Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands.
ESMO Open. 2022 Aug;7(4):100521. doi: 10.1016/j.esmoop.2022.100521. Epub 2022 Jun 27.
Adolescent and young adult (AYA) cancer survivors, 18-39 years at initial cancer diagnosis, often self-report negative consequences of cancer (treatment) for their career. Less is known, however, about the objective impact of cancer on employment and financial outcomes. This study examines the employment and financial outcomes of AYA cancer survivors with nationwide population-based registry data and compares the outcomes of AYAs with cancer with an age- and sex-matched control population at year of diagnosis, 1 year later (short-term) and 5 years later (long-term).
A total of 2527 AYAs, diagnosed in 2013 with any invasive tumor type and who survived for 5 years, were identified from the Netherlands Cancer Registry (clinical and demographic data) and linked to Statistics Netherlands (demographic, employment and financial data). AYAs were matched 1 : 4 with a control population based on age and sex (10 108 controls). Analyses included descriptive statistics, chi-square tests, independent samples t-tests, McNemar tests and logistic regression.
AYA cancer survivors were significantly less often employed compared with their controls 1 year (76.1% versus 79.5%, P < 0.001) and 5 years (79.3% versus 83.5%, P < 0.001) after diagnosis, and received more often disability benefits (9.9% versus 3.1% 1 year after diagnosis, P < 0.001; 11.2% versus 3.8% 5 years after diagnosis, P < 0.001). Unemployed AYAs were more often diagnosed with higher disease stages (P < 0.001), treated with chemotherapy (P < 0.001), radiotherapy (P < 0.001) or hormone therapy (P < 0.05) and less often with local surgery (P < 0.05) compared with employed AYAs 1 and 5 years after diagnosis.
Based on objective, nationwide, population-based registry data, AYAs' employment and financial outcomes are significantly affected compared with age- and sex-matched controls, both short and long-term after cancer diagnosis. Providing support regarding employment and financial outcomes from diagnosis onwards may help AYAs finding their way (back) into society.
18-39 岁的青少年和年轻成人（AYA）癌症幸存者在初始癌症诊断时经常自我报告癌症（治疗）对其职业的负面影响。然而，对于癌症对就业和财务结果的客观影响知之甚少。本研究使用全国性基于人群的登记处数据，检查 AYA 癌症幸存者的就业和财务结果，并将癌症幸存者与诊断时的年龄和性别匹配的对照人群（1 年短期）和 5 年后（长期）进行比较。
从荷兰癌症登记处（临床和人口统计学数据）中确定了 2527 名 2013 年诊断出患有任何侵袭性肿瘤类型并存活 5 年的 AYA，并与荷兰统计局（人口统计学、就业和财务数据）相关联。根据年龄和性别，将 AYA 与对照组（10108 名对照）进行 1：4 匹配。分析包括描述性统计、卡方检验、独立样本 t 检验、McNemar 检验和逻辑回归。
与对照组相比，1 年（76.1%比 79.5%，P <0.001）和 5 年（79.3%比 83.5%，P <0.001）后诊断时，AYA 癌症幸存者的就业比例明显较低，并且更频繁地获得残疾福利（1 年时为 9.9%比 3.1%，P <0.001；5 年时为 11.2%比 3.8%，P <0.001）。失业的 AYA 更常被诊断为更高的疾病分期（P <0.001），接受化疗（P <0.001）、放疗（P <0.001）或激素治疗（P <0.05）的比例更高，而接受局部手术治疗的比例较低（P <0.05）与 1 年和 5 年后诊断时的就业 AYA 相比。
基于客观的、全国性的、基于人群的登记处数据，与年龄和性别匹配的对照组相比，癌症诊断后短期和长期内，AYA 的就业和财务结果受到显著影响。从诊断开始就提供有关就业和财务结果的支持，可能有助于 AYA 找到重返社会的途径。
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