Lindahl Merete, Addington Silas Victor, Winther Jeanette Falck, Schmiegelow Kjeld, Andersen Klaus Kaae
Unit of Statistics, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
Unit of Cancer Survivorship, Childhood Cancer Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
JNCI Cancer Spectr. 2018 Apr 25;2(1):pky003. doi: 10.1093/jncics/pky003. eCollection 2018 Jan.
Childhood cancer survivors can experience deficits in school performance in adolescence. Few studies have investigated how social and socioeconomic factors influence and modify school performance. This study investigates the hypothesis that social and parental socioeconomic factors influence ninth grade school performance in childhood leukemia and central nervous system (CNS) tumor survivors and that the effect is different from that in healthy peers.
We analyzed data from nationwide Danish registers on school grades for children who finished ninth grade during 2002-2015 in Denmark. Using a unique within-school matched design, we compared grades from childhood cancer survivors with grades from healthy peers. Social factors were maternal/paternal civil status, immigrant status, and country of origin. Parental socioeconomic factors were measured by education and income. The study consisted of 36 426 children, of whom 460 and 289 were leukemia and CNS tumor survivors, respectively.
School grades varied considerably across social strata. However, the grades among CNS tumor survivors varied notably less in the following effect modifiers: parental educational attainment, income, and immigrant status. On the contrary, no significant effect modifiers were found among leukemia survivors as compared with healthy peers.
There is a strong effect of social and parental socioeconomic factors on school performance in healthy adolescence in Denmark. The same pattern is seen in survivors of leukemia, but a different pattern is seen in survivors of CNS tumors. This finding suggests that impairment of school-related functions differ between leukemia and CNS tumor survivors. This study contributes to knowledge on learning in adolescence in childhood cancer survivors by investigating several social and socioeconomic effect modifiers with nationwide register data and a unique statistical method particularly suitable for comparing school grades. Improved insight could make it possible to identify high-risk groups that may need different means of help.
儿童癌症幸存者在青少年时期的学业表现可能会出现缺陷。很少有研究调查社会和社会经济因素如何影响和改变学业表现。本研究调查了以下假设：社会和父母的社会经济因素会影响儿童白血病和中枢神经系统（CNS）肿瘤幸存者九年级的学业表现，且这种影响与健康同龄人不同。
我们分析了丹麦全国登记册中关于2002年至2015年在丹麦完成九年级学业的儿童的学校成绩数据。采用独特的校内匹配设计，我们将儿童癌症幸存者的成绩与健康同龄人的成绩进行了比较。社会因素包括母亲/父亲的婚姻状况、移民身份和原籍国。父母的社会经济因素通过教育程度和收入来衡量。该研究包括36426名儿童，其中460名和289名分别是白血病和中枢神经系统肿瘤幸存者。
社会阶层之间的学校成绩差异很大。然而，在以下效应修饰因素中，中枢神经系统肿瘤幸存者的成绩差异明显较小：父母的教育程度、收入和移民身份。相反，与健康同龄人相比，白血病幸存者中未发现显著的效应修饰因素。
在丹麦，社会和父母的社会经济因素对健康青少年的学业表现有很大影响。白血病幸存者也呈现出相同的模式，但中枢神经系统肿瘤幸存者则呈现出不同的模式。这一发现表明，白血病和中枢神经系统肿瘤幸存者在与学校相关的功能损害方面存在差异。本研究通过使用全国登记数据和一种特别适合比较学校成绩的独特统计方法，调查了几个社会和社会经济效应修饰因素，有助于了解儿童癌症幸存者在青少年时期的学习情况。更深入的了解有助于识别可能需要不同帮助方式的高危群体。
