Importance A cancer diagnosis can adversely affect other members of the family, including children. However, little is known about the extent to which history of parental cancer affects children's health. Objective To examine associations of parental cancer with children's school absenteeism, medical care unaffordability, health care use, and mental health. Design, Setting, and Participants This cross-sectional, nationally representative study used data from the 2010-2018 National Health Interview Survey. Statistical analyses were conducted from January to September 2021. Children aged 5 to 17 years living in families with and without a history of parental cancer were identified. Characteristics were grouped into child, parent, and family variables. Sequential multivariable regressions were conducted for unadjusted analyses and with the adjustment of child, parent, and family characteristics to assess associations between parental cancer and child outcomes. Exposures History of parental cancer. Main Outcomes and Measures School absenteeism, medical care unaffordability, health care use, and mental health. Results A total of 1232 children (mean [SD] age, 11.7 [0.13] years; 579 [48.6%] female; weighted N = 846 730; 3.4% of total sample) were living in families with a history of parental cancer. Compared with 33 870 children without a history of parental cancer (mean [SD] age, 10.8 [0.03]; 16 287 [48.8%] female; weighted N = 24 315 452; 96.6% of total sample), children of cancer survivors were more likely to be older, non-Hispanic White, and living in single parent families. Parents with a history of cancer were more likely to be older, to be female, to have more comorbid conditions, and to have public health insurance compared with parents without a history of cancer. History of parental cancer was adversely associated with school absenteeism, medical care unaffordability, health care use, and mental health among children. Sequential adjustment with child, parent, and family characteristics reduced the magnitude of the associations. For example, the odds ratios for school absenteeism of 1 day or more changed from 1.33 (95% CI, 1.11-1.59; P = .002) to 1.12 (95% CI, 0.93-1.34; P = .23) and for any child hospital emergency department visit from 1.56 (95% CI, 1.31-1.86; P < .001) to 1.36 (95 % CI, 1.13-1.64; P < .001). Similar results were found for medical care unaffordability, prescription medication use, and mental health. Conclusions and Relevance In this study, parental cancer was associated with school absenteeism, medical care unaffordability, increased health care use, and poor mental health among children. Health care professionals and policies should consider the unique needs of affected children and develop school-, parent-, and family-directed strategies to ameliorate the negative associations between parental cancer and children's health.

中文翻译：

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父母癌症与学校缺勤、医疗费用负担不起、医疗保健使用和儿童心理健康的关联。


重要性 癌症诊断可能会对家庭其他成员（包括儿童）产生不利影响。然而，人们对父母癌症史对儿童健康影响的程度知之甚少。目的 研究父母癌症与儿童缺勤、医疗负担不起、医疗保健使用和心理健康的关系。设计、设置和参与者 这项具有全国代表性的横断面研究使用了 2010-2018 年全国健康访谈调查的数据。统计分析于 2021 年 1 月至 9 月进行。确定了生活在有或没有父母癌症史的家庭中的 5 至 17 岁儿童。特征分为儿童、父母和家庭变量。对未调整的分析进行序贯多变量回归，并调整儿童、父母和家庭特征，以评估父母癌症与儿童结局之间的关联。暴露情况 父母有癌症史。主要成果和措施 学校缺勤、医疗费用负担不起、医疗保健使用和心理健康。结果 共有 1232 名儿童（平均 [SD] 年龄，11.7 [0.13] 岁；579 名 [48.6%] 女性；加权 N = 846 730；占样本总数的 3.4%）生活在有父母癌症病史的家庭中。与 33 870 名没有父母癌症史的儿童（平均 [SD] 年龄，10.8 [0.03]；16 287 名 [48.8%] 女性；加权 N = 24 315 452；占总样本的 96.6%）相比，癌症幸存者的儿童更有可能是年龄较大的非西班牙裔白人，并且生活在单亲家庭中。与没有癌症病史的父母相比，有癌症病史的父母更有可能年龄较大、为女性、患有更多合并症以及拥有公共医疗保险。 父母癌症史与儿童缺课、医疗费用负担不起、医疗保健使用和心理健康呈负相关。对儿童、父母和家庭特征的顺序调整降低了关联的程度。例如，缺勤 1 天或以上的比值比从 1.33 (95% CI, 1.11-1.59; P = .002) 变为 1.12 (95% CI, 0.93-1.34; P = .23)，并且对于任何儿童医院急诊就诊率从 1.56 (95% CI, 1.31-1.86; P < .001) 降至 1.36 (95% CI, 1.13-1.64; P < .001)。在医疗费用负担不起、处方药使用和心理健康方面也发现了类似的结果。结论和相关性 在这项研究中，父母癌症与儿童缺课、医疗费用负担不起、医疗保健使用增加以及儿童心理健康状况不佳有关。卫生保健专业人员和政策应考虑受影响儿童的独特需求，并制定学校、家长和家庭导向的策略，以改善父母癌症与儿童健康之间的负面关联。