Risk for unemployment at 10 years following cancer diagnosis among very long-term survivors: a population based study

Purpose: To clarify the association between cancer diagnosis and subsequent risk of being unemployed at 10 years after diagnosis among very long-term survivors. Methods: A historical cohort study using prospectively collected data was done which included baseline measurements from the Israeli national census. Only patients who were 50 years old or younger at the time of diagnosis were included in the current study. Binary logistic regression analyses were used to assess odds ratios for unemployment at 10 years following diagnosis, while controlling for socioeconomic measurements and employment status at 2 years prior to diagnosis. Results: The final study population included 2493 patients who were diagnosed with cancer and 7360 persons without a history of cancer, after excluding individuals who died before the end of 2015. After controlling for confounders, positive associations were found between cancer and increased risk for unemployment at 10 years (OR = 1.31, 95% CI 1.17–1.47). Analysis by cancer type revealed that patients who were diagnosed with CNS malignancies (OR = 2.71, 95% CI 1.80–4.07), followed by patients who were diagnosed with lymphoma (OR = 1.66, 95% CI 1.16–1.28) showed the greatest magnitude of effect, while the association between unemployment at 10 years following diagnosis and breast cancer was found to weaken and actually lose significance (adjusted OR = 1.22, 95% CI 0.99–1.50). Conclusions: Cancer survivors have an increased risk for long-term unemployment among very long-term survivors, mainly among patients diagnosed with CNS malignancies and lymphoma. Implications for cancer survivors: The current study emphasizes the need for tailored intervention in order to mitigate the long-term risk of unemployment.