Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Cancer. 2020 Jul 15;126(14):3330-3340. doi: 10.1002/cncr.32901. Epub 2020 May 25.
Childhood cancer is a devastating experience for the family. The objective of the current study was to assess the impact of having a child with cancer on parental separation, divorce, and future family planning among families residing in Denmark.
The authors conducted a nationwide cohort study using Danish registry data. Parents of children diagnosed with cancer between 1982 and 2014 (7066 children and 12,418 case parents) were matched with 10 comparison parents of cancer-free children per case parent (69,993 children and 125,014 comparison parents). We used discrete-time Cox regression models to compare the risk of separation (end of cohabitation) and divorce between case and comparison parents, and to identify risk factors for separation and divorce among case parents only. Descriptive statistics were used to compare family planning between case and comparison parents.
Case parents were found to have a slightly lower risk of separation (hazard ratio, 0.96; 95% confidence interval, 0.93-0.99) and divorce (hazard ratio, 0.92; 95% confidence interval, 0.87-0.97) than comparison parents. The authors found that case parents who were aged <45 years, with short education (an International Standard Classification of Education code indicating early childhood education, primary education, and lower secondary education), and who were unemployed were at an increased risk of separation and divorce. Moreover, the parents of children diagnosed with cancer at a young age (aged <15 years) were more likely to separate or divorce. No differences with regard to the total number of children and time to a next child after the cancer diagnosis were observed between case and comparison parents.
Having a child with cancer was not associated with an overall adverse impact on parents' risk of separation or divorce and future family planning. These encouraging findings should be communicated to parents to support them along their child's cancer trajectory.
儿童癌症对家庭来说是一场毁灭性的经历。本研究的目的是评估在丹麦居住的家庭中，孩子患有癌症对父母分居、离婚和未来家庭计划的影响。
作者使用丹麦登记数据进行了一项全国性队列研究。将 1982 年至 2014 年间诊断患有癌症的儿童的父母（7066 名儿童和 12418 名病例父母）与每例病例父母的 10 名无癌症儿童的对照父母（69993 名儿童和 125014 名对照父母）进行匹配。我们使用离散时间 Cox 回归模型比较病例父母和对照父母分居（同居结束）和离婚的风险，并确定仅病例父母分居和离婚的风险因素。使用描述性统计比较病例父母和对照父母的家庭计划。
与对照父母相比，病例父母的分居（风险比，0.96；95%置信区间，0.93-0.99）和离婚（风险比，0.92；95%置信区间，0.87-0.97）的风险略低。作者发现，年龄<45 岁、受教育程度较低（国际标准教育分类代码表示幼儿教育、小学教育和初中教育）、失业的病例父母分居和离婚的风险增加。此外，年龄较小（<15 岁）的儿童被诊断患有癌症的父母更有可能分居或离婚。病例父母和对照父母在癌症诊断后孩子的总数和下一胎的时间上没有差异。
儿童患有癌症与父母分居或离婚及未来家庭计划的风险总体无不利影响相关。这些令人鼓舞的发现应告知父母，以在孩子的癌症治疗过程中为他们提供支持。
