Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study

SIMPLE SUMMARY: Individuals treated for brain tumors in childhood are at high risk of cognitive and other late complications. The aim of this nationwide registry study was to explore further education following the nine years of compulsory school in Sweden in teenagers and young adults treated for childhood brain tumors. Individuals treated for embryonal tumors, low grade astrocytomas, optic pathway gliomas, craniopharyngiomas, and neuronal and mixed neuronal–glial tumors, were analyzed separately. All individuals treated for brain tumors were compared to about five times as many matched controls without cancer diagnoses or treatments. Our results demonstrate significant differences between cases and controls regarding attendance in high school, folk high school, and university. Individuals treated for embryonal tumors or optic pathway gliomas attended post-compulsory education less frequently than other analyzed diagnoses. There was a positive correlation between parental education levels and attendance in high school and university for both cases and controls. ABSTRACT: The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988–1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time.