School Bullying of Childhood Leukemia Survivors

With improving childhood cancer cure rates, there is a growing focus on the long-term health and well-being of survivors. School reintegration is crucial for their rehabilitation and psychosocial adaptation, yet little is known about school violence and bullying faced by cancer survivors upon their return.

This study aimed to investigate the prevalence and forms of school bullying against childhood acute lymphoblastic leukemia (ALL) survivors, identifying risk and protective factors.

ALL survivors aged 6-18 years were assessed through interviews and questionnaires. A paired comparison group of healthy students was recruited from their classrooms.

The study included 70 students from grades 6-12 (mean age 14.9 ± 1.82 years), comprising 35 ALL survivors and a paired comparison group. ALL survivors endured more physical (M = 1.64, SD = 1.00) and relational bullying (M = 1.50, SD = 1.04) than their healthy classmates (M = 0.90, SD = 0.58; M = 0.90, SD = 0.51 respectively), while facing similar verbal bullying levels (M = 1.71, SD = 0.99 vs. M = 1.38, SD = 0.69). However, survivors reported less cyberbullying (M = 0.45, SD = 0.36) and severe bullying (M = 0.41, SD = 0.05) than their healthy classmates (M = 1.49, SD = 0.48; M = 0.66, SD = 0.53 respectively). Survivors who returned to a different school cohort post-remission faced higher bullying risks than those who rejoined their original cohort (-0.79 < β < -0.92; p < 0.001). Physical disfigurements following cancer treatment were a risk factor for victimization only among those who returned to their original cohort.

The findings highlight the unique challenges faced by childhood leukemia survivors in school reintegration after cancer therapy, emphasizing the significant effect of the school cohort environment on their bullying experiences.