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Unemployment risk of all employed working-age cancer survivors after cancer diagnosis in South Korea: a retrospective cohort analysis of population-based administrative data

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Abstract

Purpose

As the cancer survival rate increases, discussions on the employment status of cancer survivors should be actively carried out worldwide. This study examined patients’ working status changes after cancer diagnosis to provide the basis for cancer survivors’ return to work.

Methods

We established a nationwide cohort to determine long-term work changes 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 of 1:3 with the control group. 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 controls had 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 than that of the general population, while the proportion of those who returned to work was 1.15 times lower.

Conclusion

Employment is very closely related to the quality of life of cancer survivors. These results highlight the need for a system that can support cancer survivors’ work maintenance and return to work after unemployment during the treatment period and the fact that awareness of this must be improved.

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Data availability

The data underlying this article cannot be shared publicly due to privacy laws restricting access to data obtained through the Korean National Health Insurance Service.

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Funding

This research was supported by Chung-Ang University Research Grants in 2022.

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Author notes

  1. Yoon-Joo Choi

    Present address: Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Madu 1-dong, Ilsandong-gu, Goyang, Republic of Korea

Authors and Affiliations

  1. Department of Preventive Medicine, College of Medicine, Chung-Ang University, 84, Heuk-Seok Dong, Dong-Jak Gu, Seoul, Republic of Korea

    Yoon-Joo Choi & Weon-Young Lee

Authors
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Contributions

Yoon-Joo Choi: conceptualization, data curation, formal analysis, investigation, methodology, writing—original draft, and writing—review and editing. Weon-Young Lee: conceptualization, methodology, supervision, and writing—review and editing.

Corresponding author

Correspondence to Weon-Young Lee.

Ethics declarations

Ethics approval and consent to participate

This study performed an analysis of secondary administrative data. Approval was granted by the Ethics Committee of Chung-Ang University (Date: Nov. 24, 2020/No.: 1041078–202011-BRHR-332–01).

Consent for publication

This study analyzed the secondary administrative data of the National Health Insurance Service and did not involve human subjects. The National Health Insurance Service masked personally identifiable information and provided the data to the researchers.

Competing interests

The authors declare no competing interests.

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Choi, YJ., Lee, WY. Unemployment risk of all employed working-age cancer survivors after cancer diagnosis in South Korea: a retrospective cohort analysis of population-based administrative data. Support Care Cancer 31, 135 (2023). https://doi.org/10.1007/s00520-023-07603-y

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