Workforce participation in relation to cancer diagnosis, type and stage: Australian population-based study of 163,556 middle-aged people

Abstract

Purpose To quantify the relationship of cancer diagnosis to workforce participation in Australia, according to cancer type, clinical features and personal characteristics. Methods Questionnaire data (2006–2009) from participants aged 45–64 years (n=163,556) from the population-based 45 and Up Study (n=267,153) in New South Wales, Australia, were linked to cancer registrations to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for non-participation in the paid workforce—in participants with cancer (n=8,333) versus without (n=155,223), for 13 cancer types. Results Overall, 42% of cancer survivors and 29% of people without cancer were out of the workforce (PR=1.18; 95%CI=1.15–1.21). Workforce non-participation varied substantively by cancer type, being greatest for multiple myeloma (1.83; 1.53–2.18), oesophageal (1.70; 1.13–2.58) and lung cancer (1.68; 1.45–1.93) and moderate for colorectal (1.23; 1.15–1.33), breast (1.11; 1.06–1.16) and prostate cancer (1.06; 0.99–1.13). Long-term survivors, 5 or more years post-diagnosis, had 12% (7–16%) greater non-participation than people without cancer, and non-participation was greater with recent diagnosis, treatment or advanced stage. Physical disability contributed substantively to reduced workforce participation, regardless of cancer diagnosis. Conclusions Cancer survivors aged 45–64 continue to participate in the workforce. However, participation is lower than in people without cancer, varying by cancer type, and is reduced particularly around the time of diagnosis and treatment and with advanced disease. Implications for Cancer Survivors While many cancer survivors continue with paid work, participation is reduced. Workforce retention support should be tailored to survivor preferences, cancer type and cancer journey stage.

Return to Work and Work Productivity During the First Year After Cancer Treatment

“…Examining influences on RTW after cancer diagnosis can help in focusing cancer rehabilitation on social reintegration. In particular, RTW has been seen by cancer survivors as an indication of reintegration into normal life following cancer diagnosis, which is critical for personal development, identity formation, social recovery, and promoting self-esteem and quality of life, and also as having extrinsic value for making contribution to society and economic benefits ( Spelten et al, 2002 ; Butow et al, 2020 ; Thandrayen et al, 2022 ).…”

Work: saviour or struggle? A qualitative study examining employment and finances in colorectal cancer survivors living with advanced cancer

“…Approximately 18% of Australians with CRC are of working age (15–64 years) [ 18 ]; those working average 34.6 hours per week [ 19 ]. However, 45.8% of Australian CRC survivors are unemployed, versus 29.4% of Australians without cancer [ 19 ].…”

“…Approximately 18% of Australians with CRC are of working age (15–64 years) [ 18 ]; those working average 34.6 hours per week [ 19 ]. However, 45.8% of Australian CRC survivors are unemployed, versus 29.4% of Australians without cancer [ 19 ]. Having had cancer treatment within the past month or being 5 or more years since CRC diagnosis increases survivors’ likelihood of being out of work [ 19 ].…”

“…However, 45.8% of Australian CRC survivors are unemployed, versus 29.4% of Australians without cancer [ 19 ]. Having had cancer treatment within the past month or being 5 or more years since CRC diagnosis increases survivors’ likelihood of being out of work [ 19 ]. Additionally, 43.5% of retired CRC survivors cite ill health as the cause of retirement compared to 28.9% of Australians without cancer [ 19 ].…”

“…Where curative surgery cannot be achieved, palliative chemotherapy can increase average life expectancy from 5-12 months to > 24 months, alleviate symptoms, and improve quality of life (QoL) [14][15][16]. Thus, continuing employment or returning to work (RTW), which are both personally meaningful and financially necessary for many survivors [17], is now a realistic option for survivors of CRC-A.Approximately 18% of Australians with CRC are of working age (15-64 years) [18]; those working average 34.6 hours per week [19]. However, 45.8% of Australian…”