title: Educational achievement in Swiss childhood cancer survivors compared with the general population.
abstract: BACKGROUND
  The objective of this study was to describe educational achievements of childhood cancer survivors in Switzerland compared with the general population. In particular, the authors investigated educational problems during childhood, final educational achievement in adulthood, and its predictors.
  
  
  METHODS
  Childhood cancer survivors who were aged <16 years at diagnosis from 1976 to 2003 who had survived for ≥5 years and were currently ages 20 to 40 years received a postal questionnaire during 2007 to 2009. Controls were respondents of the Swiss Health Survey ages 20 to 40 years. Educational achievement included compulsory schooling, vocational training, upper secondary schooling, and university degree. The analysis was weighted to optimize comparability of the populations. The authors analyzed the association between demographic and clinical predictors and educational achievement using multivariable logistic regression. Subgroup analyses focused on survivors aged ≥27 years.
  
  
  RESULTS
  One-third of survivors encountered educational problems during schooling (30% repeated 1 year, and 35% received supportive tutoring). In the total sample, more survivors than controls achieved compulsory schooling only (8.7% vs 5.2%) and fewer acquired a university degree (7.3% vs 11%), but more survivors than controls achieved an upper secondary education (36.1 vs 24.1%). In those aged ≥27 years, differences in compulsory schooling and university education largely disappeared. In survivors and controls, sex, nationality, language region, and migration background were strong predictors of achievement. Survivors of central nervous system tumors or those who had a relapse had poorer outcomes (P < .05).
  
  
  CONCLUSIONS
  Childhood cancer survivors encountered problems during schooling and completed professional education with some delay. However, with the exception of patients who had central nervous system tumors and those who experienced a relapse, the final educational achievement in survivors of child cancer was comparable to that of the general population.
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Kuehni
authors.forename: Marie-Pierre F
authors.initials: MP
authors.lastname: Strippoli
authors.forename: Corina S
authors.initials: CS
authors.lastname: Rueegg
authors.forename: Cornelia E
authors.initials: CE
authors.lastname: Rebholz
authors.forename: Eva
authors.initials: E
authors.lastname: Bergstraesser
authors.forename: Michael
authors.initials: M
authors.lastname: Grotzer
authors.forename: Nicolas X
authors.initials: NX
authors.lastname: von der Weid
authors.forename: Gisela
authors.initials: G
authors.lastname: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004493:Education / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D011153:Population; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult