Life after cancer in childhood:: Social adjustment and educational and vocational status of young-adult survivors

Purpose: To evaluate the long-term social effect of illness and its treatment on young-adult survivors of pediatric cancer by addressing a selection of general social adjustment criteria. Methods: In a cross-sectional case-control study, 30 young-adult survivors of childhood cancer were compared with (1) controls with no history of serious illness, matched by sex, age, and geographic area of residence, and (2) general population norms on the subject of educational and vocational factors, habitation, family/partner relationships, parenthood, and leisure activities. Results: The educational status of survivors was similar to that of controls, although a smaller proportion of the patients expressed concrete plans for future vocational or educational advancement. Survivors had less frequently entered higher education compared with general population norms. A longer duration of treatment was related to a lower estimated socioeconomic level, and poor psychological coping with the illness experience was associated with the fact that they were still living with their parents, a shorter education, and a lower socioeconomic level. Conclusions: The social, vocational, and educational adjustment of relapse-free survivors from childhood cancer appears as only moderately, if at all, negatively affected by the illness and treatment history. However, the treatment intensity and particularly the survivors' coping with their illness experience may influence their ability to achieve long-term social goals. These findings suggest that special attention should be given to matters concerning education and partner relationships at long-term follow-up of pediatric cancer patients.