Use of patient-reported controls for secular trends to study disparities in cancer-related job loss

Abstract

Purpose

Racial/ethnic minorities experience greater job loss than whites during periods of economic downturn and after a cancer diagnosis. Therefore, race/ethnicity-matched controls are needed to distinguish the impact of illness on job loss from secular trends

Methods

Surveys were administered during and 4-month post-completion of breast cancer treatment. Patients were pre-diagnosis employed women aged 18–64, undergoing treatment for stage I–III breast cancers, who spoke English, Chinese, Korean, or Spanish. Each patient was asked to: (1) nominate peers who were surveyed in a corresponding timeframe (active controls), (2) report a friend’s work status at baseline and follow-up (passive controls). Both types of controls were healthy, employed at baseline, and shared the nominating patient’s race/ethnicity, language, and age. The primary outcome was number of evaluable patient-control pairs by type of control. A patient-control pair was evaluable if work status at follow-up was reported for both individuals.

Results

Of the 180 patients, 25% had evaluable active controls (45 patient-control pairs); 84% had evaluable passive controls (151 patient-control pairs). Although patients with controls differed from those without controls under each strategy, there was no difference in the percentage of controls who were working at follow-up (96% of active controls; 91% of passive controls). However, only 65% of patients were working at follow-up.

Conclusions

The majority of patients had evaluable passive controls. There was no significant difference in outcome between controls ascertained through either method

Implications for Cancer Survivors

Passive controls are a low-cost, higher-yield option to control for secular trends in racially/ethnically diverse samples.

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Acknowledgments

Contributors: Karen Eisenberg, Dyanna Soto, Zhenlan Wang

Funding

This work was supported by the American Cancer Society (Grant No. MRSGT-11-002-01-CPHPS), the American Society of Clinical Oncology (a career development award), Supported by the Chanel Endowment for Survivorship Research at Memorial Sloan Kettering Cancer Center, and the Department of Health and Human Services (U54 CA137788), The CCNY/MSKCC Partnership for Cancer Research Training and Community Outreach; P30 CA 008748 Cancer Center Support Grant to Memorial Sloan Kettering Cancer Center), and National Institutes of Health/National Cancer Institute (awarded as R01 CA214785 and subsequently converted to an R37 CA214785 (MERIT Award)).

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Correspondence to Victoria S. Blinder.

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Conflict of interest

Victoria S. Blinder is a consultant for Workplace Transitions for People Touched by Cancer, which provides an online publicly available tool kit for employers seeking to accommodate cancer patients and their caregivers at work. Funding for the tool kit’s development and evaluation (including salary support for Blinder) has been provided by the Anthem Foundation and Pfizer Oncology. All other authors declare no conflicts of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Boards at all recruitment sites.

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data.

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Blinder, V.S., Eberle, C.E., Tran, C. et al. Use of patient-reported controls for secular trends to study disparities in cancer-related job loss. J Cancer Surviv (2020). https://doi.org/10.1007/s11764-020-00960-1

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Keywords

  • Disparities
  • Health economics
  • Health services research
  • Immigrant health
  • Measurement