Childhood lymphoma treatment impacts educational outcomes: a registry study from Sweden

J Cancer Surviv. 2023 Aug;17(4):1072-1081. doi: 10.1007/s11764-022-01266-0. Epub 2022 Nov 4.


Purpose: This study aimed to explore educational outcomes in individuals diagnosed with lymphoma in childhood concerning school grade year 9 and attendance in high school and post-compulsory education. Whether sex or age at diagnosis affected the assessed variables was also explored.

Methods: Data from 174 children born 1988-1996 and diagnosed with lymphoma before age 15 were matched with approximately five controls per patient. The mean time since diagnosis to receiving school year 9 grades was 4.88 years for Hodgkin lymphoma (HL) cases (mean age at diagnosis 10.62, 11.76, and 10.05 years for all, girls, and boys, respectively) and 7.79 years for non-Hodgkin lymphoma (NHL) cases (mean age at diagnosis 7.85, 7.87, and 7.84 years for all, girls, and boys, respectively).

Results: We observed statistically significant differences between cases and controls in physical education, both for failing (p = 0.041) and the highest grade (p = 0.015). Compared with controls, HL cases were three times more likely to fail mathematics, and significantly fewer individuals in the whole lymphoma (p = 0.011) and NHL (p = 0.035) groups attended the third year of high school.

Conclusions: Educational outcomes are impacted for children treated for lymphoma, especially in physical education. Since patients with HL are treated without central nervous system-directed therapy, other factors, such as absence from school, may affect school results. Physical late complications in lymphoma survivors warrant special attention.

Implications for cancer survivors: The problems childhood lymphoma survivors face should be known by schools and parents, to enable their management. Children treated for lymphoma should be closely monitored and included in follow-up programs when needed, for example, to support physical activity.

Keywords: Hodgkin lymphoma; Lymphoma; Non-Hodgkin lymphoma; Post-compulsory education; School grades.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cancer Survivors*
  • Child
  • Educational Status
  • Female
  • Hodgkin Disease* / complications
  • Hodgkin Disease* / epidemiology
  • Hodgkin Disease* / therapy
  • Humans
  • Lymphoma, Non-Hodgkin* / epidemiology
  • Lymphoma, Non-Hodgkin* / therapy
  • Male
  • Registries
  • Sweden / epidemiology