Wayne State University School of Medicine, Detroit, MI, USA.
Karmanos Cancer Institute, Detroit, MI, USA.
Cancer Med. 2020 Dec;9(23):9168-9177. doi: 10.1002/cam4.3512. Epub 2020 Nov 7.
African American cancer survivors disproportionately experience financial difficulties after cancer. Decreased work participation (going from being employed full time to part time or from employed to not employed) can contribute to financial hardship after cancer but employment outcomes among African American cancer survivors have not been well described. This study estimates the prevalence of work changes and identifies factors associated with decreased work participation among African American cancer survivors. We analyzed data from 916 African American breast, colorectal, lung, and prostate cancer survivors who participated in the Detroit Research on Cancer Survivors (ROCS) cohort and were employed before their cancer diagnosis. Modified Poisson models estimated prevalence ratios of decreased work participation and work changes, including changes to hours, duties, or schedules, between diagnosis and ROCS enrollment controlling for sociodemographic and cancer-related factors. Nearly half of employed survivors made changes to their schedules, duties, or hours worked due to cancer and 34.6% took at least one month off of work, including 18% who took at least one month of unpaid time off. More survivors employed full time (vs. part time) at diagnosis were on disability at ROCS enrollment (18.7% vs. 12.6%, P < 0.001), while fewer were unemployed (5.9% vs. 15.7%, P < 0.001). Nearly half (47.5%) of employed survivors decreased work participation. Taking paid time off was not associated with decreased work participation; however, taking unpaid time off and making work changes were associated with prevalence ratios of decreased work participation of 1.29 (95% CI: 1.03, 1.62) and 1.37 (95% CI: 1.07, 1.75), respectively. Employment disruptions are common after a cancer diagnosis. Survivors who take unpaid time off and make other work changes may be particularly vulnerable to experiencing decreased work participation.
非裔美国癌症幸存者在癌症后经历财务困难的比例不成比例。减少工作参与（从全职工作转为兼职工作或从有工作变为无工作）可能会导致癌症后经济困难，但非裔美国癌症幸存者的就业情况尚未得到很好的描述。本研究估计了工作变化的流行率，并确定了与非裔美国癌症幸存者工作参与减少相关的因素。我们分析了参加底特律癌症幸存者研究（ROCS）队列且在癌症诊断前有工作的 916 名非裔美国乳腺癌、结直肠癌、肺癌和前列腺癌幸存者的数据。在控制社会人口统计学和癌症相关因素的情况下，使用修正泊松模型估计了诊断和 ROCS 登记之间工作参与减少和工作变化（包括工作时间、职责或时间表的变化）的患病率比。由于癌症，近一半的在职幸存者改变了工作时间、职责或工作时间，34.6%的人至少休假一个月，包括 18%的人至少休假一个月无薪。在 ROCS 登记时，更多的诊断时全职（而非兼职）就业幸存者处于残疾状态（18.7%比 12.6%，P<0.001），而失业者较少（5.9%比 15.7%，P<0.001）。近一半（47.5%）的在职幸存者减少了工作参与。休带薪假与工作参与减少无关；然而，休无薪假和工作变动与工作参与减少的患病率比分别为 1.29（95%CI：1.03，1.62）和 1.37（95%CI：1.07，1.75）相关。癌症诊断后就业中断很常见。休无薪假和做出其他工作变动的幸存者可能特别容易经历工作参与减少。
