1590MO Income loss after a cancer diagnosis from the patient perspective: An analysis based upon the German Socio-Economic Panel (SOEP) survey

Abstract The financial implications of breast cancer diagnosis may be greater among rural and black women. Women with incident breast cancer were recruited as part of the Carolina Breast Cancer Study. We compared unadjusted and adjusted prevalence of cancer-related job or income loss, and a composite measure of either outcome, by rural residence and stratified by race. We included 2435 women: 11.7% were rural; 48.5% were black; and 38.0% reported employment changes after diagnosis. Rural women more often reported employment effects, including reduced household income (43.6% vs 35.4%, two-sided χ2 test P = .04). Rural white, rural black, and urban black women each more often reported income reduction (statistically significant vs. urban white women), although these groups did not meaningfully differ from each other. In multivariable regression, rural differences were mediated by socioeconomic factors, but racial differences remained. Programs and policies to reduce financial toxicity in vulnerable patients should address indirect costs of cancer, including lost wages and employment.

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The Person in the Images: A Patient Perspective on Cancer Diagnosis, Therapy, and Living with Cancer

Radiology: Imaging Cancer ◽

10.1148/rycan.2021210031 ◽

2021 ◽

Vol 3 (2) ◽

pp. e210031

Author(s):

Erika Lojko ◽

Brock Humphries ◽

Gary D. Luker

Keyword(s):

Cancer Diagnosis ◽

Patient Perspective ◽

Living With Cancer ◽

Diagnosis Therapy

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Employment Challenges Faced by Breast Cancer Survivors in an Upper Middle–Income Asian Setting

Journal of Global Oncology ◽

10.1200/jgo.18.25300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 119s-119s

Author(s):

Y.-C. Kong ◽

N.T. Bhoo-Pathy ◽

L.-P. Wong ◽

A.F. Aziz ◽

N.A. Taib ◽

...

Keyword(s):

Breast Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Work Environment ◽

Cancer Diagnosis ◽

Breast Cancer Survivors ◽

Breast Cancer Diagnosis ◽

Income Loss ◽

Middle Income ◽

Number Of Patients

Background: Cancer survivorship as an area, which focuses on the health and life of an individual following cancer diagnosis and treatment is increasingly being recognized as an important component of the cancer control continuum. Advances in breast cancer detection and treatments have resulted in a growing number of patients experiencing a breast cancer diagnosis at an age when career plays an important role in their lives. Yet, very little is known on how breast cancer affects employment and return to work among survivors, particularly in low- and middle-income settings. Aim: This qualitative study aims to gain an in-depth understanding on employment challenges and motivators/barriers in return to work faced by breast cancer survivors in an upper-middle income Asian setting. Methods: Eleven focus group discussions (FGDs) were conducted with breast cancer survivors representing various ethnicities and socioeconomic backgrounds in Malaysia. Patients diagnosed one to two years prior to the study were recruited from a general public hospital, a public academic hospital and two private hospitals. Data from the FGDs were examined using thematic content analysis from the NVivo software. Results: The major themes relating to impact of cancer diagnosis on employment were “decreased work ability”, “job loss”, “long absenteeism” and “hostile work environment”. Coping strategy themes frequently mentioned to offset income loss from employment changes were “savings”, “part-time work” or financial support from “family/friends” or “social security”. However, participants were quick to highlight the insufficiency and unreliability of these strategies to cope financially in the long run. When describing their decision in choosing to return to work, participants mentioned themes such as “need money”, feeling “more happy” or having a “supportive work environment”. Nonetheless, participants emphasized the “discrimination” they faced in finding a job after active treatment. Specifically, participants' frequent need to take time-off from work for their cancer follow-ups as well as their older age were perceived as disadvantages in seeking employment when compared with younger, healthy applicants. Conclusion: It is evident that a breast cancer diagnosis severely disrupts employment and return to work in middle income settings. Multisectoral interventions are urgently required to improve the employment status of our cancer survivors, including legislative reforms to prevent discrimination. Programs supporting employment and return to work among cancer survivors should be developed and integrated in the provision of a holistic survivorship care.

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PCN297 INCOME LOSS AFTER A CANCER DIAGNOSIS IN GERMANY: AN ANALYSIS BASED UPON THE SOCIO-ECONOMIC PANEL SURVEY

Value in Health ◽

10.1016/j.jval.2020.04.1760 ◽

2020 ◽

Vol 23 ◽

pp. S76 ◽

Cited By ~ 1

Author(s):

D. Hernandez ◽

M. Schlander

Keyword(s):

Cancer Diagnosis ◽

Panel Survey ◽

Income Loss

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Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption

Frontiers in Oncology ◽

10.3389/fonc.2021.690454 ◽

2021 ◽

Vol 11 ◽

Author(s):

Caitlin B. Biddell ◽

Stephanie B. Wheeler ◽

Rebekah S.M. Angove ◽

Kathleen D. Gallagher ◽

Eric Anderson ◽

...

Keyword(s):

Health Insurance ◽

Cancer Patients ◽

Ethnic Differences ◽

Cancer Diagnosis ◽

Insurance Coverage ◽

Diagnosis And Treatment ◽

Cancer Type ◽

Income Loss ◽

Financial Consequences ◽

Racial Ethnic

IntroductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.MethodsWe surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage.ResultsOf 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 – 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 – 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 – 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 – 23.0) higher probability compared to NH White respondents.DiscussionCompared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens.

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