Employment After Breast Cancer Diagnosis and Treatment Among Women in the Sister and the Two Sister Studies

Peipins, Lucy A.; Dasari, Sabitha; Rodriguez, Juan L.; White, Mary C.; Hodgson, M. Elizabeth; Sandler, Dale P.

doi:10.1007/s10926-020-09951-6

Cited by 3 publications

(3 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Employers make decisions about whether to offer health insurance coverage and paid sick leave to their workers in the United States as well as decisions related to retirement benefits for workers. Among women who were employed at the time of diagnosis of breast cancer, those with no sick leave were more than three times as likely to lose their employment as were those with paid sick leave ( 33 ). In addition, employers can choose to offer workplace accommodations to their workforce, such as flexible hours, flexible locations, and changes in responsibilities and duties ( 34, 35 ).…”

Section: Discussionmentioning

confidence: 99%

Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study

Halpern,

de Moor,

Han

et al. 2023

Cancer Research Communications

View full text Add to dashboard Cite

Financial hardship (FH), defined as adverse patient effects due to cancer costs, is experienced by approximately half of individuals diagnosed with cancer. Many individuals diagnosed with cancer also experience disruptions with their employment. This study examines associations of employment disruptions and FH among a nationally representative sample of individuals diagnosed with cancer in the United States. We utilized 2016/2017 Medical Expenditure Panel Survey Experiences with Cancer data from individuals who worked for pay following cancer diagnosis. Employment disruption included taking extended paid time off work; switching to part-time/less demanding jobs; and/or retiring early due to cancer diagnosis/treatment. FH domains included: material (e.g., borrowing money/financial sacrifices); psychologic (e.g., worrying about medical bills/income); and behavioral (delaying/forgoing healthcare services because of cost). Multivariable logistic regression analyses determined associations of employment disruption and FH. Among 732 individuals with a cancer history, 47.4% experienced employment disruptions; 55.9% experienced any FH. Any FH was significantly more common among individuals with versus without employment disruptions across multiple measures and domains (68.7% vs. 44.5%; P value of difference <0.0001). Individuals with employment disruptions were more likely to have any FH [OR, 2.38; 95% confidence interval (CI), 1.62–3.52] and more FHs (OR, 2.76; 95% CI, 1.96–3.89]. This study highlights that employment disruptions are common and significantly associated with multiple domains of FH among individuals with a cancer history. Employer workplace accommodation, physician discussions regarding potential impacts of cancer care on employment, and other policies to minimize employment disruptions among individuals diagnosed with cancer may reduce FH in this vulnerable population. Significance: Individuals diagnosed with cancer may have employment disruptions; they may also develop FHs. People with cancer who have employment changes are more likely to also have FHs. Physicians and employers can help individuals with cancer through advancing planning, workplace assistance, and improved medical leave and insurance policies.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study

Halpern,

de Moor,

Han

et al. 2023

Cancer Research Communications

View full text Add to dashboard Cite

show abstract

“…In a cross-sectional study of Israeli BCSs ( n = 206), 67% were still employed 8 years after diagnosis [ 13 ], and in a German cross-sectional study including 135 BCSs, 70% had returned to work with full or reduced working time 5 years after surgery [ 14 ]. In another recent cross-sectional study, Peipins et al found that over 80% of about 1600 US BCSs sustained their employment on average 5 years after diagnosis [ 12 ]. Although these employment rates among long-term BCSs are not directly comparable to findings in our study due to different socioeconomic and healthcare systems, they all indicate that the majority of BCSs maintain their work status also beyond the first years post-diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the employment rate may change after this point, e.g., due to late effects that persist or appear several months or even years after treatment. Three cross-sectional studies from various countries have described that > 60% of BCSs are employed approximately 5 years from diagnosis [12][13][14]. On the other hand, two register-based studies comparing longterm BC survivors to normative samples have reported lower employment rates in BCSs [15,16], indicating that BCSs have challenges maintaining work status also beyond the first 5 years post-diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Work status changes and associated factors in a nationwide sample of Norwegian long-term breast cancer survivors

