Evaluating satisfactory testing versus transcript grade performance between childhood cancer survivors and healthy controls.

10045 Background: Substantial evidence suggests that survivors of childhood cancer are at increased risk for poor academic performance including receiving poor or failing course grades. There is a paucity of primary data as many contributing studies have relied on parental reporting of school performance. In the state of Florida, a high school student graduating with a standard diploma must successfully pass required biology and math classes. These classes require taking a standardized state-wide test which constitutes 30% of their final course grade. Our team sought to evaluate the concordance of state testing and course grade performance between pediatric brain tumor survivors and matched healthy controls from Florida. Methods: Children who received radiotherapy for intracranial tumors between 2007-2020 who reside in Florida were recruited to this IRB-approved study (N=37). Electronic medical record data was linked to scholastic data provided by the Florida Department of Education. Scholastic data included state testing scores and grade transcripts. For every patient enrolled, the state provided scholastic data matched at a 3:1 ratio (healthy control to survivor), based on age, grade, school district, and eligibility for free or reduced lunch (ERFL). We used Fisher’s Exact test to perform an analysis of association of test scores and course grades between survivors and controls based on state-set pass/fail criteria. Results: Mean age of survivors was 14 years. Fifty-one percent of the survivors were female, 81% white, 8% Black, and 14% Hispanic. The majority received chemotherapy and were ERFL. Approximately 55% of survivors and controls received satisfactory math test scores (Table 1). However, survivors with unsatisfactory math scores were significantly more likely to pass their math class compared to controls (67% vs 51%; P<0.01). For biology, 79% of survivors vs 45% of controls had a satisfactory state test score; however, survivors with unsatisfactory biology scores were significantly more likely to pass their biology class compared to controls (80% vs 73%; P=0.007). Conclusions: We present the first US-based evaluation of primary evidence of childhood cancer survivors’ performance in schools looking at transcripts. Our results demonstrate a discordance that if a survivor or control performed unsatisfactorily on the state test, the survivor was significantly more likely to pass the actual course required for a standard diploma. Further work inviting stakeholder participation, including students, caregivers, and educators is needed. Comparison of standardized math test score and math course grades. State Test Number (%) P-value Unsatisfactory test Control (n=61) Survivor (n=21) Passing course 31 (51) 14 (67) P<0.01 Failing course 30 (49) 7 (33) Satisfactory test Control (n=73) Survivor (n=26) Passing course 71 (97) 26 (96) Failing course 2 (3) 1 (4)