194424 Long term employment effects of surviving cancer

Wednesday, November 11, 2009: 8:30 AM

John R. Moran, PhD , Health Policy and Administration, The Pennsylvania State University, University Park, PA
Pamela Farley Short, PhD , Health Policy and Administration, The Pennsylvania State University, University Park, PA
Christopher S. Hollenbeak, PhD , Surgery and Public Health Sciences, Penn State College of Medicine, Hershey, PA
Research objective

As survival rates have dramatically improved, cancer is being transformed from a fatal disease into a chronic illness. Our research objective was to examine one important aspect of the quality of life of cancer survivors; namely, the long-term effects of cancer on employment. Because earlier research on this question has focused more on workers diagnosed at older ages, we were particularly interested in employment effects for younger workers and in comparing effects for younger and older workers.

Study design

Four telephone interviews were conducted annually with 1173 adult cancer survivors, who were 25 to 62 years of age and working when diagnosed with cancer in 1997-1999. A non-cancer comparison group of 4723 similarly-aged adults working in June 1998 was drawn from the Panel Study of Income Dynamics (PSID). Probit/Tobit regression and propensity score matching were used to compare employment between the two groups in 2002, 3-5 years after diagnosis for the cancer survivors. Three measures of employment were considered: the percent working, the percent working full-time (35+ hours per week), and usual hours per week (including non-workers). The regression and matching estimators controlled for other factors likely to affect employment, including socio-demographic characteristics, baseline job characteristics, and the presence of other health conditions.

Population studied

The cancer survivors were identified from the cancer registries of four medical centers in Pennsylvania and Maryland. Included were survivors of all cancer types, except for common skin cancers and Stage 4 cancers where extended survival was unlikely. The PSID comparison group was nationally representative of adults in the U.S. population, excluding cancer survivors. Separate comparisons were made for four groups: older males (55-65 years of age in 2002), younger males (27-54 years of age in 2002), older females, and younger females.

Principal findings

All measures of employment were significantly lower for cancer survivors in each demographic group, except for the employment rate among older women where the difference was smallest and less precisely measured. There were no significant differences in employment effects across demographic groups. Average employment effects ranged from 4.4 to 9.9 percentage points for any employment, 9.8 to 17.3 percentage points for full-time employment, and 4.6 to 6.2 hours per week.


Even over the long-term, cancer survivors work less than other adults. Effects on the employment of workers who are nearing retirement are not very different from effects on younger workers.

Learning Objectives:
1. Compare the employment outcomes of cancer survivors to those of workers without a history of cancer. 2. Describe how the effect of survivorship on employment varies by age and gender. 3. Assess the role of cancer recurrence in determining employment outcomes among survivors.

Keywords: Cancer, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services researcher / economist who has done prior work on cancer survivorship. This work has been published in health policy journals such as Health Services Research and Inquiry. The paper I have submitted is part of a larger project funded by the American Cancer Society.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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