Educational Attainment and Employment Outcome of Survivors of Pediatric CNS Tumors in Switzerland-A Report from the Swiss Childhood Cancer Survivor Study.

Ana Guerreiro Stücklin,André Von Bueren,Katrin Scheinemann,Nicolas Gerber,Gisela Michel,Maria Otth

doi:10.3390/children9030411

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.

Highlights

Educational attainment and employment outcome are important factors in a person’s life
The study population consisted of cancer survivors (CCS) who participated in the Swiss Childhood Cancer Survivor Study (SCCSS), a national questionnaire-based study including all patients registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed between 1976 and 2010, and survived ≥5 years from first cancer diagnosis [11]
We excluded 91 participants who did not answer the questions on education or employment, resulting in a final cohort of 2154 CCS

Summary

Introduction

Educational attainment and employment outcome are important factors in a person’s life. A cancer diagnosis and its treatment expose childhood cancer survivors (CCS) to factors that can negatively influence school performance, such as school absences or treatment modalities directed to the central nervous system (CNS), including brain surgery, cranial radiotherapy [2–4], or intrathecal chemotherapy [3]. A previous Swiss study assessed educational attainment in CCS aged 20–40 years at analysis and diagnosed between 1976 and 2003 but did not focus on CNS tumor survivors and did not investigate employment outcome [6]. With this national cohort study, we aimed to close this knowledge gap by describing educational attainment and employment outcome in CNS tumor survivors and comparing them to survivors of other malignancies with or without CNS-directed treatment. This should influence clinical care of these survivors by offering vocational counseling

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Results

Conclusion