Childhood cancer survivors in poor health at greater risk for unemployment in adulthood

Childhood cancer survivors with poor physical health and neurocognitive deficits are more likely to be unemployed or work part-time in adulthood, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Research to date has indicated that while more children with cancer are surviving, the treatments received can place them at risk for health complications later in life, which may impact their ability to work, according to the study.

"We know from earlier studies that are more likely to be unemployed compared to unaffected samples. Our research points to factors such as physical health limitations that may be important to address to improve employment outcomes in this population," said Anne Kirchhoff, Ph.D., M.P.H., who was a postdoctoral research fellow at the Fred Hutchinson Cancer Research Center in Seattle, Wash., during the time of the study. Kirchhoff is currently a Huntsman Cancer Institute investigator and an assistant professor of pediatrics at the University of Utah School of Medicine.

Using data from the Childhood Cancer Survivor Study, Kirchhoff and colleagues examined 5,836 adult childhood cancer survivors aged 25 years and older to determine how their physical, mental and neurocognitive function affected their employment and occupational status.

Childhood cancer survivors in poor physical health as defined by standard questionnaires were approximately eight times more likely to be unemployed in compared with adult cancer survivors in good health, according to Kirchhoff.

"Although mental health and neurocognitive limitations were also linked to unemployment, it was surprising that physical deficits were such a major factor for childhood cancer survivors who were unable to work due to their poor health status," she said.

Among employed survivors, those with neurocognitive limitations were less likely to hold professional positions and more likely to hold part-time or lower-skilled jobs, according to the researchers. Women with neurocognitive limitations, such as task-efficiency issues, were more likely to be working in lower-skilled occupations than men with the same neurocognitive deficits.

In addition, Kirchhoff and colleagues stressed that changes in employment status could impact survivors' access to health insurance coverage, which is essential to managing any long-term complications from cancer.

"Childhood cancer survivors should be educated about the risks, be screened for any limitations, and learn strategies to manage those limitations in an effort to ensure they have more successful employment outcomes," she said.

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