Education and longer-term health outcomes for childhood cancer survivors
“This study has shown the profound impact that a cancer diagnosis has on childhood education outcomes. Hopefully this will go on to inform policy decisions which truly put the child first.”
This study is being led by Dr Selina Nath and Prof Katie Harron (UCL) and was funded by CRUK and Children with Cancer UK. The study started in 2024 and aims to finish in 2027.
This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.
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We want to find out how children who are diagnosed with cancer progress in primary and secondary school, and what their longer-term physical and mental health is like.
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Children and young people who have had cancer often miss school for treatment and recovery, and some live with lasting effects that can make learning harder. Findings from this study will help schools, health services, and policy-makers understand how to provide better, more timely support, so that children affected by cancer can achieve their potential in education and beyond.
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We will use information on diagnoses from hospital records to find children with cancer, and follow them up in education records to find out about their examination results, school attendances, and Special Educational Needs and Disability support. We will use information from the Mental Health Services Dataset to understand whether children with cancer are more likely to be referred to Mental Health services than other children.
Find out more
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Why does this matter?
Children and young people who have had cancer often miss school for treatment and recovery, and some live with lasting effects that can make learning harder.
What do we want to find out?
We want to understand how having a cancer diagnosis in childhood affects education over time, from primary school through to GCSEs at age 16.
What we will do
We will use ECHILD to compare the progress of children who had cancer with their peers that did not have cancer, while considering important factors such as age, sex, ethnicity, and socio-economic status. We will look at who sits each set of national assessments, who meets expected standards, overall GCSE results (including English and Maths), special educational needs and disabilities (SEND), and school absence. We will also explore whether the age at cancer diagnosis makes a difference to later results. Young people with lived experience of cancer, and parents, are helping to shape this research.
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Introduction:
Childhood cancer survivors (CCSs) experience educational disruptions during and following treatment, yet robust, longitudinal evidence on educational performance remains limited. We will investigate differences in educational outcomes between CCSs and non-cancer peers during primary and secondary school. We will also explore how sociodemographic factors and age at diagnosis contribute to potential differences in General Certificate of Secondary Education (GCSE) examinations, a critical indicator of future academic and employment prospects.
Methods and analysis:
We will use ECHILD to capture linked health and education data for children born in National Health Service (NHS)-funded hospitals in England. We will generate birth cohorts spanning September 1997 to August 2015 (estimated sample size: ~10 million), formed of pupils expected to have undertaken national curriculum assessments between academic years 2004/2005 and 2021/2022 including Key Stage (KS) 1, 2 and 4, corresponding to ages 7, 11 and 16 respectively. Cancer diagnosis will be identified from inpatient hospital records, using International Classification of Diseases, 10th Revision codes (ICD-10). We will investigate differences between CCS and their non-cancer peers in terms of their sociodemographic characteristics and describe trends in educational performances at all KSs, recorded Special Educational Needs and Disabilities (SEND) and school absences. Differences in KS4 (GCSE) performances between CCS and non-cancer peers will be quantified, according to and accounting for geographic region, sex, deprivation, ethnicity and birth characteristics. To assess whether cancer diagnosis disrupts academic trajectories, we will restrict analysis to those with KS2 attainment data and investigate KS4 performance. We will finally explore the influence of age at diagnosis on educational performance at KS4.
ECHILD data used:
[to be completed]
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PPIE activities:
Imogen Smith, a young person with lived experience of childhood cancer, has written a detailed analysis of the long‑term impacts of childhood cancer, offering valuable insight into education, health, and support needs from a survivor’s perspective. Read the insightful report here.