Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Med Care. 2010 Nov;48(11):1015-25. doi: 10.1097/MLR.0b013e3181eaf880.
Adult childhood cancer survivors report high levels of unemployment, although it is unknown whether this is because of health or employability limitations.
We examined 2 employment outcomes from 2003 in the Childhood Cancer Survivor Study (CCSS): (1) health-related unemployment and (2) unemployed but seeking work. We compared survivors with a nearest-age CCSS sibling cohort and examined demographic and treatment-related risk groups for each outcome.
We studied 6339 survivors and 1967 siblings ≥25 years of age excluding those unemployed by choice. Multivariable generalized linear models evaluated whether survivors were more likely to be unemployed than siblings and whether certain survivors were at a higher risk for unemployment.
Survivors (10.4%) reported health-related unemployment more often than siblings (1.8%; Relative Risk [RR], 6.07; 95% Confidence Interval [CI], 4.32-8.53). Survivors (5.7%) were more likely to report being unemployed but seeking work than siblings (2.7%; RR, 1.90; 95% CI, 1.43-2.54). Health-related unemployment was more common in female survivors than males (Odds Ratio [OR], 1.73; 95% CI, 1.43-2.08). Cranial radiotherapy doses ≥25 Gy were associated with higher odds of unemployment (health-related: OR, 3.47; 95% CI, 2.54-4.74; seeking work: OR, 1.77; 95% CI, 1.15-2.71). Unemployed survivors reported higher levels of poor physical functioning than employed survivors, and had lower education and income and were more likely to be publicly insured than unemployed siblings.
Childhood cancer survivors have higher levels of unemployment because of health or being between jobs. High-risk survivors may need vocational assistance.
成人癌症幸存者报告失业率高，尽管尚不清楚这是由于健康问题还是就业能力受限。
我们研究了儿童癌症幸存者研究（CCSS）中 2003 年的 2 项就业结果：（1）与健康相关的失业和（2）失业但正在找工作。我们将幸存者与最接近年龄的 CCSS 兄弟姐妹队列进行了比较，并检查了每个结果的人口统计学和治疗相关的风险组。
我们研究了 6339 名幸存者和 1967 名≥25 岁的兄弟姐妹，不包括因选择而失业的人。多变量广义线性模型评估了幸存者是否比兄弟姐妹更有可能失业，以及某些幸存者是否面临更高的失业风险。
幸存者（10.4%）报告与健康相关的失业比兄弟姐妹（1.8%）更频繁（相对风险[RR]，6.07；95%置信区间[CI]，4.32-8.53）。与兄弟姐妹（2.7%）相比，幸存者（5.7%）更有可能报告失业但正在找工作（RR，1.90；95%CI，1.43-2.54）。女性幸存者比男性幸存者更常见与健康相关的失业（优势比[OR]，1.73；95%CI，1.43-2.08）。颅放疗剂量≥25Gy 与失业的可能性更高相关（与健康相关：OR，3.47；95%CI，2.54-4.74；找工作：OR，1.77；95%CI，1.15-2.71）。失业幸存者报告的身体功能较差水平高于就业幸存者，且受教育程度和收入较低，与失业的兄弟姐妹相比，更有可能获得公共保险。
由于健康问题或处于失业状态，儿童癌症幸存者的失业率较高。高危幸存者可能需要职业援助。
