Zajacova Anna, Dowd Jennifer B, Schoeni Robert F, Wallace Robert B
Department of Sociology, University of Wyoming, Laramie, Wyoming.
CUNY School of Public Health, Hunter College, City University of New York, New York, New York.
Cancer. 2015 Dec 15;121(24):4425-32. doi: 10.1002/cncr.29510. Epub 2015 Oct 26.
Cancer presents a substantial hardship for patients and their families in multiple domains beyond health and survival. Relatively little is known about the economic impact of cancer. The authors present estimates of the aggregate effects of a cancer diagnosis on employment and income in a prospective, nationally representative sample of US adults.
The authors used data from the 1990 through 2009 waves of the Panel Study of Income Dynamics, a nationally representative, prospective, population-based observational study with high-quality individual and family-level economic information. Age-adjusted, sex-stratified, individual fixed-effects regression models were used to derive estimates of the impact of cancer on employment, hours worked, individual income, and total family income.
Significant effects of cancer on all 4 outcomes were observed. The probability of a cancer patient being employed dropped by almost 10 percentage points, and hours worked declined by up to 200 hours in the first year after diagnosis. Annual labor-market earnings dropped almost 40% within 2 years after diagnosis and remained low, whereas total family income declined by 20%, although it recovered within 4 years after the diagnosis. These economic impacts on survivors were driven by effects among men; the effects among women largely were not statistically significant.
A cancer diagnosis has substantial effects on the economic well-being of affected adults and their families. With the increasing number of cancer survivors in the US population, there is a growing need for examining the long-term implications for economic well-being and ways to mitigate the economic hardship associated with cancer.
癌症给患者及其家庭在健康和生存之外的多个领域带来了巨大困难。人们对癌症的经济影响了解相对较少。作者在一个具有全国代表性的美国成年人前瞻性样本中，对癌症诊断对就业和收入的总体影响进行了估计。
作者使用了1990年至2009年期间收入动态面板研究的数据，这是一项具有全国代表性的、前瞻性的、基于人群的观察性研究，包含高质量的个人和家庭层面的经济信息。采用年龄调整、性别分层的个体固定效应回归模型来估计癌症对就业、工作时长、个人收入和家庭总收入的影响。
观察到癌症对所有这4个结果都有显著影响。癌症患者就业的概率下降了近10个百分点，诊断后的第一年工作时长减少了多达200小时。诊断后2年内，年度劳动力市场收入下降了近40%，且一直处于低水平，而家庭总收入下降了20%，不过在诊断后4年内有所恢复。这些对幸存者的经济影响是由男性中的影响驱动的；女性中的影响在很大程度上没有统计学意义。
癌症诊断对受影响成年人及其家庭的经济状况有重大影响。随着美国人口中癌症幸存者数量的增加，越来越有必要研究其对经济状况的长期影响以及减轻与癌症相关经济困难的方法。
