Reduced employment and financial hardship among middle‐aged individuals with colorectal cancer

Abstract

Financial hardship may affect up to 30% of cancer survivors, however, little research has addressed the effect of employment change on financial hardship. This study compared the self-reported financial hardship of middle-aged (45-64 years) colorectal cancer survivors (n = 187) at 6 and 12 months following diagnosis with that of a matched general population group (n = 355). Colorectal cancer survivors were recruited through the Queensland Cancer Registry, Australia; data from the Household Income and Labour Dynamics in Australia (HILDA) Survey were used for the general population group. Pearson chi-square tests were used to assess the differences in proportions between the two groups and McNemar tests to assess differences across time among the same group. Generalised linear modelling was performed to produce prevalence ratios. A higher proportion of workers with colorectal cancer reported financial strain (money shortage for living essentials) at 6 months (15%) but eased and was comparable to the comparison group at 12 months (7%). Middle-aged working cancer survivors who ceased or reduced work were more likely to report not being financially comfortable, compared with those who had continued work (adjusted prevalence ratio 1.66, 95%CI: 1.12, 2.44) at 12 months. Health professionals, employers and government services should address the impact of impaired employment on financial hardship among cancer survivors.

Age-specific health-related quality of life in long-term and very long-term colorectal cancer survivors versus population controls – a population-based study

“…In stratified analyses, CRC-LTS in the <65 year age group reported greater financial difficulties which were of small clinical relevance. This could be due to changes in employment as a study of middle-aged CRC survivors showed that reduced or ceased employment contributes to financial vulnerability within a year after diagnosis [32]. It is intriguing that we find CRC survivors report significant financial problems, albeit of small clinical relevance, as Germany has a universal access health care system.…”

Financial toxicity and employment status in cancer survivors. A systematic literature review

“…The search identified 3945 unique citations (PubMed (n = 2891), Web of Science (n = 775), CINAHL (n = 180), and PsycINFO (n = 99)) with 31 studies meeting our inclusion criteria (Table 2) [8, 18, 20, 21, 26, 29-33, 36-38, 40, 41, 43], 5 studies focused on breast cancer [19,25,28,35,42,44] and 2 included multiple myeloma patients [22,45]. The other studies focused on bladder [39], prostate [23], colorectal [24], lung [27], head and neck cancer [34], and bone marrow transplant patients [17]. Time since diagnosis ranged from a mean of 8.4 months before diagnosis [27] until a mean of 13 years after diagnosis [19] often had a broad range, and sometimes was not reported at all.…”

“…Sample sizes ranged from 129 [19] to 16,771 [30] participants. Eight studies had a longitudinal design [19,24,25,27,32,35,42,44]. Both definitions and measures of financial toxicity varied strongly, and most measures were not validated making comparison between studies difficult.…”

Impact of physical and psychosocial dysfunction on return to work in survivors of oral cavity cancer

“…Second, we did not consider the support of employer, coworkers, and the work environment, nor did we consider the job requirements for returning to work . Third, factors such as economic status and social welfare allowances, which may impact the desire to return to work, were not consider in this study . Our study also did not consider personal financial resources or living expenses, which would be an important topic for future studies.…”