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.