Educational attainment among survivors of childhood cancer: a population-based cohort study in Denmark

We identified 2384 patients in the Danish Cancer Register in whom cancer had been diagnosed in 1960-1996 before they reached the age of 20 and compared them with 53143 sex- and age-matched controls identified from the Register of Population Statistics. Complete education records and demographic and socioeconomic information for the period 1980-2000 were obtained for both cohorts from Statistics Denmark. The rate ratio (RR) for educational attainment was estimated by discrete-time Cox regression analyses. An overall reduction in attaining basic education was found (RR, 0.90; 95% confidence interval, 0.83-0.96). Female survivors of central nervous system (CNS) tumours showed the largest educational deficit (RR, 0.55; 95% confidence interval, 0.37-0.82). Non-CNS tumour survivors attained education as controls at most levels. When the analyses were conditioned on completion of youth education, further educational attainment was not reduced for any group of survivors. These findings confirm that only survivors of CNS tumours in childhood experience significant educational deficits. The deficit was mainly seen among persons whose tumour was diagnosed before they reached the level of secondary education.