title: Scholastic achievements of children with brain tumors at the end of comprehensive education: a nationwide, register-based study.
abstract: BACKGROUND
  Cancer treatment may affect school performance. Scholastic achievements after childhood brain tumors have not been previously reported on the level of actual grades.
  
  
  METHODS
  Patients with brain tumor (n = 300) were identified from the Finnish Cancer Registry. Population controls (n = 1,473) were matched for age, gender, and place of living. Their ninth grade school reports were obtained from Statistics Finland. Age at diagnosis and cranial irradiation (CRT) were considered in analyses, and the level of parental education was taken into model as a covariate.
  
  
  RESULTS
  Six percent of patients did not finish their comprehensive school at the usual age. Patients had lower overall averages than their controls (95% CI for the difference -0.30, -0.16). Girls differed from their controls independently of the age at diagnosis or CRT. Boys treated with CRT at school age, but not before school age, had poorer results than their controls (95% CI -0.65, -0.18). The grades of patients were significantly lower in each school subject, and differed most in foreign language. Young girls with CRT had greatest differences from their controls (95% CI -1.73, -0.86) in this subject. In mathematics, patients diagnosed before school age had greatest difference from their controls. In their mother tongue, patients differed less from their controls.
  
  
  CONCLUSIONS
  Few patients with brain tumor missed the ninth grade certificate at the age of 16. Grades in foreign language (representing verbal performance) were most affected. However, the patients fared poorer than controls in each subject. The difference was most pronounced among girls. Girls were more sensitive to the adverse effects of irradiation.
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland. paivi.lahteenmaki@tyks.fi
authors.forename: P M
authors.initials: PM
authors.lastname: Lähteenmäki
authors.forename: A
authors.initials: A
authors.lastname: Harila-Saari
authors.forename: E I
authors.initials: EI
authors.lastname: Pukkala
authors.forename: P
authors.initials: P
authors.lastname: Kyyrönen
authors.forename: T T
authors.initials: TT
authors.lastname: Salmi
authors.forename: R
authors.initials: R
authors.lastname: Sankila
mesh_terms: D000124:Achievement; D000293:Adolescent; D001932:Brain Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D004521:Educational Measurement / Q000379:methods / Q000592:standards*; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries; D012574:Schools / Q000592:standards*