Ensuring Employment After Cancer Diagnosis: Are Workable Solutions Obvious?

Shih, Ya Chen Tina; Yabroff, K. Robin

doi:10.1200/jco.22.00929

Cited by 4 publications

(9 citation statements)

References 13 publications

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“…29 Our analysis identified similar organ system associations with employment transitions but also found an increased risk with higher numbers and grades of conditions, and in particular with the new onset of conditions from the time of the baseline of the workforce in just over 10 years, intervention strategies are needed to prevent and mitigate chronic health conditions and their impact on employment in this population. 33,34…”

Section: Discussionmentioning

confidence: 99%

Chronic Health Conditions and Longitudinal Employment in Survivors of Childhood Cancer

Bhatt,

Goodman,

Leisenring

et al. 2024

JAMA Netw Open

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ImportanceEmployment is an important factor in quality of life and provides social and economic support. Longitudinal data on employment and associations with chronic health conditions for adult survivors of childhood cancer are lacking.ObjectiveTo evaluate longitudinal trends in employment among survivors of childhood cancer.Design, Setting, and ParticipantsRetrospective cohort study of 5-year cancer survivors diagnosed at age 20 years or younger between 1970 and 1986 enrolled in the multi-institutional Childhood Cancer Survivor Study (CCSS). Sex-stratified employment status at baseline (2002 to 2004) and follow-up (2014 to 2016) was compared with general population rates from the Behavioral Risk Factor Surveillance System cohort. Data were analyzed from July 2021 to June 2022.ExposuresCancer therapy and preexisting and newly developed chronic health conditions.Main Outcomes and MeasuresStandardized prevalence ratios of employment (full-time or part-time, health-related unemployment, unemployed, not in labor force) among adult (aged ≥25 years) survivors between baseline and follow-up compared with the general population. Longitudinal assessment of negative employment transitions (full-time to part-time or unemployed at follow-up).ResultsFemale participants (3076 participants at baseline; 2852 at follow-up) were a median (range) age of 33 (25-53) years at baseline and 42 (27-65) years at follow-up; male participants (3196 participants at baseline; 2557 at follow-up) were 33 (25-54) and 43 (28-64) years, respectively. The prevalence of full-time or part-time employment at baseline and follow-up was 2215 of 3076 (71.3%) and 1933 of 2852 (64.8%) for female participants and 2753 of 3196 (85.3%) and 2079 of 2557 (77.3%) for male participants, respectively, with declining standardized prevalence ratios over time (female participant baseline, 1.01; 95% CI, 0.98-1.03; follow-up, 0.94; 95% CI, 0.90-0.98; P &lt; .001; male participant baseline, 0.96; 95% CI, 0.94-0.97; follow-up, 0.92; 95% CI, 0.89-0.95; P = .02). While the prevalence of health-related unemployment increased (female participants, 11.6% to 17.2%; male participants, 8.1% to 17.1%), the standardized prevalence ratio remained higher than the general population and declined over time (female participant baseline, 3.78; 95% CI, 3.37-4.23; follow-up, 2.23; 95% CI, 1.97-2.51; P &lt; .001; male participant baseline, 3.12; 95% CI, 2.71-3.60; follow-up, 2.61; 95% CI, 2.24-3.03; P = .002). Among survivors employed full-time at baseline (1488 female participants; 1933 male participants), 285 female participants (19.2%) and 248 male participants (12.8%) experienced a negative employment transition (median [range] follow-up, 11.5 [9.4-13.8] years). Higher numbers and grades of chronic health conditions were significantly associated with these transitions.Conclusions and RelevanceIn this retrospective analysis of adult survivors of childhood cancer, significant declines in employment and increases in health-related unemployment among cancer survivors compared with the general population were identified. A substantial portion of survivors in the midcareer age range fell out of the workforce. Awareness among clinicians, caregivers, and employers may facilitate clinical counseling and occupational provisions for supportive work accommodations.

