Race, insurance status linked to job loss after breast cancer

Job loss following early-stage breast cancer diagnosis is associated with race and insurance status, but not with any clinical or treatment-related factors, finds a new study from the Brown School at Washington University in St. Louis.

Not only were an African-American patient or an uninsured patient four times more likely to leave the workforce despite fighting a cancer with high survival rates, but they also were more likely to return in a lesser job within the first two years cancer-free.

The study, "Early-Stage Breast Cancer and Employment Participation After 2 Years of Follow-Up: A Comparison With Age-Matched Controls," was published Feb. 13 in the journal Cancer.

"We examined post-treatment employment patterns in early-stage breast cancer patients," said lead author Christine Ekenga, assistant professor at the Brown School.

"During the two-year follow-up, African-American patients were four times more likely to leave the workforce than white patients, and uninsured/publicly insured patients were 4.7 times more likely to leave the workforce than privately insured patients."

As part of a larger cohort study of 1,096 patients with early-stage breast cancer and same-aged women without breast cancer, data from 723 working-age women 40-64 years old (347 patients and 376 controls) were analyzed to evaluate four employment trajectories: sustained unemployment, diminished employment, emerging employment and sustained employment.

The study focused on patients with early-stage breast cancer, a population that has an excellent prognosis for disease-free survival.

Fatigued patients, African-American patients and publicly insured/uninsured patients with cancer were more likely to experience diminished employment after two years of follow-up.

The study collected information regarding a participant's inability to work but participants were not asked why they were unable to work. A follow up study aims to address this question.

Although cancer survivors are more likely to report unemployment than individuals without a cancer history, working after diagnosis may represent a return to normalcy for some patients with breast cancer, Ekenga wrote in the paper.

"In addition to the added benefit of employer-sponsored health insurance, paid employment has the potential to mitigate the financial stresses associated with cancer," she wrote.

"Moreover, for women with breast cancer, employment could play a significant role in post-diagnostic health. Health benefits associated with employment include an increased sense of purpose, higher self-esteem and a stronger sense of social support from others, all of which have been associated with improved quality of life."