Abstract
Purpose
The purposes of this study were to compare the working situation of cancer survivors and the general (cancer-free) population and investigate characteristics associated with the increased likelihood of unemployment between the two groups.
Methods
We selected 1927 cancer survivors from the 2008 Korean Community Health Survey data less than 65 years of age and used propensity score matching to randomly select 1924 individuals from the general population who closely resembled the cancer survivors.
Results
Compared to the general population, cancer survivors were less likely to be engaged in paid work, particularly as permanent workers, and were more likely to work regular hours. Additionally, they tended to do less work that involved lifting or moving heavy objects and uncomfortable postures and were more willing to express their emotions. An increased probability of unemployment among cancer survivors was associated with being over 50 years old, being female, having a lower monthly income, having multiple comorbidities, belonging to a nuclear family, being a National Basic Livelihood Act beneficiary, and having a recent diagnosis.
Conclusion
Cancer survivors may want to pursue flexible occupations and improve their working situation. Further, they perceive their workplace more positively compared to the general population.
Implications for cancer survivors
Respecting the cancer survivor’s choice to find flexible working conditions that suit their health needs and status, health-care providers involved in managing work-related issues among cancer survivors should be aware of the interaction between work-related concerns and post-cancer disease management.
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References
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96. doi:10.3322/ca.2007.0010.
Bouknight RR, Bradley CJ, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24(3):345–53. doi:10.1200/jco.2004.00.4929.
Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care. 2007;16(1):17–25. doi:10.1111/j.1365-2354.2007.00729.x.
Main DS, Nowels CT, Cavender TA, Etschmaier M, Steiner JF. A qualitative study of work and work return in cancer survivors. Psycho-Oncology. 2005;14(11):992–1004. doi:10.1002/pon.913.
Hoffman B. Cancer survivors at work: a generation of progress. CA Cancer J Clin. 2005;55(5):271–80.
Balak F, Roelen CA, Koopmans PC, Ten Berge EE, Groothoff JW. Return to work after early-stage breast cancer: a cohort study into the effects of treatment and cancer-related symptoms. J Occup Rehabil. 2008;18(3):267–72. doi:10.1007/s10926-008-9146-z.
Blinder V, Patil S, Eberle C, Griggs J, Maly RC. Early predictors of not returning to work in low-income breast cancer survivors: a 5-year longitudinal study. Breast Cancer Res Treat. 2013;140(2):407–16. doi:10.1007/s10549-013-2625-8.
de Boer AG, Verbeek JH, Spelten ER, Uitterhoeve AL, Ansink AC, de Reijke TM, et al. Work ability and return-to-work in cancer patients. Br J Cancer. 2008;98(8):1342–7. doi:10.1038/sj.bjc.6604302.
Lee MK, Lee KM, Bae JM, Kim S, Kim YW, Ryu KW, et al. Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer. 2008;98(4):708–15. doi:10.1038/sj.bjc.6604236.
Noeres D, Park-Simon TW, Grabow J, Sperlich S, Koch-Giesselmann H, Jaunzeme J, et al. Return to work after treatment for primary breast cancer over a 6-year period: results from a prospective study comparing patients with the general population. Support Care Cancer Off J Multinatl Assoc Suppor Care Cancer. 2013;21(7):1901–9. doi:10.1007/s00520-013-1739-1.
Pryce J, Munir F, Haslam C. Cancer survivorship and work: symptoms, supervisor response, co-worker disclosure and work adjustment. J Occup Rehabil. 2007;17(1):83–92. doi:10.1007/s10926-006-9040-5.
Bloom JR, Stewart SL, Chang S, Banks PJ. Then and now: quality of life of young breast cancer survivors. Psycho-Oncology. 2004;13(3):147–60. doi:10.1002/pon.794.
Drolet M, Maunsell E, Brisson J, Brisson C, Masse B, Deschenes L. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(33):8305–12. doi:10.1200/jco.2005.09.500.
Maunsell E, Drolet M, Brisson J, Brisson C, Masse B, Deschenes L. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96(24):1813–22. doi:10.1093/jnci/djh335.
Short PF, Vasey JJ, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Cancer. 2005;103(6):1292–301. doi:10.1002/cncr.20912.
Bushunow PW, Sun Y, Raubertas RF, Rosenthal S. Adjuvant chemotherapy does not affect employment in patients with early-stage breast cancer. J Gen Intern Med. 1995;10(2):73–6.
de Boer AG, Taskila T, Ojajarvi A, van Dijk FJ, Verbeek JH. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA J Am Med Assoc. 2009;301(7):753–62. doi:10.1001/jama.2009.187.
Orentlicher D. Destructuring disability: rationing of health care and unfair discrimination against the sick. Harvard civil rights-civil liberties law review (CR-CL). 1996;31(1).
Feldman FL. Work and cancer health histories: a study of the experiences of recovered blue-collar workers. California Division, American Cancer Society; 1978
Feldman FL. Inquiries into work experiences of recovered cancer patients: the California experience. Work and illness: the cancer patient New York: Praeger. 1989:25–47.
Feldman FL, McBroom E. Work and cancer health histories: a study of the experiences of recovered patients. California Division, American Cancer Society; 1976.
Feldman FL, McBroom E, Roberts RW. Work and cancer health histories: Work expectations and experiences of youth with cancer histories (ages 13–23). California Division, American Cancer Society; 1980.
Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A. Work problems after breast cancer: an exploratory qualitative study. Psycho-Oncology. 1999;8(6):467–73.
