Variables
We defined three types of variables (i) At each consultation during the
follow-up, oncologist pediatricians carried out a psychosocial
evaluation. During this specific dedicated time, pediatricians, children
and their parents discuss the potential psychosocial difficulties. At
the end of the discussion, a synthesis was reported using as a binary
form (yes/no) to indicate if learning or psychological difficulty was
present or not. Whether the patient received assistance for each
difficulty was also reported. (ii) The clinical variables were composed
of the patients and their tumors characteristics. We merged the tumor
types into five categories; i.e., blood disorders, CNS tumors, solid
tumors, bone tumors, and other tumors (iii) Two variables evaluated the
SES of the children and their household. First, the European Deprivation
Index (EDI) score assessed the socioeconomic environment of each
patient. This deprivation indicator is constructed by selecting
fundamental needs associated both with objective and subjective
poverty(22). This score is determined by an ecological measure using the
IRIS-scale (Ilôts Regroupés pour l’Information Statistique ),
which represents the smallest French geographical area for which there
is a statistical evaluation to estimate social deprivation. Based on
their addresses at diagnosis, each patient can be associated with an
IRIS, and thus, their EDI score can be established(22,23). For
interpretation, the highest EDI score is associated with greater social
deprivation. Second, we used the travel time defined as the shortest
time to travel by car from the patient’s address to the reference care
center to assess geographical disparities. A geographical information
system (ArcGIS 10.5®—Esri France) associated with a road map database
(Navstreets®, provided by HERE and Esri France) was used for this
estimation. For the RECAPGO database, each patient’s EDI score and
travel time to reference care center were estimated from the address at
diagnosis.