Abstract
Taking care of children diagnosed with cancer affects parents' professional life and may place the family at risk-of-poverty. We aimed to (i) compare the household income and risk-of-poverty of parents of childhood cancer survivors (CCS) to parents of the general population, and (ii) identify sociodemographic and cancer-related factors associated with risk-of-poverty. As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of CCS aged 5-15 years, who survived ≥5 years after diagnosis. Information on parents of the general population came from the Swiss Household Panel (parents with ≥1 child aged 5-15 years). Risk-of-poverty was defined as having a monthly household income of <4,500 Swiss Francs (CHF) for single parents and <6,000 CHF for parent-couples. We used logistic regression to identify factors associated with risk-of-poverty. We included parents of 383 CCS and 769 control parent households. Parent-couples of CCS had a lower household income (Ptrend < 0.001) and were at higher risk-of-poverty (30.4% vs. 19.3%, P = 0.001) compared to control parent-couples. Household income and risk-of-poverty of single parents of CCS was similar to control single parents. Parents of CCS were at higher risk-of-poverty if they had only standard education (ORmother = 3.77 [where OR is odds ratio], confidence interval [CI]: 1.61-8.82; ORfather = 8.59, CI: 4.16-17.72) and were from the German language region (OR = 1.99, CI: 1.13-3.50). We found no cancer-related risk factors. Parents of long-term CCS reported lower household income and higher risk-of-poverty than control parents. Support strategies may be developed to mitigate parents' risk-of-poverty in the long term, particularly among parents with lower education.
Highlights
Experiencing a diagnosis of childhood cancer affects the whole family with wide-ranging psychosocial consequences for family members [1-3]
Parent-couples of CCS had a lower household income and were at higher risk-of-poverty (30.4% vs. 19.3%, p=0.001) compared to control parent-couples
Parents of CCS were at higher risk-of-poverty if they had only standard education (ORmother=3.77, confidence interval (CI):1.61-8.82; ORfather=8.59, CI:4.16-17.72) and were from German language region (OR=1.99, CI:1.13-3.50)
Summary
Experiencing a diagnosis of childhood cancer affects the whole family with wide-ranging psychosocial consequences for family members [1-3]. Several studies demonstrated that treatment-related work disruptions such as time off work, quitting or reducing workload are frequent among parents of childhood cancer patients [2-11]. These work disruptions resulted in substantial income losses [28] Such losses together with non-medical out-ofpocket expenditures due to transportation or accommodation during the child’s treatment may lead to severe financial strains for families of paediatric cancer patients [8, 12-17]. A study in the US including families of children with advanced cancer reported that about 15% of families fell below the poverty line due to these financial strains [5]. Identifying families at risk-of-poverty is important as poverty places children at risk of poor health outcomes [18]. Taking care of children diagnosed with cancer affects parents’ professional life and may place the family at risk-of-poverty. We aimed to i) compare the household income and risk-of-poverty of parents of childhood cancer survivors (CCS) with parents of the general population, and ii) to identify socio-demographic and cancer-related factors associated with risk-of-poverty
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