title: Household income and risk-of-poverty of parents of long-term childhood cancer survivors.
abstract: BACKGROUND
  Taking care of children diagnosed with cancer affects parents' professional life and may place the family at risk-of-poverty. We aimed to (i) compare the household income and risk-of-poverty of parents of childhood cancer survivors (CCS) to parents of the general population, and (ii) identify sociodemographic and cancer-related factors associated with risk-of-poverty.
  
  
  METHODS
  As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of CCS aged 5-15 years, who survived ≥5 years after diagnosis. Information on parents of the general population came from the Swiss Household Panel (parents with ≥1 child aged 5-15 years). Risk-of-poverty was defined as having a monthly household income of <4,500 Swiss Francs (CHF) for single parents and <6,000 CHF for parent-couples. We used logistic regression to identify factors associated with risk-of-poverty.
  
  
  RESULTS
  We included parents of 383 CCS and 769 control parent households. Parent-couples of CCS had a lower household income (Ptrend< 0.001) and were at higher risk-of-poverty (30.4% vs. 19.3%, P = 0.001) compared to control parent-couples. Household income and risk-of-poverty of single parents of CCS was similar to control single parents. Parents of CCS were at higher risk-of-poverty if they had only standard education (ORmother= 3.77 [where OR is odds ratio], confidence interval [CI]: 1.61-8.82; ORfather= 8.59, CI: 4.16-17.72) and were from the German language region (OR = 1.99, CI: 1.13-3.50). We found no cancer-related risk factors.
  
  
  CONCLUSIONS
  Parents of long-term CCS reported lower household income and higher risk-of-poverty than control parents. Support strategies may be developed to mitigate parents' risk-of-poverty in the long term, particularly among parents with lower education.
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: Katharina
authors.initials: K
authors.lastname: Roser
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Baenziger
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Bern, Bern, Switzerland.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Tinner
authors.affiliation: Division of Hematology/Oncology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.|Division of Hematology/Oncology, McMaster Children's Hospital & McMaster University, Hamilton, ON, Canada.
authors.forename: Katrin
authors.initials: K
authors.lastname: Scheinemann
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Claudia Elisabeth
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; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000191:economics*; D010290:Parents; D011203:Poverty / Q000191:economics*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D013557:Switzerland
keywords: childhood cancer survivors; cohort; income; parents; pediatric oncology; poverty