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Education, employment, insurance, and marital status among 694 survivors of pediatric lower extremity bone tumors

A report from the childhood cancer survivor study

  1. Rajaram Nagarajan M.D., M.S.1,†,*,
  2. Joseph P. Neglia M.D., M.P.H.2,
  3. Denis R. Clohisy M.D.3,
  4. Yutaka Yasui Ph.D.4,
  5. Mark Greenberg M.D.5,
  6. Melissa Hudson M.D.6,
  7. Michael A. Zevon Ph.D.7,
  8. Jean M. Tersak M.D.8,
  9. Arthur Ablin M.D.9,
  10. Leslie L. Robison Ph.D.1

Article first published online: 30 APR 2003

DOI: 10.1002/cncr.11363

Issue

Cancer

Cancer

Volume 97, Issue 10, pages 2554–2564, 15 May 2003

Additional Information

How to Cite

Nagarajan, R., Neglia, J. P., Clohisy, D. R., Yasui, Y., Greenberg, M., Hudson, M., Zevon, M. A., Tersak, J. M., Ablin, A. and Robison, L. L. (2003), Education, employment, insurance, and marital status among 694 survivors of pediatric lower extremity bone tumors. Cancer, 97: 2554–2564. doi: 10.1002/cncr.11363

Author Information

  1. 1

    Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota

  2. 2

    Division of Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota

  3. 3

    Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota

  4. 4

    Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington

  5. 5

    Department of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada

  6. 6

    Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, Tennessee

  7. 7

    Department of Psychology, Roswell Park Cancer Institute, Buffalo, New York

  8. 8

    Department of Pediatric Hematology/Oncology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

  9. 9

    Department of Pediatrics, University of California-San Francisco, San Francisco, California

  1. †

    Fax: (612) 626-2815

*Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Mayo Mail Code 484, 420 Delaware St. SE, Minneapolis, MN 55455

Publication History

  1. Issue published online: 30 APR 2003
  2. Article first published online: 30 APR 2003
  3. Manuscript Accepted: 21 JAN 2003
  4. Manuscript Revised: 6 JAN 2003
  5. Manuscript Received: 8 NOV 2002

Funded by

  • National Childhood Cancer Fund Research Fellowship (Arcadia, CA)
  • American Society of Clinical Oncology Young Investigator Award (Alexandria, VA)
  • Children's Cancer Research Fund (Minneapolis, MN)
  • National Institutes of Health (Bethesda, MD). Grant Numbers: U24- CA 55727, T32-CA09607

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Keywords:

  • late effects;
  • marriage;
  • education;
  • employment;
  • insurance;
  • pediatric bone tumors;
  • osteosarcoma;
  • Ewing sarcoma

Amputation status and age at diagnosis did not significantly influence any of the measured psychosocial outcomes (education, employment, health insurance, and marriage). Education was a significant positive predictor of employment, as was having health insurance, and being currently in their first marriage. Male gender predicted ever being employed and female gender predicted having health insurance and marriage. When compared with siblings, amputees had significant deficits in education, employment, and health insurance. Overall, no differences between amputees and nonamputees were found. However, gender and education play a prominent role. When compared with siblings, amputees in this cohort may benefit from additional support.

Abstract

BACKGROUND

With increasing numbers of childhood cancer survivors, direct sequelae of cancer therapy and psychosocial outcomes are becoming more important. The authors described psychosocial outcomes (education, employment, health insurance, and marriage) for survivors of pediatric lower extremity bone tumors.

METHODS

The long-term follow-up study of the Childhood Cancer Survivor Study is a multiinstitutional cohort study comprising 14,054 individuals who have survived for 5 or more years after treatment for cancer diagnosed during childhood or adolescence. Baseline demographic and medical information were obtained. Six hundred ninety-four survivors had osteosarcoma or Ewing sarcoma of the lower extremity or pelvis and were classified by amputation status and by age at diagnosis. The median age at diagnosis was 14 years old with a median of 16 years of follow up since diagnosis. Demographic characteristics were used to analyze the rates of psychosocial outcomes.

RESULTS

Amputation status and age at diagnosis did not significantly influence any of the measured psychosocial outcomes. Education was a significant positive predictor of employment, having health insurance, and being currently in their first marriage. Male gender predicted ever being employed and female gender predicted having health insurance and marriage. When compared with siblings, amputees had significant deficits in education, employment, and health insurance.

CONCLUSIONS

Overall, no differences between amputees and nonamputees were found. However, gender and education play a prominent role. When compared with siblings, amputees in this cohort may benefit from additional supports. Cancer 2003;10:2554–64. © 2003 American Cancer Society.

DOI 10.1002/cncr.11363

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