Becoming unemployed after a cancer diagnosis: associated characteristics and its impact on daily life

This study compared characteristics of cancer survivors who became unemployed after diagnosis with those who remained employed and evaluated the association between employment status and the impact on daily life.

A cross-sectional online survey was conducted among adult cancer survivors employed at diagnosis. Participants were categorized based on employment status post-diagnosis. Univariate and multivariate binomial generalized linear models and multinomial logistic regression analyses were applied.

Among 2576 cancer survivors (mean age: 53.4 years, 77% female, 62% 0-5 years post-diagnosis), 1704 (66%) remained employed, while 872 (34%) became unemployed. Becoming unemployed was associated with older age [OR; 95% CI, 1.02; 1.01-1.03], low [OR; 95% CI, 2.43; 1.05-3.45] or intermediate education [OR; 95% CI, 1.60; 1.33-1.93], and indicating (probably) not getting better [OR; 95% CI, 3.94; 3.05-5.07] or having chronic cancer [OR; 95% CI, 1.68; 1.25-2.25]. Prostate cancer survivors and those diagnosed ≤5 years prior were less likely to become unemployed than those with other types of cancer or those diagnosed longer ago. Becoming unemployed was associated with a negative influence on psychological [OR; 95% CI, 2.22; 1.80-2.74] and physical well-being [OR; 95% CI, 1.96; 1.61-2.38]. Those who became unemployed were more likely than those who remained employed to perceive that financial consequences negatively influenced multiple aspects of daily life, including family and social relationships, participation in sports, hobbies, and leisure activities, for themselves as well as for their partners and children.

Unemployment was disproportionately prevalent among older, less-educated individuals and individuals with advanced cancer and was associated with declines in personal and family well-being due to experienced financial consequences.

Identifying cancer survivors vulnerable to unemployment can guide timely, targeted support to help them maintain employment if desired. The observed link between unemployment and daily life emphasizes the importance of addressing employment issues within survivorship care.