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Section: Discussionmentioning

confidence: 99%

Chronic Health Conditions and Longitudinal Employment in Survivors of Childhood Cancer

Bhatt,

Goodman,

Leisenring

et al. 2024

JAMA Netw Open

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“…Opportunities to support working caregivers exist at multiple levels, including employer, policy, and health system efforts. Recommendations for supporting caregiver employment outcomes dovetail with those supporting employment for cancer patients themselves, such as: 1) increasing the prevalence and awareness of workplace accommodations; 2) empowering patients and caregivers to communicate with both their employers and the medical team about employment‐related issues; 3) connecting families with appropriate resources; and 4) maximizing paid sick and family leave 18,26 …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, few health care systems are able to identify caregivers in the electronic medical record 35 . Strategic implementation of new fields in the electronic health record that capture employment characteristics has the potential to spur conversations around the ways that cancer can impact employment and financial well‐being for both patients and caregivers 26,36 . Processes that support the standardization of these efforts, that reflect a focus on family‐centered care, will be a key step in reducing adverse employment outcomes, financial toxicity, and particularly inequities in financial and well‐being outcomes for patients and families.…”

Section: Discussionmentioning

confidence: 99%

“…Fully appropriate resources; and 4) maximizing paid sick and family leave. 18,26 At the employer level, there are a number of policies and practices that support working caregivers, including flexible work arrangements, employee assistance programs that provide psychological support and referrals, specialized caregiving services (such as case management or back-up care) and paid family leave. 10,[27][28][29] Financial, health care, and technology sectors appear to be most likely and the service sector least likely to offer such accommodations, 25 despite evidence that paid leave is associated with better economic and health outcomes for service sector employees.…”

Section: Age-adjustedmentioning

confidence: 99%

“…35 Strategic implementation of new fields in the electronic health record that capture employment characteristics has the potential to spur conversations around the ways that cancer can impact employment and financial well-being for both patients and caregivers. 26,36 Processes that support the standardization of these F I G U R E 2 Probability of workdays lost to care for others by gender, spouse cancer treatment status, and employment characteristics. Presented as predicted probabilities adjusting for age (continuous, centered at the grand mean).…”

Section: Age-adjustedmentioning

confidence: 99%

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Employment and workdays lost among spouses of cancer survivors: Intersection with gender across cancer treatment status

Litzelman,

Han,

Zhao

et al. 2023

Cancer

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BackgroundCancer patients and survivors have high care needs, often provided by a spouse or partner. The purpose of this study was to elucidate how employment and work loss patterns differed across cancer history/treatment status and gender.MethodsUsing nationally representative data from the Medical Expenditure Panel Survey (2011, 2016, and 2017), the authors linked data across married participants and categorized them by spouses’ cancer treatment status (no cancer history, on treatment for cancer, off treatment for cancer). Multivariable logistic and zero‐inflated negative binomial regressions were used to assess the associations among cancer history/treatment status, gender, and employment outcomes (employment status and workdays lost to care for self or others).ResultsFor men, employment did not differ significantly by cancer history/treatment status (on treatment: odds ratio [OR], 0.58; 95% confidence interval [CI], 0.33–1.02, off treatment: OR, 0.84; 95% CI, 0.62–1.14 vs. no cancer history). For women, employment was not significantly different when the spouse was on treatment for cancer compared to no cancer history (OR, 0.78; 95% CI, 0.33–1.86]) but was significantly increased for women whose spouse was off treatment (OR, 1.39; 95% CI, 1.05–1.84). Among employed participants, women whose spouse was on cancer treatment were nine times more likely to take days off work to provide care (OR, 9.52; 95% CI, 3.94–23.03) and took more than three times as many days off to care for others (OR, 3.21; 95% CI, 2.07–4.97) as men whose spouse had no cancer history.ConclusionsWives of cancer survivors are at increased risk of work loss, with implications for their financial and psychological well‐being. Employers, policymakers, and clinicians have opportunities to support working caregivers.

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Strategies to support cancer survivors at work: content analysis of cancer survivor, healthcare provider, and employer perspectives

Forcino,

Morrissette,

Stevens

et al. 2024

J Cancer Surviv

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Ensuring Employment After Cancer Diagnosis: Are Workable Solutions Obvious?

Abstract: Author affiliations and support information (if applicable) appear at the end of this article.

Cited by 4 publications

References 13 publications

Chronic Health Conditions and Longitudinal Employment in Survivors of Childhood Cancer

Chronic Health Conditions and Longitudinal Employment in Survivors of Childhood Cancer

Employment and workdays lost among spouses of cancer survivors: Intersection with gender across cancer treatment status

Strategies to support cancer survivors at work: content analysis of cancer survivor, healthcare provider, and employer perspectives

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