Unemployment Among Adult Survivors of Childhood Cancer A Report From the Childhood Cancer Survivor Study

被引:112
|
作者
Kirchhoff, Anne C. [1 ,2 ]
Leisenring, Wendy [1 ]
Krull, Kevin R. [3 ]
Ness, Kirsten K. [3 ]
Friedman, Debra L. [4 ]
Armstrong, Gregory T. [3 ]
Stovall, Marilyn [5 ]
Park, Elyse R. [6 ]
Oeffinger, Kevin C. [7 ]
Hudson, Melissa M. [3 ]
Robison, Leslie L. [3 ]
Wickizer, Thomas [8 ]
机构
[1] Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA
[2] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA
[3] St Jude Childrens Res Hosp, Memphis, TN 38105 USA
[4] Vanderbilt Ingram Canc Ctr, Nashville, TN USA
[5] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
[6] Massachusetts Gen Hosp, Boston, MA 02114 USA
[7] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
[8] Ohio State Univ, Coll Publ Hlth, Columbus, OH 43210 USA
关键词
pediatric cancer; cancer survivorship; employment; socioeconomic factors; LONG-TERM SURVIVORS; HEALTH-STATUS; COHORT;
D O I
10.1097/MLR.0b013e3181eaf880
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Adult childhood cancer survivors report high levels of unemployment, although it is unknown whether this is because of health or employability limitations. Objectives: We examined 2 employment outcomes from 2003 in the Childhood Cancer Survivor Study (CCSS): (1) health-related unemployment and (2) unemployed but seeking work. We compared survivors with a nearest-age CCSS sibling cohort and examined demographic and treatment-related risk groups for each outcome. Methods: We studied 6339 survivors and 1967 siblings >= 25 years of age excluding those unemployed by choice. Multivariable generalized linear models evaluated whether survivors were more likely to be unemployed than siblings and whether certain survivors were at a higher risk for unemployment. Results: Survivors (10.4%) reported health-related unemployment more often than siblings (1.8%; Relative Risk [RR], 6.07; 95% Confidence Interval [CI], 4.32-8.53). Survivors (5.7%) were more likely to report being unemployed but seeking work than siblings (2.7%; RR, 1.90; 95% CI, 1.43-2.54). Health-related unemployment was more common in female survivors than males (Odds Ratio [OR], 1.73; 95% CI, 1.43-2.08). Cranial radiotherapy doses >= 25 Gy were associated with higher odds of unemployment (health-related: OR, 3.47; 95% CI, 2.54-4.74; seeking work: OR, 1.77; 95% CI, 1.15-2.71). Unemployed survivors reported higher levels of poor physical functioning than employed survivors, and had lower education and income and were more likely to be publicly insured than unemployed siblings. Conclusions: Childhood cancer survivors have higher levels of unemployment because of health or being between jobs. High-risk survivors may need vocational assistance.
引用
收藏
页码:1015 / 1025
页数:11
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