Background
The international incidence of pediatric cancer is reported to be 140.6 cases per million children aged 0–14 years per year. In children aged 15–19 years, the incidence increases to 185.3 cases per million person-year(1). In France, these rates are reported to be 156.6 and 231.9 cases per million person-years, respectively(2,3). Over time, a significant improvement in long-term survival rates of pediatric cancers has been achieved, with a current 5-year survival rate at 75% in Europe(4). Therefore, the post-treatment period is a key part of the management, and the goal is to help the patient return to a normal life. Childhood cancer and its treatments may induce sequalae. Among them, the psychosocial affections, i.e. difficulties on educational achievement, psychological well-being, and the household’s economic status are well-known and can be prognosis for the success of the patients’ postcancer reintegration(5–7). Learning and psychological consequences are mostly described for children with central-nervous system (CNS) tumors, with cranial radiotherapy and with a younger age at diagnosis(5,8–12). Late repercussions are described, with survivors being at greater risk of unemployment and the later development mental disorders than their siblings(11,13). Some of these consequences may be related to the household’s socioeconomic background. Socioeconomic status (SES) can influence the probability of psychosocial difficulty in addition to the ability of the family to be able to deal with its occurrence. For cancer survivors, some studies established associations among learning difficulties at school, psychological well-being and household SES(14–17). However, these studies show links that are not based on reproductible socioeconomic deprivation scores, and mainly focus on the evaluation of only one type of social difficulties and when the social reintegration is effective(8,10,11,15,16,18–21). The aim of this study was to estimate the psychosocial difficulties in childhood cancer survivors at the posttreatment period based on a social deprivation score. We evaluated educational and psychological difficulties immediately after the hospital care period, a time when interventions could be possible to avoid the long-term consequences and improve social reintegration rates.