Abstract D061: Long-term socioeconomic status of childhood leukemia survivors and their family in a universal healthcare coverage system: A PETALE study
Bibliographic record
Abstract
Abstract Introduction: Financial toxicity as a side effect of cancer treatments has been well demonstrated in adults survivors, mainly in countries without universal healthcare coverage. Evidence supporting an association between socioeconomic deprivation and decreased survival for most prevalent adult cancer are mounting, including in various European healthcare coverage settings. As such, the relationship between cancer and socioeconomic status can generally be considered bidirectional. Although financial hardship on families during childhood cancer treatment has been demonstrated, long-term impact has been less studied. Purpose of the study: Study the long-term socioeconomic status evolution of childhood acute lymphoblastic leukemia (cALL) survivors and their family using residential aggregated data from Canadian government administrative databases. Methods: The PETALE cohort (n = 246) includes cALL survivors who were diagnosed and treated at Sainte-Justine University Health Center using DFCI treatment protocols. They participated to an extensive late adverse effects evaluation at 15.5 ± 5.2 years post-diagnosis, at an average age of 21.6 ± 6.3 years old. Patients with refractory disease, relapse or transplant were excluded from the study. Data from 1996, 2001, 2006, 2011 and 2016 Canadian government extensive population census linked to territorial codes (postal codes) were used to extrapolate socioeconomic variables. Centiles for average household income, % of single parent families, % of adults without minimal high school education completion, % of households with less than 20 000 CAD annual income and % of households under the minimum threshold of low income were compared at diagnosis and at PETALE study. Summary of findings: From diagnosis to PETALE Study, most families maintain (54.6%) or improve (33.5%) their socioeconomic status. However, for 1 out of 5 families (21.6%) suffer from a decrease in average household income. Age at diagnosis, participant gender and radiotherapy as part of the treatments do not alter outcomes. Excluding participants > 20 years old at PETALE (i.e. analyzing only families were participants can be assumed to live with their parents) did not change findings. Conclusions: Although ecological fallacy cannot be excluded, the ratio of precarious families does not seem to increase in a sustained way once non-complicated (no relapse, no graft) survivorship is achieved. The universal healthcare coverage and various financial supportive policies (example: financial assistance programs for handicapped children) and other public policies for kids and adolescents in Québec (Canada) could explain these findings. Citation Format: Sophie Marcoux, Marie-France Raynault, Caroline Laverdière, Daniel Sinnett. Long-term socioeconomic status of childhood leukemia survivors and their family in a universal healthcare coverage system: A PETALE study [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D061.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".