Employment risks of all employed working-age cancer survivors after cancer diagnosis: a retrospective cohort analysis of population-based administrative data

Abstract

Abstract PURPOSE : Discussions on the employment status of cancer survivors should be actively examined worldwide as the cancer survival rate increases. This study attempted to examine the status of working status changes after cancer diagnosis to improve the quality of life of cancer survivors.METHODS: We established a nationwide cohort to determine long-term changes of work after cancer diagnosis. All patients aged 19 to 50 years who were newly diagnosed with cancer while working for the previous 3 years were considered as the case group in 2010. Using propensity score matching (PSM), the cases were matched by sex and age at a ratio 1:3 with the control group. The Kaplan-Meier curve and Cox hazard model analyses were performed to determine the occurrence of unemployment and return to work in the case and control groups on a yearly basis.RESULTS: According to the 6-year follow-up after cancer diagnosis, 26.5% of cancer patients and 23.2% of controls had lost their jobs by the end of the follow-up (P<.0001). Meanwhile, 50.5% of cancer patients and 57.4% of control patients returned to work after unemployment (P<.0001). Subsequently, based on the Cox hazard model, the unemployment risk of cancer patients was 1.42 times higher while the proportion of return to work was 1.15 times lower than those of the general population.CONCLUSIONS: Employment is very closely related to the quality of life of cancer survivors. These results highlight that there is a need for a system that can support cancer survivors' work maintenance and return to work after unemployment during the treatment period, and that awareness of this needs to be improved.