title: Social outcomes in adult survivors of childhood cancer compared to the general population: linkage of a cohort with population registers.
abstract: Self-reported data show differences in social outcomes (not being married/having a registered partnership; not living independently; using social benefits) for childhood cancer survivors compared with their peers. We aimed to determine differences in these social outcomes between survivors and the general population using national register data and explored associated risk factors.
  
  
  
  We performed medical record linkage between a single-centre cohort of 1768 ≥ 5-year survivors of childhood cancer (diagnosed 1966-2001) and two national registers (1999-2011) and obtained a random reference sample matched on gender and year of birth per survivor. We used multivariable logistic regression to calculate in adult survivors of childhood cancer (born before 1990) the odds of the specified social outcomes at the end of follow-up in both groups. Within the survivors, we analysed risk factors for the social outcomes.
  
  
  
  We retrieved data from 1283 adult childhood cancer survivors and 25 082 reference persons. Survivors had higher odds (odds ratio; 95% confidence interval) of not being married (1.2; 1.07-1.42), not living independently (1.7; 1.41-2.00) and using social benefits (2.3; 1.98-2.69) compared with reference persons. Radiotherapy to head and/or neck, and an original central nervous system tumour diagnosis negatively influenced all social outcomes examined in childhood cancer survivors.
  
  
  
  National register data show differences between social outcomes in childhood cancer survivors and the general population, especially for survivors treated with radiotherapy to head and/or neck and those originally diagnosed with central nervous system tumours. Development and implementation of effective targeted support strategies to improve social outcomes of childhood cancer survivors needs consideration. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Font-Gonzalez
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Elizabeth Lieke
authors.initials: EL
authors.lastname: Feijen
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Elske
authors.initials: E
authors.lastname: Sieswerda
authors.affiliation: Department of Pediatric Oncology/Hematology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
authors.forename: Eline
authors.initials: E
authors.lastname: van Dulmen-den Broeder
authors.affiliation: Psychosocial Department, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Martha
authors.initials: M
authors.lastname: Grootenhuis
authors.affiliation: Psychosocial Department, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Helena
authors.initials: H
authors.lastname: Maurice-Stam
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Huib
authors.initials: H
authors.lastname: Caron
authors.affiliation: Department of Public Health, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.|Department of Medical Oncology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Helena
authors.initials: H
authors.lastname: van der Pal
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Geskus
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands.
authors.forename: Leontien
authors.initials: L
authors.lastname: Kremer
mesh_terms: D000328:Adult; D000073116:Cancer Survivors / Q000523:psychology / Q000706:statistics & numerical data*; D016543:Central Nervous System Neoplasms; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008498:Medical Record Linkage; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D016017:Odds Ratio; D012042:Registries; D012307:Risk Factors