service de Néphrologie Pédiatrique, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Institut Imagine, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris, Paris, France
| | - Dil Sahali
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Corinne Alberti
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Unité d'Épidémiologie Clinique, CIC 1426, AP-HP.Nord, Hôpital Universitaire Robert Debré, Inserm, 75019, Paris, France
| | - Vincent Audard
- Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", 51 Avenue du Marechal-de-Lattre-de-Tassigny, Créteil Cedex, 94010, Creteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, Equipe 21, Creteil, France
| | - Hélène Mellerio
- Université de Paris, ECEVE UMR 1123, INSERM, 75010, Paris, France.,Service de médecine d'adolescent, Plateforme de Transition AD'venir, AP-HP, Hôpital Robert Debré, Paris, France.,Groupe Français de Recherche en Médecine et Santé de l'Adolescent, Paris, France
| |
Collapse
|
27
|
Scholtes C, Baust K, Weinhold L, Creutzig U, Gnekow A, Hinz A, Kaatsch P, Kreitz K, Langer T, Rutkowski S, Singer S, Spix C, Teske C, Schmid M, Dilloo D, Calaminus G. Health status, health-related quality of life, and socioeconomic outcome in childhood brain tumor survivors: a German cohort study. Neuro Oncol 2021; 21:1069-1081. [PMID: 30793186 DOI: 10.1093/neuonc/noz044] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND With rising numbers of childhood cancer survivors, somatic and socioeconomic outcome as well as health-related quality of life (QoL) gain increasing relevance. Based on the first nationwide German Survey on Life Situation, State of Health, and Quality of Life of Childhood Cancer Survivors, the VIVE survey, we report the outcome of survivors of childhood brain tumors localized in the posterior fossa. METHODS Two hundred seventy participants with a median follow-up period of 21.9 years completed a questionnaire on socioeconomic and somatic late effects as well as a standardized QoL questionnaire (European Organisation for Research and Treatment of Cancer QLQ-C30). Comparisons were performed between World Health Organization (WHO) grades I-II, WHO grades III-IV brain tumor survivors (BTS), and the general population adjusting for potential confounders. RESULTS The socioeconomic and QoL results of WHO grades I-II BTS were largely comparable to the general population, while grades III-IV BTS were at higher risk for significantly worse outcomes. Of WHO grades III-IV BTS, 36.8% were still living with their parents or in assisted living facilities compared with 16.1% of grades I-II BTS and 7.8% of the age-adjusted general population. Of grades III-IV BTS, 60.8% achieved at least an intermediate school degree in comparison to 80.5% of grades I-II BTS and 75.6% of the general population. Grades III-IV BTS developed up to 2 times more somatic late effects than survivors of grades I-II tumors. CONCLUSION Derived from a large and homogeneous cohort, these results stress the importance of an appropriate follow-up period focusing not only on physical aspects but encompassing the entire living situation to allow patient-tailored support.
Collapse
Affiliation(s)
- Cathy Scholtes
- Pediatric Hematology/Oncology, University Children's Hospital Bonn, Bonn, Germany
| | - Katja Baust
- Pediatric Hematology/Oncology, University Children's Hospital Bonn, Bonn, Germany
| | - Leonie Weinhold
- Department of Medical Biometry, Informatics, and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Ursula Creutzig
- Pediatric Hematology/Oncology, Hannover Medical School, Hannover, Germany
| | - Astrid Gnekow
- Pediatric Hematology/Oncology, Children's Hospital Augsburg, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Peter Kaatsch
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Mainz, Germany
| | - Kiana Kreitz
- Institute for Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Thorsten Langer
- Pediatric Hematology/Oncology, University Children's Hospital Lübeck, Germany
| | - Stefan Rutkowski
- Pediatric Hematology/Oncology, University Children's Hospital Hamburg, Germany
| | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology, and Informatics, Mainz, Germany
| | - Claudia Spix
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Mainz, Germany
| | - Carmen Teske
- Pediatric Hematology/Oncology, University Children's Hospital Bonn, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics, and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Dagmar Dilloo
- Pediatric Hematology/Oncology, University Children's Hospital Bonn, Bonn, Germany
| | - Gabriele Calaminus
- Pediatric Hematology/Oncology, University Children's Hospital Bonn, Bonn, Germany
| |
Collapse
|
28
|
Poulalhon C, Vignon L, Idbrik L, Bernier-Chastagner V, Fabre M, Schleiermacher G, Dijoud F, Perrin C, Varlet P, Faure L, Guissou S, Désandes E, Hémon D, Berger C, Lacour B, Clavel J. Data Resource Profile: The French Childhood Cancer Observation Platform (CCOP). Int J Epidemiol 2021; 49:1434-1435k. [PMID: 32642766 DOI: 10.1093/ije/dyaa048] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Claire Poulalhon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Lucie Vignon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | - Latifa Idbrik
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | | | - Monique Fabre
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Necker-Enfants Malades, AP-HP, and Faculté de Médecine, Université de Paris, Paris, France
| | | | - Frédérique Dijoud
- Service d'Anatomie et Cytologie Pathologiques, Groupement Hospitalier Est, Hospices Civils de Lyon, and Université Claude Bernard Lyon 1, Lyon, France
| | - Corinne Perrin
- Centre de Pathologie et de Neuropathologie Est, Hospices Civils de Lyon, Lyon, France
| | - Pascale Varlet
- Service de Neuropathologie, Hôpital Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, and Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Laure Faure
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Sandra Guissou
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Emmanuel Désandes
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Denis Hémon
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France
| | - Claire Berger
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Service d'Hématologie-Oncologie Pédiatrique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Brigitte Lacour
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Jacqueline Clavel
- Epidémiologie des Cancers des Enfants et des Adolescents (EPICEA), Centre de Recherche en Epidémiologie et Statistiques (CRESS), INSERM, UMR 1153, Université de Paris, Paris, France.,Registre National des Cancers de l'Enfant, Hôpital Paul Brousse, Groupe Hospitalier Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris (AP-HP), Villejuif, and Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| |
Collapse
|
29
|
Berger C, Casagranda L, Sudour-Bonnange H, Massoubre C, Dalle JH, Teinturier C, Martin-Beuzart S, Guillot P, Lanlo V, Schneider M, Dal Molin B, Dal Molin M, Mounier O, Garcin A, Fresneau B, Clavel J, Demoor-Goldschmidt C. Personalized Massive Open Online Course for Childhood Cancer Survivors: Behind the Scenes. Appl Clin Inform 2021; 12:237-244. [PMID: 33763845 DOI: 10.1055/s-0041-1725185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Today, in France, it is estimated that 1 in 850 people aged between 20 and 45 years has been treated for childhood cancer, which equals 40,000 to 50,000 people. As late effects of the cancer and its treatment affect a large number of childhood cancer survivors (CCS) and only 30% of them benefit from an efficient long-term follow-up care for prevention, early detection, and treatment of late effects, health education of CCS represents a challenge of public health. OBJECTIVES Massive open online courses (MOOCs) are a recent innovative addition to the online learning landscape. This entertaining and practical tool could easily allow a deployment at a national level and make reliable information available for all the CCS in the country, wherever they live. METHODS The MOOC team brings together a large range of specialists involved in the long-term follow-up care, but also associations of CCS, video producers, a communication consultant, a pedagogical designer, a cartoonist and a musician. We have designed three modules addressing transversal issues (lifestyle, importance of psychological support, risks of fertility problems) and eight modules covering organ-specific problems. Detailed data on childhood cancer treatments received were used to allocate the specific modules to each participant. RESULTS This paper presents the design of the MOOC entitled "Childhood Cancer, Living Well, After," and how its feasibility and its impact on CCS knowledge will be measured. The MOOC about long-term follow-up after childhood cancer, divided into 11 modules, involved 130 participants in its process, and resulted in a 170-minute film. The feasibility study included 98 CCS (31 males vs. 67 females; p < 0.0001). CONCLUSION Such personalized, free, and online courses with an online forum and a possible psychologist consultation based on unique characteristics and needs of each survivor population could improve adherence to long-term follow-up without alarming them unnecessarily.
Collapse
Affiliation(s)
- Claire Berger
- Department of Pediatric Hematology and Oncology, University-Hospital, Saint-Etienne, France.,UMR-S1153, Inserm, Paris Descartes University, Paris, France
| | - Léonie Casagranda
- Department of Pediatric Hematology and Oncology, University-Hospital, Saint-Etienne, France.,Host Research Team EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France
| | | | - Catherine Massoubre
- Department of Psychiatry, University-Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Hugues Dalle
- Department of Immunology and Hematology, Robert Debré Hospital, GH APHP-Nord Université de Paris, France
| | - Cecile Teinturier
- Department of Pediatric Endocrinology and diebetology, Bicêtre Hospital, Paris Sud University - Kremlin Bicêtre, France.,Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France
| | | | - Pascale Guillot
- Department of Rhumatology, University Hospital Nantes, Nantes, France
| | - Virginie Lanlo
- Consultant, Communication and Pedagogical Designer Specialized in MOOC, Pantin, France
| | | | | | | | - Olivier Mounier
- Department of Informatics, University Jean Monnet, Saint-Etienne, France
| | - Arnauld Garcin
- Host Research Team EA4607 SNA-EPIS, Jean Monnet University of Saint-Etienne, PRES Lyon, Saint-Etienne, France.,Department of Research, University Hospital, Saint-Etienne, Cedex, France
| | - Brice Fresneau
- Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France.,Department of Pediatric Oncology, Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | | | - Charlotte Demoor-Goldschmidt
- Inserm U 1018, CESP, Cancer and Radiation Team, University of Paris-Saclay, Paris-Sud University, Villejuif, France.,Department of Pediatric Hematology and Oncology, University-Hospital of Angers, Angers, France
| |
Collapse
|
30
|
Martinez-Santos AE, Fernandez-De-La-Iglesia JDC, Sheaf G, Coyne I. A systematic review of the educational experiences and needs of children with cancer returning to school. J Adv Nurs 2021; 77:2971-2994. [PMID: 33598984 DOI: 10.1111/jan.14784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/11/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022]
Abstract
AIMS To critically review and synthesize empirical studies on childhood cancer survivors' experiences and needs on returning to school after treatment. DESIGN A mixed-method systematic review. DATA SOURCES A search of CINAHL, PsycINFO, EMBASE, MEDLINE, ERIC and Web of Science was conducted for studies published in English, Spanish and Portuguese languages between January 2010 and May 2020. REVIEW METHODS Twenty-one studies were eligible for inclusion (13 qualitative studies, 6 quantitative and 2 mixed-method studies). The quality of the studies was assessed using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Findings were synthesized using data-based convergent synthesis design. RESULTS Findings were synthesized under four themes: academic continuity and school re-entry; physical and psychological well-being; school life and participation and stakeholders' responses to childhood cancer. Findings indicated that prolonged/recurring absences, physical and mental changes, personal/health factors impacted children's social participation, peer relationships and school re-integration. Factors which contributed to a more positive experience included maintaining contact with peers and teachers throughout treatment, peer relationships, understanding and support from school community. Sharing information about cancer was an ongoing challenging issue for children, that needed to be handled sensitively. CONCLUSION It is evident that re-entry to school was very challenging for most children due to treatment side effects, prolonged absences, disrupted peer relationships, lack of preparation and lack of communication between schools, families and healthcare professionals. IMPACT Despite the growing number of childhood cancer survivors worldwide, there is a deficit of studies about children's re-entry experiences and educational needs. This review illustrates the considerable challenges that children face on school re-entry and the critical importance of better care, support and collaboration from healthcare professionals, parents and school personnel. Nurses could help by raising awareness and leading on preparation for school re-entry.
Collapse
Affiliation(s)
- Alba-Elena Martinez-Santos
- Faculty of Education Sciences, University of Santiago de Compostela, Santiago de Compostela, Spain.,Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Greg Sheaf
- The Library of Trinity College Dublin, Trinity College Dublin, Dublin, Ireland
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
31
|
Mavrea K, Efthymiou V, Katsibardi K, Tsarouhas K, Kanaka-Gantenbein C, Spandidos DA, Chrousos G, Kattamis A, Bacopoulou F. Cognitive function of children and adolescent survivors of acute lymphoblastic leukemia: A meta-analysis. Oncol Lett 2021; 21:262. [PMID: 33664825 PMCID: PMC7882890 DOI: 10.3892/ol.2021.12523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/14/2021] [Indexed: 11/05/2022] Open
Abstract
Pediatric cancer and its treatment may have an impact on the neurocognitive functions of childhood cancer survivors (CCS). The aim of the present meta-analysis was to compare the intelligence quotient (IQ) scores between CCS of acute lymphoblastic leukemia (ALL) and controls. A comprehensive electronic search identified original research articles that reported scores of the Wechsler Intelligence Scale (WISC; WISC-III, WISC-IV and WISC-R) for children and adolescents, aged 6-16 years at evaluation, survivors of ALL and healthy controls. The included CCS had completed anticancer treatment and were in remission at the time of assessment. A total of 16 studies were included in the meta-analysis, out of 128 extracted studies, and involved a total of 1,676 children and adolescents: 991 CCS (ALL) and 685 healthy controls. Among the studies, a random effects model revealed a moderate estimate of effect size [standardized mean difference (SMD), -0.78; 95% CI, -1.05 to -0.50], indicating that the WISC scores for total IQ were significantly lower in the CCS than in the controls. The mean total IQ range was 85.2-107.2 in the CCS and 88.4-114.1 in the controls. The difference in the mean total IQ between controls and CCS ranged from -13.8 to 20.6. As regards the WISC scores for verbal IQ, 11 studies were included. A random effects model revealed a moderate estimate of effect size (SMD, -0.71; 95% CI, -1.05 to -0.38), indicating that the WISC scores for verbal IQ were significantly lower in the CCS than in the controls. Among the 9 studies that had available data for performance IQ scores, a fixed effect model revealed a moderate estimate of effect size (SMD, -0.80; 95% CI, -1.09 to -0.52), indicating that the WISC scores for performance IQ were significantly lower in the CCS than in the controls. As the survival rates of children and adolescents with ALL are steadily increasing, regular, lifelong follow-up for neurocognitive late effects is imperative in order to improve their education and employment prospects and overall, their quality of life.