Bradley CJ, Neumark D, Luo Z, Schenk M. Employment and cancer: findings from a longitudinal study of breast and prostate cancer survivors. Cancer Investig. 2007;25(1):47–54. doi:10.1080/07357900601130664.
Earle CC, Chretien Y, Morris C, Ayanian JZ, Keating NL, Polgreen LA, et al. Employment among survivors of lung cancer and colorectal cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2010;28(10):1700–5. doi:10.1200/jco.2009.24.7411.
Bradley CJ, Bednarek HL. Employment patterns of long-term cancer survivors. Psycho-Oncology. 2002;11(3):188–98. doi:10.1002/pon.544.
Kim YT, Choi BY, Lee KO, Kim H, Chun JH, Kim SY, et al. Overview of Korean community health survey. J Korean Med Assoc. 2012;55(1):74–83.
Rim H, Kim H, Lee K, Chang S, Hovell MF, Kim Y-T, et al. Validity of self-reported healthcare utilization data in the Community Health Survey in Korea. J Korean Med Sci. 2011;26(11):1409–14.
Amir Z, Moran T, Walsh L, Iddenden R, Luker K. Return to paid work after cancer: a British experience. J Cancer Survivorship Res Pract. 2007;1(2):129–36. doi:10.1007/s11764-007-0021-2.
Ehrmann-Feldmann D, Spitzer WO, Del Greco L, Desmeules L. Perceived discrimination against cured cancer patients in the work force. CMAJ Can Med Assoc J J de l’Assoc Med Can. 1987;136(7):719–23.
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41–55.
Peterson PN, Varosy PD, Heidenreich PA, Wang Y, Dewland TA, Curtis JP, et al. Association of single- vs dual-chamber ICDs with mortality, readmissions, and complications among patients receiving an ICD for primary prevention. JAMA J Am Med Assoc. 2013;309(19):2025–34. doi:10.1001/jama.2013.4982.
Bradley CJ, Bednarek HL, Neumark D. Breast cancer and women’s labor supply. Health Serv Res. 2002;37(5):1309–28.
Taskila T, Martikainen R, Hietanen P, Lindbohm ML. Comparative study of work ability between cancer survivors and their referents. Eur J Cancer (Oxford, England: 1990). 2007;43(5):914–20. doi:10.1016/j.ejca.2007.01.012.
Thornton AA. Perceiving benefits in the cancer experience. J Clin Psychol Med Settings. 2002;9(2):153–65.
Moskowitz MC, Todd BL, Chen R, Feuerstein M. Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors. J Cancer Survivorship Res Pract. 2014;8(2):173–82. doi:10.1007/s11764-013-0340-4.
Paraponaris A, Teyssier LS, Ventelou B. Job tenure and self-reported workplace discrimination for cancer survivors 2 years after diagnosis: does employment legislation matter? Health Policy (Amsterdam, Netherlands). 2010;98(2–3):144–55. doi:10.1016/j.healthpol.2010.06.013.
Drolet M, Maunsell E, Mondor M, Brisson C, Brisson J, Masse B, et al. Work absence after breast cancer diagnosis: a population-based study. CMAJ Can Med Assoc J J de l’Assoc Med Can. 2005;173(7):765–71. doi:10.1503/cmaj.050178.
Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96(17):1322–30. doi:10.1093/jnci/djh255.
Greenwald HP, Dirks SJ, Borgatta EF, McCorkle R, Nevitt MC, Yelin EH. Work disability among cancer patients. Soc Sci Med. 1989;29(11):1253–9.
Fantoni SQ, Peugniez C, Duhamel A, Skrzypczak J, Frimat P, Leroyer A. Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil. 2010;20(1):49–58. doi:10.1007/s10926-009-9215-y.
Johnsson A, Fornander T, Rutqvist LE, Vaez M, Alexanderson K, Olsson M. Predictors of return to work ten months after primary breast cancer surgery. Acta Oncol (Stockholm, Sweden). 2009;48(1):93–8. doi:10.1080/02841860802477899.
Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, et al. Cancer, fatigue and the return of patients to work-a prospective cohort study. Eur J Cancer (Oxford, England: 1990). 2003;39(11):1562–7.
Mols F, Thong MS, Vreugdenhil G, van de Poll-Franse LV. Long-term cancer survivors experience work changes after diagnosis: results of a population-based study. Psycho-Oncology. 2009;18(12):1252–60. doi:10.1002/pon.1522.
Chan F, Strauser D, da Silva CE, Xi Zheng L, Chan JY, Feuerstein M. State vocational services and employment in cancer survivors. J Cancer Survivorship Res Pract. 2008;2(3):169–78. doi:10.1007/s11764-008-0057-y.
Sharp L, Timmons A. Social welfare and legal constraints associated with work among breast and prostate cancer survivors: experiences from Ireland. J Cancer Survivorship Res Pract. 2011;5(4):382–94. doi:10.1007/s11764-011-0183-9.
Chirikos TN, Russell-Jacobs A, Jacobsen PB. Functional impairment and the economic consequences of female breast cancer. Women Health. 2002;36(1):1–20. doi:10.1300/J013v36n01_01.
Acknowledgements
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2014R1A1A1006809).
Conflict of interest
Myung Kyung Lee and Young Ho Yun declare that they have no conflict of interest.
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Lee, M.K., Yun, Y.H. Working situation of cancer survivors versus the general population. J Cancer Surviv 9, 349–360 (2015). https://doi.org/10.1007/s11764-014-0418-7
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DOI: https://doi.org/10.1007/s11764-014-0418-7