Employment Five Years After Cancer Diagnosis Among Native and Immigrant Women in Norway

To compare employment status 5 years post-diagnosis among native Norwegian, Western immigrant, and non-Western immigrant female cancer survivors (CSs) and their matched controls without cancer, who were employed at the time of diagnosis.

Participants were categorized into three groups based on data from Statistics Norway: Natives (CSs = 6587, control = 6587), Western immigrants (CSs = 209, control = 209), and non-Western immigrants (CSs = 105, control = 105). Women were aged 30-55 at diagnosis, employed (salaried/self-employed) at baseline, and alive at 5-year follow-up. CSs and controls were matched on age, education, and employment at diagnosis. Associations between cancer status, immigrant background, and employment were analyzed using binary logistic regressions and Firth penalized logistic regression to account for potential bias from small subgroup sizes.

At 5 years, female CSs had lower odds of employment compared with controls. Western immigrants did not differ from natives, whereas non-Western immigrants showed reduced employment. Higher income was positively associated with employment, while being married or cohabiting and working in the public sector were linked to higher odds. Interaction terms between cancer survivorship and immigrant background were not significant.

Among women employed at baseline, cancer survivorship and non-Western immigrant background were independently associated with lower odds of employment five years later. Tailored employment support is needed for non-Western immigrants to improve long-term outcomes. Interventions should also target employers and workplaces to support employment maintenance among CSs.