Increased Unemployment Found Among Cancer Survivors

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Life can throw you a difficult blow when you are given the diagnosis of cancer. What happens afterwards to employment?

That's the question Angela de Boer, PhD and colleagues chose to look. They wanted to know if there was any change in the risk of unemployment among adult cancer survivors compared with healthy control participants.

They found that it did. Overall more than a third of cancer survivors (33.8%) were found to be unemployed than their healthy counterparts (15.2%).

The researchers did a literature review of studies published from 1966 to June 2008, with no language restrictions. The criteria for inclusion included having a control group of healthy participants, a group of patients diagnosed with cancer working at the time of diagnosis, mean age at diagnosis 18 years or older, and mean average age at time of study 18 to 60 years, and assessment of employment status measured in a follow-up study design.

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The results of their study was published in the Feb 18 issue of the Journal of the American Medical Association. The researchers identified 26 papers describing 36 studies in which employment was either a primary or secondary outcome. The studies were conducted in the U.S., Canada, Europe, Asia, and Australia. There were 20,366 cancer survivors (mean age at diagnosis ranged from 40 to 56) and 157,603 healthy controls.

Cancer survivors are 1.37 times more likely to be unemployed than healthy control participants. The ones with the highest increased risks for unemployment were survivors of breast cancer (1.28), gastrointestinal cancers (1.44), and cancer of the female reproductive organs (1.28).

Survivors of blood cancer, prostate cancers, and testicular cancer did not have a higher unemployment risk. Nor did age have a clear association with unemployment risk.

Seven of the included studies reported unemployment resulting from disability, which was 2.84-fold higher among cancer survivors. This is likely to be at least one mechanism behind the higher unemployment rate among cancer survivors.

The researchers said "Employment outcomes can be improved with innovations in treatment and with clinical and supportive services aimed at better management of symptoms, rehabilitation, and accommodation for disabilities. Moreover, workplace interventions are needed that are aimed at realizing workplace accommodations and paid sick leave during treatment."

Source reference:
De Boer A, et al "Cancer survivors and unemployment: a meta-analysis and meta-regression" JAMA 2009; 301: 753-762.

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