Income in Adult Survivors of Childhood Cancer

Abstract

Introduction: Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income.

Methods: As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age <21 years, who had survived ≥5 years after diagnosis of the primary tumor. Siblings were used as a comparison group. We asked questions about education, profession and income and retrieved clinical data from the SCCR. We used multivariable logistic regression to identify characteristics associated with income.

Results: We analyzed data from 1'506 survivors and 598 siblings. Survivors were less likely than siblings to have a high monthly income (>4'500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, p<0.001). Older age, male sex, personal and parental education, and number of working hours were associated with high income. Survivors of leukemia (OR = 0.40, p<0.001), lymphoma (OR = 0.63, p = 0.040), CNS tumors (OR = 0.22, p<0.001), bone tumors (OR = 0.24, p = 0.003) had a lower income than siblings. Survivors who had cranial irradiation, had a lower income than survivors who had no cranial irradiation (OR = 0.48, p = 0.006).

Discussion: Even after adjusting for socio-demographic characteristics, education and working hours, survivors of various diagnostic groups have lower incomes than siblings. Further research needs to identify the underlying causes.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Interaction effects on socio-demographic predictors of monthly income >4’500 CHF.

Fig 1 shows interaction effects of gender and study group on socio-demographic predictors of monthly income >4’500 CHF. aResults were retrieved from multivariable logistic regression adjusted for baseline and secondary socio-demographic variables that were significant in the univariable model (Table 3). An OR<1 means that the respective group is less likely to have a monthly income of >4’500 CHF; bReference group are those aged 18 –<25 years; cReference group are those with 0 children.

Fig 2. Association of diagnostic group with having a monthly income of >4’500 CHF.

Fig 2 shows the association of diagnostic group with having a monthly income of >4’500 CHF compared to siblings. aMultivariable analysis showing ORs adjusted for baseline and secondary socio-demographic variables that were significant in the univariable model (Table 3); bSibling population is standardized on age, gender, migration background and language region according to the survivor population.