PhD Scientific Days 2025

Pathological and Oncological Sciences III.

Employment and Family Formation-related Challenges of Childhood Cancer Survivors

Name of the presenter

Hernádfői Márk

Institute/workplace of the presenter

Semmelweis University/Bethesda Children's Hospital

Authors

Márk Hernádfői, MD^1,2, Dóra Kornélia Koch, MD^3,4, Tamás Kói, PhD^3,5, Miklós Garami MD, MSc, PhD^3,4

1: Centre for Translational Medicine
2: Bethesda Children's Hospital
3: Centre for Translational Medicine, Semmelweis University
4: Pediatric Center, Semmelweis University
5: Institute of Mathematics, Department of Stochastics, Budapest University of Technology and Economics

Text of the abstract

Introduction
In recent decades, significant advancements in pediatric oncology, the number of childhood cancer survivors (CCSs) continues to rise. While the short-, medium-, and long-term somatic effects of cancer and its treatment have been widely studied, evidence on survivors’ psychosocial and socioeconomic reintegration remains inconsistent and often conflicting. Therefore, there is an urgent need for a comprehensive sythesis of data to clarify the long-term impact of childhood cancer. In this work the authors represent a subset of findings from a broader study.
Aims
To comprehensively review and analyze the socioeconomic attainment of CCSs compared with their unaffected peers.
Methods
A systematic review and meta-analysis was conducted using data obtained from a comprehensive search of MEDLINE (via PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases until July 31, 2023. Eligible studies reported on a major socioeconomic or psychosocial outcomes of CCSs and compared them with unaffected peers. Article selection and data extraction were performed independently in duplicate by four blinded reviewers. Outcomes were expressed as Odds Ratios (ORs) or Mean Differences (MDs) with 95% Confidence Intervals (CIs), and pooled using random-effects model.
Results
Of 43,913 articles screened, 280 studies met the inclusion criteria, reporting data on a total of 389,502 survivors. Compared to population-based controls, CCSs showed higher odds of health-related unemployment (OR: 2.94; 95% CI: 1.90-4.57), lower rates of marriage (OR: 0.72; 95% CI: 0.63-0.84), and parenthood (OR: 0.60; 95% CI: 0.49-0.74).
Conclusion
Our findings highlight persistent and complex socioeconomic challenges faced by CCSs, particularly impacting their employment opportunities and family formation. Our study emphasizes the need for pediatric oncology to shift its focus towards mitigating long-term adverse outcomes and establishing comprehensive, lifelong support systems that facilitate complete social reintegration of survivors.
Funding
The study was supported by grants KDP-12-3/PALY-2022 from the KDP-21 Cooperative Doctoral Programme for Doctoral Scholarships, and the National Excellence Program EKÖP-2024-131 of the Ministry for Innovation and Technology funded by the National Research, Development, and Innovation Fund.