The Childhood, Adolescent, and Young Adult Cancer Survivors Research Program (CAYACS) has been established in the province of British Columbia (BC), Canada, to carry out research into late effects and survivor care in multiple domains, and to inform policy and practice.

9555 Background: Long-term survivors of childhood and adolescent cancers are at risk for late mortality and morbidity. Using database linkages we assessed the extent of these issues and health care utilization in a population based cohort in British Columbia. Methods: Retrospective cohorts of 3,483 survivors (>5 years from diagnosis), and representative comparison groups, have been identified from population-based registries. Linkages were made with administrative databases of risk factors and outcomes. Late mortality, second cancers, late morbidity, health services utilization, continuity of care, and educational outcomes, among those diagnosed before age 20 between 1970 to 1995, and followed to 2000, have been examined. Results: Survivors experienced a 9-fold increase in mortality (SMR 9.1, 95% CI 7.8–10.5). Risk of developing a second cancer was 5 times higher than in the general population (SIR 5.0, 95% CI 3.8–6.5). Survivors had three times the odds of being hospitalized (OR 2.97, 95% CI 2.56–3.45) in a three-year period (1998–2000). Survivors were significantly more likely than the population group to consult any physician (excluding oncologists) (adj. RR 1.61, 95% CI 1.51–1.70). Survivors were found to experience a drop in continuity of primary health care as they aged and transitioned into adult care. Survivors were significantly more likely than their peers to receive special education (32.5% vs. 14.1%), most significantly among CNS survivors who received cranial irradiation. Conclusions: Survivors of childhood and adolescent cancers have severe long term health issues and increased health care utilization. Survivors of CNS tumors were at highest risk of poor health and educational outcomes measured. Data linkage provides useful insights for survivorship research. No significant financial relationships to disclose.

BACKGROUND: Increased survival of patients with childhood cancer has resulted in a growing population of survivors within the education system, many of whom may experience educational difficulties. The current study provides a comprehensive assessment of survivors' educational achievements. METHODS: Seven hundred eighty-two childhood cancer survivors from the British Columbia (BC) Cancer Registry who attended BC schools from 1995 to 2004, were compared with a randomly selected comparison group of 8386 BC school children. Grade repetition, standard Foundation Skills Assessments (FSA), graduation-year examinations, and special education designations were compared, and factors that affected survivors' educational outcomes were identified. RESULTS: Survivors of central nervous system tumors had statistically significant FSA deficits in numeracy and reading (adjusted odds ratios from 0.2 to 0.5 in various grades); leukemia survivors also had lower FSA scores, although most differences were not statistically significant. Other survivors demonstrated no significant differences in FSA scores. Survivors were significantly more likely than controls to receive special education (32.5% vs 14.1%). Females and those who had received radiation treatment (particularly cranial radiation) were at increased risk for poor educational outcomes. CONCLUSIONS: The current results have implications for the management of survivors in the education system to maximize their educational experience. Cancer 2009;115:2234-45. (C) 2009 American Cancer Society.

In this article, labour market outcomes of British Columbia graduates from liberal arts and applied education programs are investigated by examining the 1996 cohort of baccalaureate graduates one year and five years after graduation. We argue that the individual return to education has to be analyzed from a multi-dimensional perspective, in relation to initial educational and career goals of graduates who have anticipated both intellectual challenges and economic rewards from their investment in education. The study reveals differences in outcomes (i.e., employment, earnings) by program type, gender and age. Our main conclusion is that graduates from applied education programs experience a more rapid integration into the labour market as compared to graduates from liberal arts education programs. Although earning differences by program type and age either decrease or even disappear over time, earning differences by gender are enhanced five years after graduation. Also, we conclude that graduates from applied education programs establish and accomplish more focused educational and career goals, while graduates from liberal education programs establish broader educational and career goals.