Early Survivorship Outcomes in Childhood Cancer Survivors: School Reintegration, Nutritional Status, and Revaccination
Maya Prasad, Niranjan Hegde, Venkata Ramamohan Gollamudi, Savita Goswami, Girish ChinnaswamyABSTRACT
Background
With improving survival in childhood cancer, the focus is shifting toward early survivorship, a critical period for recovery and transition to long‐term care. Data from low‐ and middle‐income countries (LMICs) on outcomes during this phase remain limited.
Methods
We conducted a retrospective study of childhood cancer survivors (aged 5–18 years) enrolled in a dedicated survivorship clinic at a tertiary cancer center in India between 2013 and 2024. Early survivorship was defined as the period within 5 years of diagnosis following treatment completion. Primary outcomes included school rejoining and academic performance; secondary outcomes included nutritional status (underweight and overweight) and revaccination. Multivariable logistic regression was used to identify predictors of outcomes.
Results
A total of 596 survivors were included (mean age 14.3 years; 70% male). School rejoining was high (568/587, 96.8%); however, 50 (8.8%) of those who rejoined subsequently dropped out. Good academic performance was associated with lower odds of school dropout (OR 0.42, 95% CI 0.20–0.88; p = 0.02), while treatment period, socioeconomic status, diagnosis, and maternal education were not significantly associated. Overweight increased significantly across treatment periods (2014–2016: OR 2.17, p = 0.047; 2017–2020: OR 2.63, p = 0.004), with a concurrent decline in underweight. Higher socioeconomic status was associated with lower odds of underweight (OR 0.45, p = 0.001). No independent predictors of revaccination were identified.
Conclusions
Early survivorship in this LMIC cohort is characterized by high school re‐entry but incomplete educational retention, alongside a transition from undernutrition to increasing overweight. These findings highlight the need for structured, multidisciplinary follow‐up models during early survivorship to support sustained educational engagement, nutritional health, and preventive care.