Collapse
Affiliation(s)
- Kalliopi Mavrea
- Clinic for Assessment of Adolescent Learning Difficulties, Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Vasiliki Efthymiou
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Katerina Katsibardi
- Pediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | | | - Christina Kanaka-Gantenbein
- Clinic for Assessment of Adolescent Learning Difficulties, Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece.,University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion 71409, Greece
| | - George Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Antonis Kattamis
- Pediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Flora Bacopoulou
- Clinic for Assessment of Adolescent Learning Difficulties, Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece.,University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| |
Collapse
|
32
|
Lamore K, Bourdeau C, Alos N, Bertout L, Curnier D, Drouin S, Krajinovic M, Laverdière C, Lippé S, Marcil V, Robaey P, Rondeau É, Sinnett D, Sultan S. Contributing Factors of Unmet Needs Among Young Adult Survivors of Childhood Acute Lymphoblastic Leukemia with Comorbidities. J Adolesc Young Adult Oncol 2020; 10:462-475. [PMID: 32924727 DOI: 10.1089/jayao.2020.0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose: This study aimed to: (1) describe the domains and levels of unmet needs of young adult survivors of childhood acute lymphoblastic leukemia (cALL) with comorbidities, and (2) to explore the factors associated with higher levels of unmet needs. Unmet need was considered as supportive care needs not met. Methods: The most vulnerable cALL survivors from the PETALE study cohort completed the Short-Form Survivor Unmet Needs Survey, the Brief Pain Inventory and the 15D instrument of health-related quality of life. Demographic and clinical information, including comorbidities, were obtained from medical records or self-reporting. The participants' needs and contributing factors to their needs were evaluated using nonparametric tests. Results: Of the 72 participants, 9 (13%) reported moderate/high levels of overall unmet needs. "Worry about earning money" (56%) and "Dealing with feeling tired" (51%) were the most frequent unmet needs (all levels combined). The factors associated significantly with any domain of unmet needs were: having a comorbidity, reporting altered functional health status, high ALL risk status, pain, age (<26 years), and having previously received psychological support. Conclusion: A minority of young adult survivors of cALL with comorbidities interviewed reported moderate/high levels of unmet needs. However, financial concerns and emotional health and relationship are the two domains of greatest need. Survivors with altered health condition are most at risk of experiencing moderate/high levels of unmet needs. If confirmed in larger samples, interventions should target modifiable contributors of unmet needs such as physical health and comfort, fatigue, and emotional health.
Collapse
Affiliation(s)
- Kristopher Lamore
- Sainte-Justine University Health Center (SJUHC), Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada.,Université de Paris, LPPS, Boulogne-Billancourt, France
| | - Camille Bourdeau
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Nathalie Alos
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center (SJUHC), Montréal, Canada
| | - Daniel Curnier
- Sainte-Justine University Health Center (SJUHC), Montréal, Canada.,Department of Kinesiology, Université de Montréal, Montréal, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center (SJUHC), Montréal, Canada
| | - Maja Krajinovic
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Caroline Laverdière
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Sarah Lippé
- Department of Psychology, Université de Montréal, Montréal, Canada.,Sainte-Justine UHC Research Center, Montréal, Canada
| | - Valérie Marcil
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Nutrition, and Université de Montréal, Montréal, Canada
| | - Philippe Robaey
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada.,Department of Psychiatry, University of Ottawa, Ottawa, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center (SJUHC), Montréal, Canada
| | - Daniel Sinnett
- Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montréal, Canada.,Sainte-Justine UHC Research Center, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Canada
| |
Collapse
|
33
|
Pinto S, Fresneau B, Hounsossou HC, Mayet A, Marchi J, Pein F, Journy N, Mansouri I, Drubay D, Letort V, Lemler S, Demoor-Goldschmidt C, Jackson A, Souchard V, Vu-Bezin G, Diallo I, Rubino C, Oberlin O, Haddy N, de Vathaire F, Dumas A, Allodji RS. Identifying clusters of health risk behaviors and their predictors in adult survivors of childhood cancer: A report from the French Childhood Cancer Survivor Study. Psychooncology 2020; 29:1595-1603. [PMID: 32658375 DOI: 10.1002/pon.5470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/20/2020] [Accepted: 07/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Health risk behaviors (HRB) of childhood cancer survivors (CCS) are generally studied separately, despite the evidence suggesting that HRB are not independent. To our knowledge, few studies have examined HRB profiles in the former pediatric cancer patients. In this study, we identified HRB profiles and examined predictors engaging in unhealthy behaviors in CCS. METHODS We used data from a French cohort of CCS that includes five-year survivors diagnosed between 1945 and 2000 and treated before reaching age 18, in five centers in France. A total of 2961 adult CCS answered a self-reported questionnaire pertaining to HRB. Latent class analysis was used to identify HRB profiles combining physical activity, smoking, cannabis use, and alcohol drinking. Multinomial logistic analyses examined predictors for engaging in unhealthy behaviors. RESULTS Three HRB patterns emerged: "Low-risk" (n = 1846, 62.3%) included CCS who exhibited the highest frequency for usual physical activity and the lowest probabilities for current smoking or cannabis use, but most drank at least moderately; "Moderate-risk behaviors" (n = 291, 9.8%), and "High-risk behaviors" (n = 824, 27.8%) for CCS who exhibited the highest frequencies for current smoking, cannabis use, and heavy drinking. The multivariable regression revealed that male CCS, less educated or not married were significantly more likely to be in the high-risk behaviors group than the low-risk group. CONCLUSIONS As CCS remain a vulnerable population, screening for HRB should be routinized in long-term follow-up care and interventions targeting multiple HRB simultaneously among survivors should be developed.
