Most studies on survivorship and employment have focused on older patients, have not followed patients more than 2 years after diagnosis, or have been limited to one disease site. To extend knowledge on work patterns of survivors, Moran and colleagues studied prime-age (28-54 years) male and female survivors of all types of cancers. What they found offers valuable information for those who craft public policy: Prime-age cancer survivors have lower em ployment rates and work fewer hours than matched healthy controls.
In a new analysis of data from the Penn State Cancer Survivor Survey, researchers identified 673 cancer survivors who were working at the time of their diagnosis. For analysis, survivors were examined as a whole and also split into 2 groups: those with metastases, recurrences, and/or second primary cancers; and those who remained cancerfree. Employment outcomes were divided into 3 categories: the probability of working; the probability of working full time (35+ hr/week); and the usual number of hours worked per week.
The researchers first determined the employment outcomes for all cancer survivors. The employment rate for women was 6% lower for survivors compared with controls. For men, it was 7.5% lower. The full-time employment rate was reduced 11% among female survivors and 9% among male survivors compared with controls. Female survivors usually worked 4 hours less per week than controls. Male survivors worked 5 hours less.
Separating survivors by recurrence status highlighted the considerable long-term effects of cancer on those experiencing metastases, recurrences, and/or second primary cancers. Among those “with a new cancer,” the employment rate for female survivors was 18% lower than controls, their full-time employment rate was 24.5% lower, and their number of usual hours worked per week was lowered by 9 hours. For male survivors with a new cancer, the employment rate was 29% lower than controls, the full-time employment rate was 25% lower, and the number of hours worked per week was reduced by 15 hours.
Survivors with no new cancer still experienced reduced employment outcomes compared with controls. Employment rates were 3.7% and 3.6% lower than controls for female and male “cancerfree” survivors, respectively. Full-time employment rates were 8.5% and 6% lower, respectively. And both female and male survivors worked 3 hours less per week than controls.
The reasons for these findings are not yet clear and likely vary. “In some cases, survivors suffer from ongoing disabilities, related either to their cancer or its treatment, which prevents them from working full time or from working at all. In other cases, survivors may face employment discrimination due to concerns about productivity, absenteeism, or insurance costs. Finally, some survivors may quit working or reduce their hours voluntarily to spend more time with family,” said John Moran, PhD, assistant professor of health policy and administration at Penn State University, noting that these conjectures are based on anecdotal impressions and will need further study.