Does mortality after childhood cancer depend upon parents' social or economic resources? A population-based study
Menée en Norvège à partir des données des registres nationaux, cette étude évalue l’impact du niveau de ressources financières des parents sur la mortalité des enfants atteints de cancer
Abstract Diagnostic and treatment protocols for childhood cancer are generally standardized, and survival ought therefore be fairly equal across social strata in societies with free public health care readily available. This study explores whether there nevertheless are disparities in mortality after childhood cancer in Norway depending on parents' socioeconomic status. Limited knowledge on differentials exist from earlier analyses. Discrete-time hazard regression models for all-cause mortality the first ten years following diagnosis were estimated for all Norwegian children (<20 years) diagnosed with cancer 1974-2007 (N=6280), using data from five national registers. Mortality was reduced by about 15% for children with highly educated mothers and children without siblings. These effects were most pronounced for cancers predicted to encompass intense, long-lasting treatments resulting in chronic health problems. Neither parents' earnings nor their marital status affected children's survival. This large, registry-based study suggests that parents' time constraints and various non-economic rewards from their education impact on childhood cancer survival. It may be that children with resourceful parents are healthier at the outset and/or more likely to avoid later health problems. It may also be that children of well-informed and strongly involved parents are offered better treatment or are able to make better use of what is offered, for instance by adhering more closely to recommendations for follow-up treatment. The possibility of such differentials in offered and actual treatment should be addressed in future research. © 2011 Wiley-Liss, Inc.