Cancer’s impact on employment and earnings—a population-based study from Norway

Abstract

Introduction Increased attention is being paid to the longterm health and well-being of people living with a history of cancer. Of particular concern is cancer's effect on productivity and work ability, which in turn is important for persons' financial situation, life satisfaction, and social relationships. We explored the extent to which Norwegian cancer survivors stay affiliated to working life compared to the cancer-free population, and quantified cancer-associated earning declines. Methods and results Logistic regression models were estimated to explore the impact of cancer on employment using register data covering the entire Norwegian population in 2001, 567,000 men and 549,300 women 40-59 years old, of whom 34,000 were diagnosed with cancer. These analyses revealed that a cancer diagnosis was strongly associated with not being employed. Log-linear regression models were used to estimate the effect of cancer on labor earnings in 2001 for those employed. Cancer was associated with a 12% decline in earnings overall. Leukemia, lymphomas, lung, brain, bone, colorectal, and head-andneck cancer resulted in the largest reductions in employment and earnings. Earning declines were strongly associated with educational level. In addition, linear regression models were used to estimate differentials in earnings before and after cancer. These results accorded well with those from crosssectional models. Conclusion and implications for cancer survivors Cancer survivors are less likely to be employed than the cancer-free population, and undertake modifications in their employment, e.g. reduce work-hours or hold lower-wage jobs, which result in reduced earnings. A social class gradient is present and must be addressed to accommodate appropriate intervention from welfare societies.

The impact of cancer on spouses' labor earnings

“…Individuals' earnings have, however, been shown to decline with more advanced stage in a previous study using similar data. 16 Statistically, husbands' earnings remain Table 3. y Intercept.…”

“…[11][12][13][14][15] Norwegian women earn on average 30% to 40% less than men, primarily because they work parttime and hold lower level positions, which pay less. 16 This is also the case in the other Nordic countries, Canada, the United States, and the United Kingdom. 10,17 Knowledge of the impact on household earnings of other cancer forms, and perhaps in particular among men, is thus warranted.…”

“…Employment and earnings may be affected more severely for persons in lower social strata, 16,24 and the effects of cancer for people with high versus those with low earnings at the start point (defined as above or below $30,000/year) were therefore estimated. By and large, there were no differences between the groups (data not shown).…”

Cancer rehabilitation indicators for Europe

“…[23][24][25][26][29][30][31]38 To quantify the rehabilitation services used by cancer survivors, cancer registry databases can be linked with those of the structures providing rehabilitation services. For example, a Danish study combined cancer registry and population-based databases to assess hospitalisation for depression as a measure of the psychological burden experienced by cancer patients.…”

“…For example a Dutch study used the ArboNed Occupational Health Service register, containing sickness absence data and medical diagnoses for 1 million Dutch wage earners working in 33,000 companies in various economic sectors, to estimate return to work. [23][24][25][26] Cancer registry data were linked to census data in Finland, 27,28 with the Directorate of Taxes database in Norway, 29 and with the Labour Market Research Database in Denmark. 30,31 However, these methods of study cannot be extended to other countries because the occupational databases exploited by these studies do not exist in most other European countries.…”