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Chronic Health Conditions and Academic Achievement: A Childhood Cancer Survivor Study Report
Lisa Bashore1,2, Rachel K Peterson3,4, Chenghong Li5
1Cook Children's Health Care System, Fort Worth, TX.
JCO Oncology Practice
|September 8, 2025
Summary
Childhood cancer survivors used special education more than siblings but were less likely to graduate college. Cognitive issues and chronic health conditions increased non-graduation risk, unaffected by special education.
Area of Science:
- Pediatric Oncology
- Health Outcomes Research
- Special Education
Background:
- Childhood cancer survivors face unique challenges impacting long-term educational and health outcomes.
- Understanding factors influencing college graduation is crucial for this population.
- Special education services aim to support students with learning difficulties.
Purpose of the Study:
- To investigate the relationship between special education, chronic health conditions (CHCs), and college graduation rates.
- To compare outcomes between childhood cancer survivors and their siblings.
- To identify risk factors for not graduating college among survivors.
Main Methods:
- Utilized data from the Childhood Cancer Survivor Study, including 23,082 survivors and 5,037 siblings.
- Collected self-reported data on special education use, reasons for use, CHCs, and college graduation.
- Analyzed associations using chi-square statistics and modified Poisson regression models.
Main Results:
- Survivors reported higher special education use (26.5%) compared to siblings (8.6%).
- Learning and concentration problems were primary reasons for special education.
- Despite special education, survivors had lower college graduation rates than siblings (RR, 0.76).
- Risk factors for not graduating included CNS tumors, cranial irradiation, and severe CHCs.
Conclusions:
- Cognitive problems and CHCs significantly increase the risk of not graduating college.
- Special education services did not appear to mitigate the risk of lower college graduation for survivors.
- Further interventions are needed to address cognitive deficits and health issues impacting academic achievement in survivors.
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