Khalil Mujtaba, Woldesenbet Selamawit, Altaf Abdullah, Rashid Zayed, Zindani Shahzaib, Thammachack Razeen, Husain Syed, Pawlik Timothy M
Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Ann Surg Oncol. 2025 Jun 26. doi: 10.1245/s10434-025-17683-1.
Understanding the extent of employment disruption and the financial strain faced by individuals with GI cancer is crucial to develop targeted support services. We sought to investigate employment disruption and financial burden among patients with gastrointestinal cancer (GI) diagnosis.
Patients diagnosed with GI cancer were identified using the MarketScan database. Multivariable Cox proportional hazards models were used to evaluate the risk of employment disruption among patients with a GI cancer diagnosis.
A total of 11,832 individuals with GI cancer were included. Median patient age was 54 years (IQR: 49-59) with a majority of patients being male (n=7054; 59.6%). In the year following a GI cancer diagnosis, 13.8% (n=1638) of patients experienced employment disruption. Notably, individuals working in finance (HR 1.66, 95% CI 1.37-2.02), manufacturing (HR 1.19, 95% CI 1.01-1.42), and the transportation industry (HR 1.33, 95% CI 1.11-1.60) were at a higher risk of experiencing employment disruption. Patients with GI cancer had higher out-of-pocket (OOP) costs ($3250 [IQR: $1756-$5,255] vs. $453 [IQR: $142-$1189]), more workdays missed (50 [IQR: 28-$72] vs. 5 [IQR: 2-10]) (both p < 0.001) and a threefold higher risk of employment disruption (HR 3.16, 95% CI 2.96-3.38) compared with individuals without a GI cancer diagnosis.
Patients with GI cancer are three times more likely to experience employment disruption and face significant financial burdens. Targeted measures, such as flexible work arrangements, job protection policies, and access to vocational rehabilitation services, are needed for patients with cancer.
了解胃肠道癌症患者的就业中断程度和所面临的经济压力对于制定有针对性的支持服务至关重要。我们旨在调查胃肠道（GI）癌症诊断患者的就业中断情况和经济负担。
使用MarketScan数据库识别出被诊断患有胃肠道癌症的患者。采用多变量Cox比例风险模型评估胃肠道癌症诊断患者的就业中断风险。
共纳入11832例胃肠道癌症患者。患者中位年龄为54岁（四分位间距：49 - 59岁），大多数患者为男性（n = 7054；59.6%）。在胃肠道癌症诊断后的一年中，13.8%（n = 1638）的患者经历了就业中断。值得注意的是，从事金融行业（风险比1.66，95%置信区间1.37 - 2.02）、制造业（风险比1.19，95%置信区间1.01 - 1.42）和运输行业（风险比1.33，95%置信区间1.11 - 1.60）的个体经历就业中断的风险更高。与未被诊断患有胃肠道癌症的个体相比，胃肠道癌症患者的自付费用更高（3250美元[四分位间距：1756 - 5255美元]对453美元[四分位间距：142 - 1189美元]），缺勤工作日更多（50天[四分位间距：28 - 72天]对5天[四分位间距：2 - 10天]）（两者p < 0.001），就业中断风险高三倍（风险比3.16，95%置信区间2.96 - 3.38）。
胃肠道癌症患者经历就业中断的可能性是常人的三倍，并且面临重大经济负担。对于癌症患者，需要采取有针对性的措施，如灵活的工作安排、工作保护政策以及获得职业康复服务的机会。
