School Bullying of Childhood Leukemia Survivors

Background: With improving childhood cancer cure rates, there is a growing focus on the long-term health and well-being of survivors. School reintegration is crucial for their rehabilitation and psychosocial adaptation, yet little is known about school violence and bullying faced by cancer survivors upon their return. Aims: This study aimed to investigate the prevalence and forms of school bullying against childhood acute lymphoblastic leukemia (ALL) survivors, identifying risk and protective factors. Methods: ALL survivors aged 6–18 years were assessed through interviews and questionnaires. A paired comparison group of healthy students was recruited from their classrooms. Results: The study included 70 students from grades 6–12 (mean age 14.9 ± 1.82 years), comprising 35 ALL survivors and a paired comparison group. ALL survivors endured more physical (M = 1.64, SD = 1.00) and relational bullying (M = 1.50, SD = 1.04) than their healthy classmates (M = 0.90, SD = 0.58; M = 0.90, SD = 0.51 respectively), while facing similar verbal bullying levels (M = 1.71, SD = 0.99 vs. M = 1.38, SD = 0.69). However, survivors reported less cyberbullying (M = 0.45, SD = 0.36) and severe bullying (M = 0.41, SD = 0.05) than their healthy classmates (M = 1.49, SD = 0.48; M = 0.66, SD = 0.53 respectively). Survivors who returned to a different school cohort post-remission faced higher bullying risks than those who rejoined their original cohort (−0.79 < β < −0.92; p < 0.001). Physical disfigurements following cancer treatment were a risk factor for victimization only among those who returned to their original cohort. Conclusions: The findings highlight the unique challenges faced by childhood leukemia survivors in school reintegration after cancer therapy, emphasizing the significant effect of the school cohort environment on their bullying experiences.