Employment Situation of Parents of Long-Term Childhood Cancer Survivors

Abstract

Background: Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment.

Methods: As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years). Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry.

Results: We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers). Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007). However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002), which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07) were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71) increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73) and >2 children (OR = 0.48, CI:0.30-0.75); and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36).

Conclusion: Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education, additional children, and whose child had a more severe cancer disease could improve their long-term employment situation.

Fig 1. Participants of the parents questionnaire of the Swiss Childhood Cancer Survivor Study.

Flow diagram of our study population starting from those eligible in the Swiss Childhood Cancer Registry to those included in the analysis.

Fig 2. Employment situation of parents of survivors compared to control parents.

Comparison of employment situation of mothers and fathers of survivors (CCS) and control mothers and fathers (SHS). The numbers in the figure represent the proportion of mothers and fathers who reported the respective employment situation. P-values were calculated from chi-square statistics comparing mothers of survivors with control mothers and fathers of survivors with control fathers. *Weighted proportions and numbers for control mothers and fathers according to age at study, migration background, language region, education, and number of children of mothers and fathers of survivors. Abbreviations: CCS, childhood cancer survivors; SHS, Swiss Health Survey.