Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Cancer. 2011 Jul 1;117(13):3033-44. doi: 10.1002/cncr.25867. Epub 2011 Jan 18.
The authors examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher-skill occupations than a sibling comparison and whether certain survivors were at higher risk for lower-skill jobs.
The authors created 3 mutually exclusive occupational categories for participants aged ≥ 25 years: Managerial/Professional, Nonphysical Service/Blue Collar, and Physical Service/Blue Collar. The authors examined currently employed survivors (4845) and their siblings (1727) in multivariable generalized linear models to evaluate the likelihood of being in 1 of the 3 occupational categories. Multinomial logistic regression was used among all participants to examine the likelihood of these outcomes compared to being unemployed (survivors, 6671; siblings, 2129). Multivariable linear models were used to assess survivor occupational differences by cancer- and treatment-related variables. Personal income was compared by occupation.
Employed survivors were less often in higher-skilled Managerial/Professional occupations (relative risk, 0.93; 95% confidence interval 0.89-0.98) than their siblings. Survivors who were black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Managerial/Professional occupations than other survivors. In multinomial models, female survivors' likelihood of being in full-time Managerial/Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors' personal income was lower than siblings within each of the 3 occupational categories in models adjusted for sociodemographic variables.
Adult childhood cancer survivors are employed in lower-skill jobs than siblings. Survivors with certain treatment histories are at higher risk for lower-skill jobs and may require vocational assistance throughout adulthood.
作者研究了儿童癌症幸存者研究中的幸存者是否比兄弟姐妹对照组更不可能从事高技能职业，以及某些幸存者是否从事低技能工作的风险更高。
作者为年龄≥25 岁的参与者创建了 3 个互斥的职业类别：管理/专业、非体力服务/蓝领和体力服务/蓝领。作者在多变量广义线性模型中检查了目前在职的幸存者（4845 人）及其兄弟姐妹（1727 人），以评估他们在 3 个职业类别中某一类别的可能性。在所有参与者中，使用多项逻辑回归来检查与失业相比（幸存者 6671 人，兄弟姐妹 2129 人）这些结果的可能性。使用多变量线性模型评估癌症和治疗相关变量对幸存者职业差异的影响。按职业比较个人收入。
与兄弟姐妹相比，在职幸存者从事高技能管理/专业职业的比例较低（相对风险，0.93；95%置信区间 0.89-0.98）。黑人幸存者、诊断年龄较小或接受高剂量颅脑放疗的幸存者，与其他幸存者相比，从事管理/专业职业的可能性较小。在多项模型中，女性幸存者全职从事管理/专业职业的可能性（27%）低于男性幸存者（42%）和女性（41%）和男性（50%）兄弟姐妹。在调整了社会人口统计学变量的模型中，幸存者的个人收入低于每个职业类别的兄弟姐妹。
成年儿童癌症幸存者从事低技能工作的比例高于兄弟姐妹。有某些治疗史的幸存者从事低技能工作的风险更高，可能需要在整个成年期提供职业援助。
