Cancer and its treatment can impact an individual’s ability to work, and employment disruptions can lead to financial hardships. A new study indicates that women who were diagnosed with cancer as adolescents or young adults can be especially vulnerable to these effects. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society (ACS).
For the study, Clare Meernik, MPH, of the University of North Carolina at Chapel Hill, and her colleagues surveyed 1,328 young women in North Carolina and California who were diagnosed with cancer between the ages of 15 to 39 years and were employed at the time of their cancer diagnosis. Surveys were conducted a median of seven years after diagnosis, and questions in the survey assessed the impact of one’s cancer diagnosis and treatment in relation to a broad range of survivorship topics.
Survey results revealed that 32 percent of the women experienced employment disruption, meaning that they stopped working or worked fewer hours following their cancer diagnosis.
Twenty-seven percent of women in the study reported that they had to borrow money, go into debt, or file for bankruptcy because of their cancer treatment; and women with disrupted employment had a 17-percentage point higher prevalence of reporting this than women without disrupted employment.
Also, 50 percent of women in the study reported psychological distress about having to pay large medical bills related to their cancer treatment, and women with disrupted employment had an 8-percentage point higher prevalence of reporting this than women without disrupted employment.
“Our study addresses the burden of employment disruption and financial hardship among young women with cancer–a group who may be at particular risk for poor financial outcomes after cancer given their age and gender,”
“Our findings highlight the need for effective interventions to promote job maintenance and transition back to the workforce after cancer treatment, as well as increased workplace accommodations and benefits, to improve cancer outcomes for young women.”
The importance of addressing adverse financial effects of cancer among adolescents and young adults (AYAs) is paramount as survival improves. In the current study, the authors examined whether cancer‐related employment disruption was associated with financial hardship among female AYA cancer survivors in North Carolina and California.
AYA cancer survivors identified through the North Carolina Central Cancer Registry and the Kaiser Permanente Northern/Southern California tumor registries responded to an online survey. Disrupted employment was defined as reducing hours, taking temporary leave, or stopping work completely because of cancer.
Financial hardship was defined as material conditions or psychological distress related to cancer. Descriptive statistics and chi‐square tests were used to characterize the invited sample and survey respondents. Marginal structural binomial regression models were used to estimate prevalence differences (PDs) and 95% confidence intervals (95% CIs).
Among 1328 women employed at the time of their diagnosis, women were a median age of 34 years at the time of diagnosis and 7 years from diagnosis at the time of the survey and approximately 32% experienced employment disruption.
A substantial percentage reported financial hardship related to material conditions (27%) or psychological distress (50%). In adjusted analyses, women with disrupted employment had a 17% higher burden of material conditions (95% CI, 10%‐23%) and an 8% higher burden of psychological distress (95% CI, 1%‐16%) compared with those without disruption.
Financial hardship related to employment disruption among female AYA cancer survivors can be substantial. Interventions to promote job maintenance and transition back to the workforce after treatment, as well as improved workplace accommodations and benefits, present an opportunity to improve cancer survivorship.