Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors Journal Article


Authors: Ketterl, T. G.; Syrjala, K. L.; Casillas, J.; Jacobs, L. A.; Palmer, S. C.; McCabe, M. S.; Ganz, P. A.; Overholser, L.; Partridge, A.; Rajotte, E. J.; Rosenberg, A. R.; Risendal, B.; Rosenstein, D. L.; Baker, K. S.
Article Title: Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors
Abstract: Background: The impact of cancer and its treatment on employment and financial burden in adolescents/young adults (AYAs) is not fully known. Methods: Eligibility for this cross-sectional study of AYA cancer survivors included the diagnosis of a malignancy between ages 18 and 39 years and survey completion within 1 to 5 years from diagnosis and ≥1 year after therapy completion. Participants were selected randomly from the tumor registries of 7 participating sites and completed an online patient-reported outcomes survey to assess employment and financial concerns. Treatment data were abstracted from medical records. Data were analyzed across diagnoses and by tumor site using logistic regression and Wald-based 95% confidence intervals adjusting for age (categorized), sex, insurance status, education (categorized), and treatment exposures. Results: Participants included 872 survivors (breast cancer, n = 241; thyroid cancer, n = 126; leukemia/lymphoma, n = 163; other malignancies, n = 342). Exposure to chemotherapy in breast cancer survivors was associated with an increase in self-reported mental impairment in work tasks (odds ratio [OR], 2.66) and taking unpaid time off (OR, 2.62); survivors of “other” malignancies reported an increase in mental impairment of work tasks (OR, 3.67) and borrowing >$10,000 (OR, 3.43). Radiation exposure was associated with an increase of mental impairment in work tasks (OR, 2.05) in breast cancer survivors, taking extended paid time off work in thyroid cancer survivors (OR, 5.05), and physical impairment in work tasks in survivors of “other” malignancies (OR, 3.11). Finally, in survivors of “other” malignancies, having undergone surgery was associated with an increase in physical (OR, 3.11) and mental impairment (OR, 2.31) of work tasks. Conclusions: Cancer treatment has a significant impact on AYA survivors’ physical and mental work capacity and time off from work. © 2019 American Cancer Society
Keywords: adolescent; adult; cancer chemotherapy; controlled study; leukemia; young adult; major clinical study; follow up; tumor localization; breast cancer; odds ratio; radiation injury; information processing; cancer therapy; radiation exposure; cancer survivor; self report; confidence interval; health insurance; questionnaire; lymphoma; medical record; data analysis; survivorship; mental disease; cancer registry; cross-sectional study; sex difference; thyroid cancer; age distribution; mental function; educational status; logistic regression analysis; task performance; physical performance; drug exposure; work; online system; employment; patient-reported outcome; physical disability; physical disease; cancer; human; male; female; priority journal; article; health impact assessment; malignant neoplasm; financial deficit; adolescent/young adult; finances
Journal Title: Cancer
Volume: 125
Issue: 11
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2019-06-01
Start Page: 1908
End Page: 1917
Language: English
DOI: 10.1002/cncr.31985
PUBMED: 30707763
PROVIDER: scopus
PMCID: PMC6508988
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric Score
MSK Authors
  1. Mary McCabe
    97 McCabe