Collapse
Affiliation(s)
- Sandrine Pinto
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Department of Pediatric oncology, Université Paris-Saclay, Villejuif, France
| | - Hubert C Hounsossou
- Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, Cotonou, Benin
| | - Aurélie Mayet
- Center for Epidemiology and Public Health of the French Army (CESPA), Marseille, France
| | - Joeffrey Marchi
- Center for Epidemiology and Public Health of the French Army (CESPA), Marseille, France
| | - François Pein
- Département de Recherche, Institut de Cancérologie de l'Ouest, Site René Gauducheau CLCC Nantes-Atlantique, Saint-Herblain, France
| | - Neige Journy
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Imene Mansouri
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Damien Drubay
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
| | - Véronique Letort
- Laboratory of Mathematics in Interaction with Computer Science (MICS), CentraleSupélec, Gif-sur-Yvette, France
| | - Sarah Lemler
- Laboratory of Mathematics in Interaction with Computer Science (MICS), CentraleSupélec, Gif-sur-Yvette, France
| | - Charlotte Demoor-Goldschmidt
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,Département de Recherche, Institut de Cancérologie de l'Ouest, Site René Gauducheau CLCC Nantes-Atlantique, Saint-Herblain, France.,Pediatric Oncology, Chu de Nantes, Nantes, France
| | - Angela Jackson
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Vincent Souchard
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Giao Vu-Bezin
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Ibrahima Diallo
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Carole Rubino
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Odile Oberlin
- Gustave Roussy, Department of Pediatric oncology, Université Paris-Saclay, Villejuif, France
| | - Nadia Haddy
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Florent de Vathaire
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Agnès Dumas
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,ECEVE-INSERM UMR 1123, Paris, France
| | - Rodrigue S Allodji
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, Cotonou, Benin
| |
Collapse
|
34
|
Erdmann F, Frederiksen LE, Bonaventure A, Mader L, Hasle H, Robison LL, Winther JF. Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol 2020; 71:101733. [PMID: 32461035 DOI: 10.1016/j.canep.2020.101733] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Abstract
Since the 1960s, paediatric oncologists have gradually become better organised in large study groups and participation in clinical trials is today considered as the standard of care, with most children with cancer in Europe and North America being enrolled on available treatment protocols. Chemotherapy is nowadays the main element of therapy, but irradiation is still required for some patients. With the advent of multimodality therapy and supportive care, five-year cancer survival exceeds 80 % in most European and North American countries today. The substantial improvements in survival led to a constantly growing population of childhood cancer survivors. Concerns regarding the risk of late effects of the intensive cancer treatment at a young age, together with increasing numbers of survivors, have directed attention towards survivorship research. Survivors of childhood cancer are at longstanding risk of various severe somatic and mental health conditions attributable to the cancer and its treatment, as well as adverse social and socioeconomic consequences, and diminished psychological well-being and quality of life. It is, however, important to stress that some survivors have no or very mild adverse health conditions. Nevertheless, joint efforts are warranted for the care and long-term follow-up of childhood cancer patients. With this article, we provide a comprehensive overview of improvements in survival and treatment modalities over time, as well as the related somatic and mental late effects, and social and socioeconomic difficulties that these children might encounter later in life.
Collapse
Affiliation(s)
- Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Germany.
| | | | - Audrey Bonaventure
- Epidemiology of Childhood and Adolescent Cancer Team, Centre of Research in Epidemiology and Statistics, University of Paris, UMR 1153 INSERM, France
| | - Luzius Mader
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Henrik Hasle
- Department of Paediatrics, Aarhus University Hospital, Denmark
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, 38105, United States
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Denmark
| |
Collapse
|
35
|
Lee JA, Lee JM, Park HJ, Park M, Park BK, Ju HY, Kim JY, Park SK, Lee YH, Shim YJ, Kim HS, Park KD, Lim YJ, Chueh HW, Park JK, Kim SK, Choi HS, Ahn HS, Hah JO, Kang HJ, Shin HY, Lee MJ. Korean parents' perceptions of the challenges and needs on school re-entry during or after childhood and adolescent cancer: a multi-institutional survey by Korean Society of Pediatric Hematology and Oncology. Clin Exp Pediatr 2020; 63:141-145. [PMID: 32024325 PMCID: PMC7170787 DOI: 10.3345/kjp.2019.00696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/13/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND For children and adolescents with cancer, going back to school is a key milestone in returning to "normal life." PURPOSE To identify the support vital for a successful transition, we evaluated the parents' needs and the challenges they face when their children return to school. METHODS This multi-institutional study was conducted by the Korean Society of Pediatric Hematology and Oncology. The written survey comprised 24 questions and was completed by 210 parents without an interviewer. RESULTS Most parents (165 of 206) reported that their children experienced difficulties with physical status (n=60), peer relationships (n=30), academic performance (n=27), emotional/behavioral issues (n=11), and relationships with teachers (n=4) on reentering school. Parents wanted to be kept informed about and remain involved in their children's school lives and reported good parent-teacher communication (88 of 209, 42.1%). Parents reported that 83.1% and 44.9% of teachers and peers, respectively, displayed an adequate understanding of their children's condition. Most parents (197 of 208) answered that a special program is necessary to facilitate return to school after cancer therapy that offers emotional support (n=85), facilitates social adaptation (n=61), and provides tutoring to accelerate catch up (n=56), and continued health care by hospital outreach and school personnel (n=50). CONCLUSION In addition to scholastic aptitude-oriented programs, emotional and psychosocial support is necessary for a successful return to school. Pediatric oncologists should actively improve oncology practices to better integrate individualized school plans and educate peers and teachers to improve health literacy to aid them in understanding the needs of children with cancer.
Collapse
Affiliation(s)
- Jun Ah Lee
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Hyeon Jin Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Meerim Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Byung Kiu Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Hee Young Ju
- Department of Pediatrics, Samsung Medical Center, Seoul, Korea
| | - Ji Yoon Kim
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Kyu Park
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Ho Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Ye Jee Shim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Heung Sik Kim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung Duk Park
- Department of Pediatrics, Chonbuk National University Hospital, Jeonju, Korea
| | - Yeon-Jung Lim
- Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hee Won Chueh
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
| | - Ji Kyoung Park
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
| | - Soon Ki Kim
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
| | - Hyoung Soo Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo Seop Ahn
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong Ok Hah
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Young Shin
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Mee Jeong Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| |
Collapse
|
36
|
Saatci D, Thomas A, Botting B, Sutcliffe AG. Educational attainment in childhood cancer survivors: a meta-analysis. Arch Dis Child 2020; 105:339-346. [PMID: 31601570 DOI: 10.1136/archdischild-2019-317594] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess differences across educational outcomes in survivors of childhood cancer (CCS) compared with peers. DESIGN Systematic review and meta-analysis of observational studies. DATA SOURCES AND STUDY SELECTION Medline, EMBASE, ERIC, CINAHL and PsycInfo from inception to 1st August 2018. Any peer reviewed, comparative study with a population of any survivor of childhood cancer, from high-economy countries, reporting outcomes on educational attainment, were selected. RESULTS 26 studies representing 28 434 CCS, 17 814 matched controls, 6582 siblings and six population studies from 11 high-income countries, which have similar access to education and years of mandatory schooling as reported by the Organisation for Economic Cooperation and Development, were included. CCS were more likely to remain at compulsory level (OR 1.36, 95% CI 1.26 to 1.43) and less likely to complete secondary (OR 0.93, 95% CI 0.87 to 1.0) and tertiary level education (OR 0.87, 95% CI 0.78 to 0.98). They were more likely to require special educational needs (OR 2.47, 95% CI 1.91 to 3.20). Subgroup analyses revealed that survivors, irrespective of central nervous system (CNS) involvement, were less likely to progress onto secondary level compared with cancer-free peers (OR 1.77. 95% CI 1.46 to 2.15; OR 1.19, 95% CI 1.00 to 1.42, respectively). This, however, changed at tertiary level where those with CNS involvement continued to perform worse (OR 0.61, 95% CI 0.55 to 0.68) but those without appeared to perform similarly to their peers (OR 1.12, 95% CI 1.0 to 1.25). CONCLUSIONS Compared with controls, we have elucidated significant differences in educational attainment in survivors. This is sustained across different countries, making it an international issue. CNS involvement plays a key role in educational achievement. Clinicians, teachers and policymakers should be made aware of differences and consider advocating for early educational support for survivors.
