Educational attainment in survivors of childhood cancer in Denmark, Finland, and Sweden

BACKGROUND: Survivors of childhood cancer may face difficulties at school. We investigated whether childhood cancer affects attainment of upper secondary education in a register-based cohort study from Denmark, Finland, and Sweden, limiting bias from selection and participation. METHODS: From national cancer registers, we identified all long-term survivors of childhood cancer diagnosed at ages 0–14 years in 1971–2005 (n=7629) and compared them to matched population comparisons (n=35,411) and siblings (n=6114), estimating odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Overall, 6127 survivors (80%) had attained upper secondary education by age 25, compared to 84% among comparison groups. Elevated ORs for not attaining this level were mainly confined to survivors of central nervous system (CNS) tumours (ORSurv_PopComp 2.05, 95% CI: 1.83–2.29). Other risk groups included survivors who spent more time in hospital around diagnosis and those with hospital contacts in early adulthood, particularly psychiatric. Survivors of all cancer types were less likely to have attained upper secondary education without delay. CONCLUSIONS: Although survivors of childhood cancer experienced delays in education, many had caught up by age 25. Except for survivors of CNS tumours, survivors attained upper secondary education to almost the same extent as their peers.