Work loss is a potential adverse consequence of cancer. There is limited research on patterns and correlates of paid work after diagnosis of breast cancer, especially among ethnic minorities. Women with non-metastatic breast cancer diagnosed from June 2005 to May 2006 who reported to the Los Angeles County SEER registry were identified and asked to complete the survey after initial treatment (median time from diagnosis = 8.9 months). Latina and African American women were over-sampled. Analyses were restricted to women working at the time of diagnosis, <65 years of age, and who had complete covariate information (N = 589). The outcome of the study was missed paid work (≤1 month, >1 month, stopped all together). Approximately 44, 24, and 32% of women missed ≤1 month, >1 month, or stopped working, respectively. African Americans and Latinas were more likely to stop working when compared with Whites [OR for stop working vs. missed ≤1 month: 3.0, 3.4, (P < 0.001), respectively]. Women receiving mastectomy and those receiving chemotherapy were also more likely to stop working, independent of sociodemographic and treatment factors [ORs for stopped working vs. missed ≤1 month: 4.2, P < 0.001; 7.9, P < 0.001, respectively]. Not having a flexible work schedule available through work was detrimental to working [ORs for stopped working 18.9, P < 0.001 after adjusting for sociodemographic and treatment factors]. Many women stop working altogether after a diagnosis of breast cancer, particularly if they are racial/ethnic minorities, receive chemotherapy, or those who are employed in an unsupportive work settings. Health care providers need to be aware of these adverse consequences of breast cancer diagnosis and initial treatment.
Breast cancer Survivorship Employment Multi-ethnic sample
The study was supported by a grant from the National Cancer Institute (1R01CA109696) to the University of Michigan. Dr. Katz was supported by an Established Investigator Award in Cancer Prevention, Control, Behavioral and Population Sciences from the National Cancer Institute (K05 CA111340). The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Sect. 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35139 awarded to the University of Southern California, contract N01-PC-54404 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement 1U58DP00807-01 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.
The authors thank the Robert Wood Johnson Foundation Health & Society Scholars program for its financial support.
Bowen DJ, Alfano CM, McGregor BA, Kuniyuki A, Bernstein L, Meeske K, Baumgartner KB, Fetherolf J, Reeve BB, Smith AW et al (2007) Possible socioeconomic and ethnic disparities in quality of life in a cohort of breast cancer survivors. Breast Cancer Res Treat 106(1):85–95. doi:10.1007/s10549-006-9479-2CrossRefPubMedGoogle Scholar
Maunsell E, Drolet M, Brisson J, Brisson C, Masse B, Deschenes L (2004) Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst 96(24):1813–1822PubMedCrossRefGoogle Scholar
Bradley CJ, Oberst K, Schenk M (2006) Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psychooncology 15(8):739–747. doi:10.1002/pon.1016CrossRefPubMedGoogle Scholar
Drolet M, Maunsell E, Mondor M, Brisson C, Brisson J, Masse B, Deschenes L (2005) Work absence after breast cancer diagnosis: a population-based study. CMAJ 173(7):765–771. doi:10.1503/cmaj.050178PubMedGoogle Scholar
Lantz PM, Mujahid M, Schwartz K, Janz NK, Fagerlin A, Salem B, Liu L, Deapen D, Katz SJ (2006) The influence of race, ethnicity, and individual socioeconomic factors on breast cancer stage at diagnosis. Am J Public Health 96(12):2173–2178. doi:10.2105/AJPH.2005.072132CrossRefPubMedGoogle Scholar
Hershman D, McBride R, Jacobson JS, Lamerato L, Roberts K, Grann VR, Neugut AI (2005) Racial disparities in treatment and survival among women with early-stage breast cancer. J Clin Oncol 23(27):6639–6646. doi:10.1200/JCO.2005.12.633CrossRefPubMedGoogle Scholar
Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, Clayton S, Williams I, Hills D (2004) Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology 13(6):408–428. doi:10.1002/pon.750CrossRefPubMedGoogle Scholar
Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, Kammeijer M, de Haes JC, Sprangers MA (2003) Cancer, fatigue and the return of patients to work-a prospective cohort study. Eur J Cancer 39(11):1562–1567. doi:10.1016/S0959-8049(03)00364-2CrossRefPubMedGoogle Scholar
Satariano WA, DeLorenze GN (1996) The likelihood of returning to work after breast cancer. Public Health Rep 111(3):236–241PubMedGoogle Scholar