Collapse
Affiliation(s)
- Defne Saatci
- General and Adolscent Paediatric Unit, Institute of Child Health, London, UK
| | - Andrew Thomas
- General and Adolscent Paediatric Unit, Institute of Child Health, London, UK
| | - Beverley Botting
- General and Adolscent Paediatric Unit, Institute of Child Health, London, UK
| | | |
Collapse
|
37
|
Mellerio H, Jacquin P, Trelles N, Le Roux E, Belanger R, Alberti C, Tubiana-Rufi N, Stheneur C, Guilmin-Crépon S, Devilliers H. Validation of the "Good2Go": the first French-language transition readiness questionnaire. Eur J Pediatr 2020; 179:61-71. [PMID: 31515671 DOI: 10.1007/s00431-019-03450-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/24/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
Abstract
The use of transition readiness questionnaires is strongly recommended in adolescents with chronic conditions. The aim of our study was to validate "Good2Go," the first French-language transition readiness questionnaire. We analyzed the data from 2 multicentric studies (Canada and France) involving adolescents with chronic conditions (type 1 diabetes, inflammatory bowel disease, cystic fibrosis, epilepsy, juvenile idiopathic arthritis). Content and construct validity were examined using factorial and Rasch analysis (structural validity), Spearman's correlation, and Mann-Whitney test (external validity). Cronbach's α and intra-class correlation coefficients explored reliability. Cognitive interviews assessed wording comprehension and item appropriateness. Good2Go was completed by 321 participants (boys = 51%; mean age = 16.4 years (standard deviation = 1.5; min = 14.0; max = 18.0); Canada = 51.1%). Factor analysis identified 3 domains: "health self-advocacy," "knowledge about chronic conditions," and "self-management skills." The 3-domain structure showed a satisfying Rasch fit, internal consistency, and test-retest reliability. Good2Go domain scores were significantly higher in participants over 17 years of age, indicating satisfactory external validity.Conclusion: Good2Go is a valid 20-item questionnaire to assess transition readiness in adolescents with chronic conditions and may be useful in routine care to propose individually tailored preparation for their transfer to adult healthcare. Further research is now needed to analyze correlation between domain scores and success of transition.What is Known:• In adolescents with chronic conditions, the use of transition readiness questionnaires is recommended to propose individually tailored preparation for their transfer to adult healthcare.• However, no French-language questionnaire has been so far validated.What is New:• Based on a complete validation methodology, this study highlights that the French-language 20-items Good2Go questionnaire has good psychometric properties.• It explores all transition key points though 3 scored domains: "health self-advocacy", "knowledge about chronic disease" and "self-management skills".
Collapse
Affiliation(s)
- Hélène Mellerio
- Plateforme de transition Ad'venir, Unité de médecine d'adolescent, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010, Paris, France. .,INSERM, ECEVE U1123 and CIC-EC, CIC 1426, 75010, Paris, France. .,Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France. .,French Clinical Research Group in Adolescent Medicine and Health, 75014, Paris, France. .,RECaP Network-Perceived health measurement Working Group, Paris, France.
| | - Paul Jacquin
- Plateforme de transition Ad'venir, Unité de médecine d'adolescent, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France.,French Clinical Research Group in Adolescent Medicine and Health, 75014, Paris, France
| | - Nelson Trelles
- Service de chirurgie viscérale et digestive, Centre Hospitalier René Dubos, 95303, Pontoise, France
| | - Enora Le Roux
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010, Paris, France.,INSERM, ECEVE U1123 and CIC-EC, CIC 1426, 75010, Paris, France.,Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France.,RECaP Network-Perceived health measurement Working Group, Paris, France
| | - Richard Belanger
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec, Québec, QC, G1E 6W2, Canada.,Département de pédiatrie, Centre mère-enfant Soleil du CHU de Québec, Université Laval, Quebec, Canada
| | - Corinne Alberti
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010, Paris, France.,INSERM, ECEVE U1123 and CIC-EC, CIC 1426, 75010, Paris, France.,Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France.,RECaP Network-Perceived health measurement Working Group, Paris, France
| | - Nadia Tubiana-Rufi
- Service d'Endocrinologie et de Diabétologie pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France
| | - Chantal Stheneur
- Département de pédiatrie, CHU Saint Justine, Montréal, QC, Canada.,Faculté de médecine, Université de Montréal, Quebec, Canada
| | - Sophie Guilmin-Crépon
- Plateforme de transition Ad'venir, Unité de médecine d'adolescent, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010, Paris, France.,INSERM, ECEVE U1123 and CIC-EC, CIC 1426, 75010, Paris, France.,Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France.,Service d'Endocrinologie et de Diabétologie pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 75019, Paris, France
| | - Hervé Devilliers
- RECaP Network-Perceived health measurement Working Group, Paris, France.,Service de Médecine interne et Maladies systémiques (Médecine interne 2), Hôpital François-Mitterrand, 21079, Dijon cedex, France
| |
Collapse
|
38
|
Gummersall T, Skaczkowski G, Wilson C. Childhood cancer, age at diagnosis and educational attainment: A meta-analysis. Crit Rev Oncol Hematol 2020; 145:102838. [DOI: 10.1016/j.critrevonc.2019.102838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/25/2019] [Accepted: 11/20/2019] [Indexed: 12/23/2022] Open
|
39
|
Abstract
PURPOSE OF REVIEW Adverse late effects of pediatric brain tumors can be numerous and complex and potentially alter the life trajectories of survivors in a multitude of ways. We review these inter-related late effects that compromise neurocognitive function, general health, social and psychological adjustment, and overall adaptive and vocational outcomes, and threaten to undermine the ability of survivors to transition independently into adulthood and effectively manage their care. Intervention/prevention strategies and advances in treatment that may reduce such late effects are discussed. RECENT FINDINGS Studies of neuropsychological late effects have revealed specific deficits in core cognitive functions of attention, working memory and processing speed, with many survivors demonstrating decline in working memory and processing speed over time, irrespective of tumor type or treatment. This in turn affects the ongoing development of higher order neurocognitive skills. Research also highlights the increasing burden of health-related, neuropsychological and psychosocial late effects into adulthood and impact across life outcomes. SUMMARY Pediatric brain tumor survivors require coordinated interdisciplinary care, ongoing evaluation and management of late effects, and timely interventions focused on mitigating the impact of late effects. The transition to adulthood can be especially vulnerable and addressing barriers to care is of paramount importance.
