Employment among Childhood Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

To date, there are heterogeneous studies related to childhood cancer survivors’ (CCS) employment rates. Given the importance of this topic, we aimed to perform a systematic review and meta-analysis to investigate the prevalence of employment among CCS and to examine its association with socio-demographic and clinical factors. We followed the PRISMA guidelines to search for pertinent articles in relevant electronic databases. Eighty-nine articles comprising 93 cohorts were included. The overall prevalence of employment was 66% (CI: 95% 0.63–0.69). Subgroup meta-analyses showed that lower rates were found for central nervous system tumor survivors (51%, CI: 95% 0.43–0.59), and for CCS treated with cranial-radiotherapy (53%, CI: 95% 0.42–0.64) or haematopoietic stem-cell transplantation (56%, CI: 95% 0.46–0.65). The studies conducted in Asia highlighted employment rates of 47% (CI: 95%, 0.34–0.60). Univariate meta-regressions identified the following socio-demographic factors associated with higher rates of employment: a female gender (p = 0.046), a higher mean age at the time of investigation (p = 0.00), a longer time since diagnosis (p = 0.00), a higher educational level (p = 0.03), and a married status (p = 0.00). In conclusion, this systematic review and meta-analysis provides evidence that two-thirds of CCS are employed worldwide. Identifying vulnerable groups of CCS may allow for the design of multidisciplinary support strategies and interventions to promote employment in this population.

Multifaceted support for quality of life in childhood cancer survivors: Questionnaire survey

“…In the area of employment, a recent systematic review and meta‐analysis focusing on employment status among CCSs revealed that approximately two‐thirds of these individuals were gainfully employed worldwide. This employment rate, however, is strongly influenced by socio‐demographic factors, emphasizing the need for comprehensive, multidisciplinary support and interventions 10 . In the present research, we first aimed to clarify the current status of CCSs in Japan.…”

“…This employment rate, however, is strongly influenced by socio-demographic factors, emphasizing the need for comprehensive, multidisciplinary support and interventions. 10 In the present research, we first aimed to clarify the current status of CCSs in Japan. For this purpose, we examined how interventions from the medical, educational, and administrative institutions affected the QOL of pediatric patients or adult CCSs in our institution.…”

“…Another important social issue for CCSs in adulthood is employment after graduating from school. 10 Childhood cancer survivors may have some disabilities in adulthood; it is therefore important to have appropriate support from public administrative agencies. To invigorate employment support for people with disabilities, the Japanese government has been offering extensive support to enhance cooperation among health, employment, welfare, and education sectors.…”

“…Another important social issue for CCSs in adulthood is employment after graduating from school 10 . Childhood cancer survivors may have some disabilities in adulthood; it is therefore important to have appropriate support from public administrative agencies.…”

Comparison of Neurocognitive Functioning and Fine Motor Skills in Pediatric Cancer Survivors and Healthy Children

“…Only 66% of all childhood cancer survivors are employed. A recent meta-analysis shows the lowest rate of employment for central nervous system tumor survivors, patients treated with cranial-radiotherapy and hematopoietic stem-cell transplantation (with employment rates of 51%, 53% and 56%, respectively) [ 12 ]. Thereby, late sequelae cognitive and motor impairments secondary to their primary disease, the time of its onset, treatment and adjuvant therapy significantly affect the whole life of cancer survivors.…”