et al. 2022

View full text Add to dashboard Cite

Purpose The study aims to describe work status at diagnosis and 8 years post-diagnosis in a nationwide sample of breast cancer survivors (BCSs), and investigate associated and self-reported factors of reduced work status. Methods Women aged 20–65 years when diagnosed with stage I–III breast cancer (BC) in 2011 or 2012 were invited to participate in a questionnaire study in 2019 (n = 2803), of whom 49% (n = 1361) responded. For this sub-study, we included 974 BCSs below the legal retirement age in Norway (< 67 years) at survey and with complete work status data. Reduced work status was defined as being in paid work at BC diagnosis and not working at time of survey. Logistic regression analyses were applied to identify factors associated with reduced work status. Results Of BCSs who were in paid work at diagnosis (n = 845), 63% maintained their work status to 8 years later. Reduced work status was associated with not living with children (OR .44, 95% CI .24–.82), age (OR 1.16, 95% CI 1.11–1.21), chemotherapy (OR 2.83, 95% CI 1.24–6.61), > 2 comorbid conditions (OR 2.27, 95% CI 1.16–4.32), cognitive function (OR .99, 95% CI .98–.99), fatigue (OR 1.02, 95% CI 1.01–1.03), and neuroticism (OR 1.57, 95% CI 1.00–2.46). BC and late effects were reported as reasons for reduced work status and disability. Conclusions The majority of BCSs who were in paid work at diagnosis were working 8 years later. Implications for Cancer Survivors Our results suggest a need to focus on fatigue and reduced cognitive function among long-term BCSs, with the ultimate aim of improving work sustainability.

show abstract

Breast Cancer–Related Employment Disruption and Financial Hardship in the Sister Study

Meernik

Sandler

Peipins

et al. 2021

JNCI Cancer Spectrum

Self Cite

View full text Add to dashboard Cite

Background More than half of breast cancer cases are diagnosed among women aged younger than 62 years, which may result in employment challenges. This study examined whether cancer-related employment disruption was associated with increased financial hardship in a national U.S. study of women with breast cancer. Methods Women with breast cancer who were enrolled in the Sister or Two Sister Studies completed a survivorship survey in 2012. Employment disruption was defined as stopping work completely or working fewer hours after diagnosis. Financial hardship was defined as 1) experiencing financial problems paying for cancer care, 2) borrowing money/incurring debt, or 3) filing for bankruptcy because of cancer. Prevalence ratios and 95% confidence intervals for the association between employment disruption and financial hardship were estimated using multivariable Poisson regression with robust variance. Results We analyzed data from women employed at diagnosis (n = 1,628). Women were a median age of 48 years at diagnosis and 5.6 years from diagnosis at survey completion. Overall, 27.3% of women reported employment disruption (15.4% stopped working; 11.9% reduced hours), and 21.0% experienced financial hardship (16.0% had difficulty paying for care; 12.6% borrowed money/incurred debt; 1.8% filed for bankruptcy). In adjusted analysis, employment disruption was associated with nearly twice the prevalence of financial hardship (prevalence ratio = 1.93, 95% confidence interval = 1.58 to 2.35). Conclusions Women experiencing employment disruptions after breast cancer may be more vulnerable to financial hardship. Findings highlight the need to target risk factors for employment disruption, facilitate return to work or ongoing employment, and mitigate financial consequences after cancer.

show abstract

Employment After Breast Cancer Diagnosis and Treatment Among Women in the Sister and the Two Sister Studies

Cited by 3 publications

References 47 publications

Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study

Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study

Work status changes and associated factors in a nationwide sample of Norwegian long-term breast cancer survivors

Breast Cancer–Related Employment Disruption and Financial Hardship in the Sister Study

Contact Info

Product

Resources

About