IMPACT de la déprivation sociale sur les difficultés psychosociales au décours d’un cancer pédiatrique : une étude prospective
IMPACT of the Social Deprivation on Psychosocial Difficulties of Pediatric Cancer Survivors: A Prospective Study
Abstract
The posttreatment period is a key part of the management of pediatric cancer. During this time, school and psychological difficulties have been described in childhood cancer survivors (CCS) and can be prognostic for the success of social reintegration. This study estimated the influence of the household’s socioeconomic status (SES) on these psychosocial difficulties. This study is based on a prospective multicentric database and focused on children who received a psychosocial evaluation during their follow-up from 2013 to 2020. We retrieved data on school and psychological difficulties. Household SES was estimated by a social deprivation score. Data from1003 patients were analyzed. School difficulties were noted in 22% of CCS. A greater social deprivation was significantly associated with school difficulty. Tumor relapse, treatment with hematopoietic stem cell transplantation, and central nervous system (CNS) tumors remained significant risk factors. In the subgroup of CNS tumors, school difficulties were increased and associated with greater social deprivation. Psychological difficulties were not associated with the deprivation score. There is a link between SES and school difficulties in CCS. Further investigations should be carried out for children with CNS tumors, which is the population of the greatest concern.
Résumé
La période post-traitement une part fondamental de la prise en charge du cancer pédiatrique. Durant cette période, les difficultés scolaires et psychologiques chez les survivants d’un cancer pédiatriques (SCP) sont connues et peuvent être pronostic sur la bonne réintégration sociale. Cette étude estime l’influence de la déprivation sociale du foyer de l’enfant sur ces difficultés. Notre étude se base sur une base de données multicentrique, et se concentre sur les SCP avant reçu une évaluation psychosociale au cours de leur suivi, de 2013 à 2020. Nous rapportons les données des difficultés scolaires et psychologiques. Le statut socio-économique du foyer de l’enfant a été estimé par un score de déprivation sociale. Nous rapportons les données de 1003 patients. Les difficultés scolaires ont été rapportés chez 22% d’entre eux. Une déprivation sociale plus importante était associée à la survenue de difficultés scolaires. La rechute tumorale, le traitement par greffe de cellules souches hématopoïétiques, et les tumeurs du système nerveux central étaient d’autres facteurs de risque. Dans le groupe des patients avec tumeurs du système nerveux central, la déprivation sociale était également un facteur associé à la survenue de difficultés scolaires. Les difficultés psychologiques n’étaient quant à elles pas associées avec le score de déprivation. Il existe un lien entre statut socio-économique et les difficultés scolaires chez les SCP. Des analyses complémentaires doivent être réalisées, notamment chez les enfants avec tumeurs du système nerveux central, qui est la population la plus concernée.
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