Collapse
Affiliation(s)
- Celiane Rey-Casserly
- Department of Psychiatry, Boston Children's Hospital
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Tanya Diver
- Department of Psychiatry, Boston Children's Hospital
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
40
|
Social attainment in survivors of pediatric central nervous system tumors: a systematic review and meta-analysis from the Children's Oncology Group. J Cancer Surviv 2019; 13:921-931. [PMID: 31625086 DOI: 10.1007/s11764-019-00808-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Improved therapies for pediatric central nervous system (CNS) tumors have increased survival rates; however, many survivors experience significant long-term functional limitations. Survivors of pediatric CNS tumors can experience deficits in social attainment. The aim of this review was to systematically amalgamate findings pertaining to social attainment (i.e., educational attainment, marriage, employment outcomes) in survivors of pediatric CNS tumors. METHODS PubMed (web-based), PsycINFO (EBSCO), EMBASE (Ovid), and Web of Science (Thomson Reuters) were used to identify articles published between January 2011 and September 2018. Eligible studies reported outcomes for survivors of pediatric CNS tumors diagnosed before age 21 years and > 5 years from diagnosis and/or > 2 years off therapy. All data were independently abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS The search yielded 7021 unique publications. Forty-six were included in the current review. Meta-analyses revealed survivors of CNS tumors were significantly more likely to have completed compulsory education only (OR = 1.87, 95% CI = 1.66, 2.12, p < 0.00001), less likely to be married (OR = 4.70, 95% CI = 3.89, 5.68, p < 0.00001), and more likely to be unemployed (OR = 2.84, 95% CI = 2.62, 3.08, p < 0.00001) compared to non-cancer controls. Cranial radiation therapy, neurocognitive deficits, and younger age at diagnosis were associated with poorer outcomes. Hearing loss and bilateral blindness were also related to poorer outcomes. Sex did not impact social attainment outcomes. CONCLUSIONS Survivors of pediatric CNS tumors are at elevated risk for poor attainment of key adult social outcomes. IMPLICATIONS FOR CANCER SURVIVORS There is a critical need to develop interventions to support survivors in becoming independent and productive adults.
Collapse
|
41
|
Molcho M, D'Eath M, Alforque Thomas A, Sharp L. Educational attainment of childhood cancer survivors: A systematic review. Cancer Med 2019; 8:3182-3195. [PMID: 31007000 PMCID: PMC6558589 DOI: 10.1002/cam4.2154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/14/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background Advances in treatment mean that most children diagnosed with cancer during childhood survive. Therefore, it is increasingly important to examine the long‐term consequences of childhood cancer, including educational attainment. This systematic review investigated whether the educational attainment of childhood cancer survivors differ from the cancer‐free population. Design/methods We searched seven databases for articles published from January 2005 to August 2018. We identified full papers in English, reporting primary data on academic attainment of adult survivors of childhood cancer, compared to a control group. Quality appraisal was conducted using the Newcastle‐Ottawa Scale. Results Fourteen studies met the inclusion criteria. Nine papers included patients with various types of cancers, four focused on a single type of cancer, and one on patients who underwent stem cell transplantation. Of the 14 papers, 2 studies were considered good quality, 10 were considered adequate quality, and 2 were considered poor quality. Four studies reported more favorable educational attainment among survivors while six did not report significant differences. Less favorable attainment was consistently reported for CNS survivors in four studies. Conclusion The literature does not provide a clear pattern of the long‐term consequences of childhood cancer on education attainment. While this may suggest that there is no consistent difference between the education attainment of cancer survivors and controls, it may also be the result of limitations in the existing research. To better assess the education attainment of survivors, there is a need for high‐quality studies, with appropriate comparators, and standardized measures of education attainment across countries.
Collapse
Affiliation(s)
| | | | | | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
42
|
Erdmann F, Feychting M, Mogensen H, Schmiegelow K, Zeeb H. Social Inequalities Along the Childhood Cancer Continuum: An Overview of Evidence and a Conceptual Framework to Identify Underlying Mechanisms and Pathways. Front Public Health 2019; 7:84. [PMID: 31106186 PMCID: PMC6492628 DOI: 10.3389/fpubh.2019.00084] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
Inequalities in health according to social conditions are regarded as unnecessary and unjust. There is a large body of evidence on inequalities in adult cancer, observable throughout the societies on a national level as well as on a global scale. Socioeconomic influences on health matter at all ages including childhood, for which childhood cancer is the leading cause of disease related death in high-income countries (HICs). Substantial differences in the reported incidence of childhood cancers have been observed globally by socioeconomic development of a population. This is reflected in the higher incidence rates reported for HICs, particularly for acute lymphoblastic leukemia, and for cancer in infants (below 1 year), compared to low- and middle-income countries (LMICs). Considerable inequalities between populations and degree of socioeconomic development are also noted for survival from childhood cancer, with substantially lower survival rates seen in most LMICs compared to HICs. With respect to inequalities by socioeconomic position (SEP) within countries, findings of an association between SEP and childhood cancer risk are diverse and limited to studies from HICs. On the contrary, observations on social inequalities in survival within countries are accumulating and indicate that survival inequalities do not only concern resource-poor countries but also high-income populations including European countries. In turn, a childhood cancer diagnosis in itself may have implications on the parents' socioeconomic situation as well as on the later socioeconomic life after having survived the disease. The underlying mechanisms and causal pathways of these empirically demonstrated social inequalities are poorly understood, although it is of significant public health relevance for any actions or strategies to reduce childhood cancer-related inequity. We propose a conceptual framework on potential underlying mechanism and pathways specifically addressing social inequalities in childhood cancer and after childhood cancer to (i) illustrate potential pathways by which social determinants may create health inequities at different points of the childhood cancer continuum; (ii) illustrate potential pathways by which a childhood cancer diagnosis may impact the socioeconomic situation of the concerned family or the later life of a childhood survivor; and (iii) point out how major determinants may relate to each other.
Collapse
Affiliation(s)
- Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- 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
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz - Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| |
Collapse
|
43
|
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: 54] [Impact Index Per Article: 9.0] [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.
Collapse
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
| |
Collapse
|
44
|
Pini S, Gardner P, Hugh-Jones S. How and Why School Is Important to Teenagers with Cancer: Outcomes from a Photo-Elicitation Study. J Adolesc Young Adult Oncol 2018; 8:157-164. [PMID: 30300045 DOI: 10.1089/jayao.2018.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Being diagnosed with cancer during the teenage years can be significant given that young people are at a key developmental, educational, and future-planning stage. Little is known about young people's attitude toward and engagement with school postdiagnosis, nor how this changes over time. We adopted a novel qualitative approach to examine accounts over time of young people recently diagnosed with cancer. METHODS Twelve teenagers (13-16 years), recently diagnosed with cancer, participated in photo-elicitation interviews at three time points (∼2, 6, and 9 months postdiagnosis), generating 30 interviews in total. Photo-elicitation interviews center around images that participants bring to represent key experiences and issues that matter to them. Transcripts were analyzed using interpretative phenomenological analysis. RESULTS Seven themes were generated, representing experiences over time. Themes convey how significant school was to the young people postdiagnosis, principally because it mattered to them to maintain a normative educational pathway. Young people felt tension between wanting to be the same as their peers but feeling distinctly changed. Keeping ownership and control of their cancer story within school was challenging. Survivorship brought, for some, a legacy of missed schooling. CONCLUSION Support for young people and reintegration plans for school need to be tailored to the young person's emerging way of understanding their cancer and recovery, and their orientation to coping. Young people need help to understand that schoolwork exemptions/extensions do not implicate academic deficiency, and how they could accept a "same but different" position as they continue to develop personally and educationally with their peers.
