title: Employment Situation of Parents of Long-Term Childhood Cancer Survivors.
abstract: BACKGROUND
  Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment.
  
  
  METHODS
  As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years). Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry.
  
  
  RESULTS
  We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers). Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007). However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002), which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07) were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71) increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73) and >2 children (OR = 0.48, CI:0.30-0.75); and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36).
  
  
  CONCLUSIONS
  Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education, additional children, and whose child had a more severe cancer disease could improve their long-term employment situation.
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Luzius
authors.initials: L
authors.lastname: Mader
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Corina S
authors.initials: CS
authors.lastname: Rueegg
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Janine
authors.initials: J
authors.lastname: Vetsch
authors.affiliation: Department of Oncology/Hematology, Children's Hospital, Cantonal Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Rischewski
authors.affiliation: Unit of Oncology/Hematology, Department of Pediatric, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Ansari
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Kuehni
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.|Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Gisela
authors.initials: G
authors.lastname: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms; D010290:Parents; D012044:Regression Analysis; D012959:Socioeconomic Factors; D017741:Survivors