Wage Losses in the Year After Breast Cancer: Extent and Determinants Among Canadian Women (original) (raw)
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SSRN Electronic Journal, 2017
Using an administrative data set (Hygie), we apply a difference-in differences with dynamic matching estimation method to the onset of breast cancer. The employment probability decreases by 10 percentage points (pp) one year after the onset of cancer compared to the not-treated group. The detrimental effect of breast cancer on employment increases significantly over time, by up to 12 pp after five years. Another aim of our study is to identify some socio-demographic and work-related protective factors against the adverse effects of breast cancer on labour market outcomes. We stress four potential protective factors related to the negative effect of breast cancer. First, a young age at occurrence reduces this deleterious effect. Second, a high first job wage also appears to be a protective factor. Third, having faced less unemployment in the past is associated with a weaker negative effect of breast cancer on employment in the short run. Finally, we find a moderate "generational effect" after stratification by year of cancer onset.
Unemployment among breast cancer survivors
Scandinavian Journal of Public Health, 2014
Aim: Though about 20% of working age breast cancer survivors do not return to work after treatment, few studies have addressed risk factors for unemployment. The majority of studies on occupational consequences of breast cancer focus on non-employment, which is a mixture of sickness absence, unemployment, retirement pensions and other reasons for not working. Unemployment in combination with breast cancer may represent a particular challenge for these women. The aim of the present study is therefore to analyze the risk for unemployment in the years following diagnosis and treatment for breast cancer. Method: This study included 14,750 women diagnosed with breast cancer in Denmark 2001-2009 identified through a population-based clinical database and linked with information from Danish administrative population based registers for information on labour market affiliation, socio-demography and co-morbid conditions. Multivariable analyses were performed by Cox's proportional hazard models. Results: Two years after treatment, 81% of patients were still part of the work force, 10% of which were unemployed. Increasing duration of unemployment before breast cancer was associated with an adjusted HR = 4.37 (95% CI: 3.90-4.90) for unemployment after breast cancer. Other risk factors for unemployment included low socioeconomic status and demography, while adjuvant therapy did not increase the risk of unemployment. Conclusions: Duration of unemployment before breast cancer was the most important determinant of unemployment after breast cancer treatment. This allows identification of a particularly vulnerable group of patients in need of rehabilitation.
International Journal Of Community Medicine And Public Health, 2020
Background: Breast cancer survivors constitute a big proportion among all female cancer survivors and the employment status of breast cancer survivors is an important public health issue. The aim of the study is to evaluate the effects of some demographic properties and the treatment modalities used for breast cancer on patients’ employment status.Methods: This is a single-center cross-sectional study. We assessed 2550 patients with breast cancer for eligibility. Face to face interview was performed with 688 breast cancer survivors. A total of 249 patients who had an income-generating job before diagnosis and completed at least 1 year after surgery and/or adjuvant radiotherapy, chemotherapy for breast cancer were included in the study. The job loss rate of the patients was evaluated according to their demographics, clinical features and treatment methods applied for breast cancer. Univariate and multivariate analyses were used in order to show these associations.Results: The job los...
Journal of Clinical Oncology
PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors' work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and $ 5 years younger than legal retirement age (# 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires , Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade $ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
Changes in employment status up to 5 years after breast cancer diagnosis: A prospective cohort study
The Breast, 2019
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Trends in return to work of breast cancer survivors
Breast Cancer Research and Treatment, 2011
Purpose: Most women interrupt their work activities during the treatment of cancer. This study investigated return to work (RTW) after treatment of breast cancer in the period from Methods: ArboNed Occupational Health Services records the sickness absence and RTW data of more than one million workers of whom approximately 40% are women. Incident cases of sickness absence due to breast cancer (ICD-10 code C50) were selected from the ArboNed register. Proportions of partial RTW, with 50% of the earnings before sickness absence, and full RTW were determined one year after diagnosis. Trends in partial RTW and full RTW were examined by Chi-square trend analysis. The time to partial RTW and full RTW was analysed by Cox regression and stratified by age (<40 years, 40-50 years and >50 years).
Breast Cancer and Women's Labor Supply
Health Services Research, 2002
Objective. To investigate the effect of breast cancer on women's labor supply. Date Source/Study Setting. Using the 1992 Health and Retirement Study, we estimate the probability of working using probit regression and then, for women who are employed, we estimate regressions for average weekly hours worked using ordinary least squares (OLS). We control for health status by using responses to perceived health status and comorbidities. For a sample of married women, we control for spouses' employer-based health insurance. We also perform additional analyses to detect selection bias in our sample. Principal Findings. We find that the probability of breast cancer survivors working is 10 percentage points less than that for women without breast cancer. Among women who work, breast cancer survivors work approximately three more hours per week than women who do not have cancer. Results of similar magnitude persist after health status is controlled in the analysis, and although we could not definitively rule out selection bias, we could not find evidence that our results are attributable to selection bias. Conclusions. For some women, breast cancer may impose an economic hardship because it causes them to leave their jobs. However, for women who survive and remain working, this study failed to show a negative effect on hours worked associated with breast cancer. Perhaps the morbidity associated with certain types and stages of breast cancer and its treatment does not interfere with work.
Racial/ethnic differences in job loss for women with breast cancer
Journal of Cancer Survivorship, 2011
Introduction We examined race/ethnic differences in treatment-related job loss and the financial impact of treatment-related job loss, in a population-based sample of women diagnosed with breast cancer. Methods Three thousand two hundred fifty two women with non-metastatic breast cancer diagnosed (August 2005-February 2007) within the Los Angeles County and Detroit Metropolitan Surveillance Epidemiology and End Results registries, were identified and asked to complete a survey (mean time from diagnosis =8.9 months). Latina and African American women were over-sampled (n=2268, eligible response rate 72.1%). Results One thousand one hundred eleven women (69.6%) of working age (<65 years) were working for pay at time of diagnosis. Of these women, 10.4% (24.1% Latina, 10.1% African American, 6.9% White, p<0.001) reported that they lost or quit their job since diagnosis due to breast cancer or its treatment (defined as job loss). Latina women were more likely to experience job loss compared to White women (OR=2.0, p=0.013)), independent of sociodemographic factors. There were no significant differences in job loss between African American and White women, independent of sociodemographic factors. Additional adjustments for clinical and treatment factors revealed a significant interaction between race/ethnicity and chemotherapy (p=0.007). Among women who received chemotherapy, Latina women were more likely to lose their job compared to White women (OR=3.2, p<0.001), however, there were no significant differences between Latina and White women among those who did not receive chemotherapy. Women who lost their job were more likely to experience financial strain (e.g. difficulty paying bills 27% vs. 11%, p<0.001). Conclusion Job loss is a serious consequence of treatment for women with breast cancer. Clinicians and staff need to be aware of aspects of treatment course that place women at higher risk for job loss, especially ethnic minorities receiving chemotherapy.
RePEc: Research Papers in Economics, 2019
We estimate the effect of breast cancer on labour market participation in France, up to five years after the cancer onset. The causal inference is systematically confounded by differences in age, wage at the beginning of career, past health and the past history in the labour market. We account for all these issues thanks to an administrative data set which follows individuals from their entry in the labour market. We find that the detrimental effect of the breast cancer for women increases significantly over time up to 10 percentage points after five years. We also find evidence that the effect of cancer is reduced for younger generations.