Collapse
Affiliation(s)
- Simon Pini
- The School of Psychology, The University of Leeds , Leeds, England
| | - Peter Gardner
- The School of Psychology, The University of Leeds , Leeds, England
| | | |
Collapse
|
45
|
Brinkman TM, Recklitis CJ, Michel G, Grootenhuis MA, Klosky JL. Psychological Symptoms, Social Outcomes, Socioeconomic Attainment, and Health Behaviors Among Survivors of Childhood Cancer: Current State of the Literature. J Clin Oncol 2018; 36:2190-2197. [PMID: 29874134 PMCID: PMC6053297 DOI: 10.1200/jco.2017.76.5552] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer. Results suggest that although most survivors are psychologically well adjusted, survivors are at risk for anxiety and depression compared with siblings. Although the absolute risk of suicide ideation and post-traumatic stress symptoms is low, adult survivors are at increased risk compared with controls. Moreover, young adult survivors are at risk for delayed psychosexual development, lower rates of marriage or cohabitation, and nonindependent living. Survivors' socioeconomic attainment also is reduced, with fewer survivors graduating college and gaining full-time employment. Despite risk for late health-related complications, survivors of childhood cancer generally engage in risky health behaviors at rates similar to or only slightly lower than siblings and peers. CNS tumors and CNS-directed therapies are salient risk factors for poor psychosocial outcomes. In addition, physical health morbidities resulting from cancer-directed therapies are associated with worse psychosocial functioning. Several studies support the effectiveness of cognitive and behavioral interventions to treat psychological symptoms as well as to modify health behaviors. Additional randomized controlled trials are needed to evaluate the efficacy and long-term outcomes of intervention efforts. Future research should focus on the identification of potential genetic predispositions related to psychosocial outcomes to provide opportunities for preventive interventions among survivors of childhood cancer.
Collapse
Affiliation(s)
- Tara M Brinkman
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Christopher J Recklitis
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Gisela Michel
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Martha A Grootenhuis
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - James L Klosky
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| |
Collapse
|
46
|
Dumas A, De Vathaire F, Vassal G. Access to loan-related insurance for French cancer survivors. Lancet Oncol 2018; 17:1354-1356. [PMID: 27733259 DOI: 10.1016/s1470-2045(16)30452-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Agnès Dumas
- Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Sud, Université Paris-Saclay, 94807 Villejuif, France; Department of Clinical Research, Gustave Roussy, U1018 INSERM, B2M, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
| | - Florent De Vathaire
- Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Sud, Université Paris-Saclay, 94807 Villejuif, France; Department of Clinical Research, Gustave Roussy, U1018 INSERM, B2M, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, U1018 INSERM, B2M, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| |
Collapse
|
47
|
Guzzinati S, Virdone S, De Angelis R, Panato C, Buzzoni C, Capocaccia R, Francisci S, Gigli A, Zorzi M, Tagliabue G, Serraino D, Falcini F, Casella C, Russo AG, Stracci F, Caruso B, Michiara M, Caiazzo AL, Castaing M, Ferretti S, Mangone L, Rudisi G, Sensi F, Mazzoleni G, Pannozzo F, Tumino R, Fusco M, Ricci P, Gola G, Giacomin A, Tisano F, Candela G, Fanetti AC, Pala F, Sardo AS, Rugge M, Botta L, Dal Maso L. Characteristics of people living in Italy after a cancer diagnosis in 2010 and projections to 2020. BMC Cancer 2018; 18:169. [PMID: 29426306 PMCID: PMC5807846 DOI: 10.1186/s12885-018-4053-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/25/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Estimates of cancer prevalence are widely based on limited duration, often including patients living after a cancer diagnosis made in the previous 5 years and less frequently on complete prevalence (i.e., including all patients regardless of the time elapsed since diagnosis). This study aims to provide estimates of complete cancer prevalence in Italy by sex, age, and time since diagnosis for all cancers combined, and for selected cancer types. Projections were made up to 2020, overall and by time since diagnosis. METHODS Data were from 27 Italian population-based cancer registries, covering 32% of the Italian population, able to provide at least 7 years of registration as of December 2009 and follow-up of vital status as of December 2013. The data were used to compute the limited-duration prevalence, in order to estimate the complete prevalence by means of the COMPREV software. RESULTS In 2010, 2,637,975 persons were estimated to live in Italy after a cancer diagnosis, 1.2 million men and 1.4 million women, or 4.6% of the Italian population. A quarter of male prevalent cases had prostate cancer (n = 305,044), while 42% of prevalent women had breast cancer (n = 604,841). More than 1.5 million people (2.7% of Italians) were alive since 5 or more years after diagnosis and 20% since ≥15 years. It is projected that, in 2020 in Italy, there will be 3.6 million prevalent cancer cases (+ 37% vs 2010). The largest 10-year increases are foreseen for prostate (+ 85%) and for thyroid cancers (+ 79%), and for long-term survivors diagnosed since 20 or more years (+ 45%). Among the population aged ≥75 years, 22% will have had a previous cancer diagnosis. CONCLUSIONS The number of persons living after a cancer diagnosis is estimated to rise of approximately 3% per year in Italy. The availability of detailed estimates and projections of the complete prevalence are intended to help the implementation of guidelines aimed to enhance the long-term follow-up of cancer survivors and to contribute their rehabilitation needs.
Collapse
Affiliation(s)
- Stefano Guzzinati
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
| | - Saverio Virdone
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | | | - Chiara Panato
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | - Carlotta Buzzoni
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
- AIRTUM Database, Florence, Italy
| | - Riccardo Capocaccia
- Dipartimento di Ricerca Epidemiologica e Medicina Molecolare (DREaMM), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anna Gigli
- Institute for Research on Population and Social Policies, National Research Council, Rome, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry, Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, Italy
| | - Claudia Casella
- Registro Tumori Ligure, Epidemiologia Clinica, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Antonio Giampiero Russo
- Cancer Registry of Milan, Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Bianca Caruso
- Modena Cancer Registry, Public Health Department, AUSL Modena, Modena, Italy
| | - Maria Michiara
- Parma Cancer Registry, Oncology Unit, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | | | - Marine Castaing
- Registro Tumori Integrato Catania-Messina-Siracusa-Enna, Università degli Studi di Catania, Catania, Italy
| | - Stefano Ferretti
- Ferrara Cancer Registry, Ferrara Local Health Board, University of Ferrara, USL Ferrara, Ferrara, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology unit, AUSL ASMN-IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppa Rudisi
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, Palermo, Italy
| | - Flavio Sensi
- North Sardinia Cancer Registry, Azienda Regionale per la Tutela della Salute, Sassari, Italy
| | | | - Fabio Pannozzo
- Cancer Registry of Latina Province, AUSL Latina, Latina, Italy
| | | | - Mario Fusco
- Cancer Registry of ASL Napoli 3 Sud, Napoli, Italy
| | - Paolo Ricci
- Mantova Cancer Registry, Epidemilogy Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Gemma Gola
- Como Cancer Registry, ATS Insubria, Varese, Italy
| | - Adriano Giacomin
- Registro Tumori Piemonte, Provincia di Biella CPO, Biella, Italy
| | - Francesco Tisano
- Cancer Registry of of the Province of Siracusa, Local Health Unit of Siracusa, Siracusa, Italy
| | - Giuseppa Candela
- Trapani Cancer Registry, Dipartimento di Prevenzione della Salute, Trapani, Italy
| | | | - Filomena Pala
- Nuoro Cancer Registry, RT Nuoro, ASSL Nuoro/ATS Sardegna, Nuoro, Italy
| | | | - Massimo Rugge
- Veneto Tumor Registry, Veneto Region, Padova, Passaggio Gaudenzio 1, 35131 Padova, Italy
- Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Laura Botta
- Dipartimento di Ricerca Epidemiologica e Medicina Molecolare (DREaMM), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Via Franco Gallini 2, 33081 Aviano, PN Italy
| |
Collapse
|
48
|
Winterling J, Johansson E, Wettergren L, Ljungman P, Alexanderson K. Occupational status among adult survivors following allogeneic stem cell transplantation in childhood. Eur J Cancer Care (Engl) 2018; 27:e12808. [PMID: 29315926 DOI: 10.1111/ecc.12808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/28/2022]
Abstract
This study examined occupational status and factors associated with sick leave and disability pension among adult long-term survivors previously treated with allogeneic stem cell transplantation (allo-SCT) during childhood. Moreover, occupational status was compared to that of a reference group. Data were collected with questionnaires and from medical records. The SCT group included 59 adults (18-45 years old: response rate 63%) treated with allo-SCT in childhood with a median of 17 (range 3-28) years earlier. The reference group included 296 individuals randomly selected from the general population. The results show that 54% of the long-term survivors were working part- or full-time and that 19% were on sick leave or disability pension. A larger proportion of the SCT group was on sick leave or disability pension (19% vs. 6%: p < .001) than of the reference group. The logistic regression analysis revealed that being on sick leave or disability pension among long-term survivors was associated with late effects related to the allo-SCT (OR 12.28: 95% CI 1.3-111.6: p = .03). The results underscore that long-term survivors' engagement in paid work is influenced many years after treatment and highlights the need to include vocational assistance in the rehabilitation following allo-SCT in childhood.
Collapse
Affiliation(s)
- Jeanette Winterling
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.,Center of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Johansson
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena Wettergren
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Per Ljungman
- Center of Haematology, Karolinska University Hospital, Stockholm, Sweden.,Division of Haematology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
49
|
Demoor-Goldschmidt C, Tabone MD, Bernier V, de Vathaire F, Berger C. Long-term follow-up after childhood cancer in France supported by the SFCE-force and weakness-current state, results of a questionnaire and perspectives. Br J Radiol 2018; 91:20170819. [PMID: 29293375 DOI: 10.1259/bjr.20170819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The survival rate of children treated for cancer is currently about 80% at 5 years and we estimate that about 50,000 adults in France have survived childhood cancer. In 2011, there was a call for projects relating to long-term follow-up (LTFU), which led to several studies being conducted. Five years later, we sent a questionnaire to present LTFU in France and describe its strengths and weaknesses and to establish appropriate steps that should be taken. METHODS A questionnaire was sent by email to all the members of the French Society of Childhood Cancers in spring 2016. The study involved 44 centres/hospitals with a Paediatric Oncology Department. RESULTS 54 answers were analysed, provided by 31/44 (70%) centres working together with the French Society of Childhood Cancers. Screening is the main objective of LTFU care (90%). The main difficulties that arose were: lack of sufficient time to devote to this activity (57%), difficulties contacting adult childhood cancer survivors (aCCSs) (26%), aCCSs who ultimately did not show up to the consultation (19%), cost (15%), and lack of organization (13%). Seven LTFU programmes were identified: two regional organizations (Rhône Alpes and Grand Ouest), four centre-size organizations, and one national study (involving 15 Haematology Centres) relating to Child and Adolescent Leukaemia. CONCLUSION LTFU is a major concern for French centres specialized in paediatric oncology. Organization is not well defined and difficulties still arise (Who are the best care providers? What frequency of care is most appropriate? etc.). Advances in knowledge: LTFU focused on health problems (physical, psychological, social, economic issues) that affect CCSs is needed to ensure that these patients regain the most optimal physical and emotional health possible. Practitioners suggest different ways to improve LTFU, such as national co-operation with Epidemiology Registers to promote homogenous LTFU care.
Collapse
Affiliation(s)
- Charlotte Demoor-Goldschmidt
- 1 Cancer and Radiation team, Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, University Paris-Sud, UVSQ, University Paris-Saclay , Villejuif , France.,2 Department of Pediatric Onco-hematology, CHU Angers , Angers , France
| | | | - Valérie Bernier
- 4 Department of Radiation Oncology, Institut de Cancérologie de Lorraine , Nancy , France
| | - Florent de Vathaire
- 1 Cancer and Radiation team, Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, University Paris-Sud, UVSQ, University Paris-Saclay , Villejuif , France
| | - Claire Berger
- 5 Department of hemato-oncology pediatric, Chu nord st Etienne , Saint-Etienne , France
| |
Collapse
|
50
|
Duijts SFA. Management of work through the seasons of cancer survivorship. Curr Opin Support Palliat Care 2017; 12:80-85. [PMID: 29176331 DOI: 10.1097/spc.0000000000000320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW Survival from cancer has expanded enormously over the past decades. It is estimated that 40-50% of all cancer survivors are of working age at time of diagnosis and thus potentially part of the labor force. The seasons of survivorship can be used as a steppingstone to describe issues regarding employability survivors are dealing with. RECENT FINDINGS The acute survival stage begins at the point of diagnosis. Disclosure of diagnosis, and flexibility of both employers and (occupational) healthcare professionals are important factors in this stage. Extended survival starts when the survivor has completed the basic course of treatment. Survivors become aware that the old normality at work will be difficult to achieve. Problems like fear of recurrence, cognitive, and physical limitations might intensify during this stage and affect work ability. Permanent survival can be called long-term remission. Prospective studies on work-related outcomes and work-related interventions in this stage are rare. SUMMARY It is important to improve our understanding of the seasons of survival and to explore concepts, such as employability, against the background of these seasons. This perspective may help both survivors and (occupational) healthcare professionals to develop better strategies for dealing with the difficult life event cancer represents in each specific stage.
Collapse
Affiliation(s)
- Saskia F A Duijts
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| |
Collapse
|