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Factors influencing changes in employment among women with newly diagnosed breast cancer†

  1. Michael J. Hassett MD, MPH1,‡,*,
  2. A. James O'Malley PhD2,
  3. Nancy L. Keating MD, MPH2,3

Article first published online: 13 APR 2009

DOI: 10.1002/cncr.24301

Issue

Cancer

Cancer

Volume 115, Issue 12, pages 2775–2782, 15 June 2009

Additional Information

How to Cite

Hassett, M. J., O'Malley, A. J. and Keating, N. L. (2009), Factors influencing changes in employment among women with newly diagnosed breast cancer. Cancer, 115: 2775–2782. doi: 10.1002/cncr.24301

Author Information

  1. 1

    Center for Outcomes and Policy Research, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts

  2. 2

    Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts

  3. 3

    Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

  1. ‡

    Fax: (617) 632-2270

*Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115-6084

  1. †

    See editorial on pages 2598-601, this issue.

Publication History

  1. Issue published online: 4 JUN 2009
  2. Article first published online: 13 APR 2009
  3. Manuscript Accepted: 27 OCT 2008
  4. Manuscript Revised: 17 OCT 2008
  5. Manuscript Received: 2 JUN 2008

Funded by

  • Agency for Healthcare Research and Quality. Grant Number: PO1-HS10803
  • National Cancer Institute. Grant Number: R01 CA104118
  • American Society of Clinical Oncology Career Development Award. Grant Number: R25 CA092203

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Keywords:

  • breast cancer;
  • employment;
  • disability;
  • outcomes;
  • risk factors

Abstract

BACKGROUND:

Although studies have demonstrated that women are less likely to work after they are diagnosed with breast cancer, the influence of cancer treatments on employment is less clear. The authors of this report assessed whether chemotherapy or radiation therapy was associated with a disruption in employment during the year after a breast cancer diagnosis.

METHODS:

Using a database of health insurance claims that covered 5.6 million US residents, 3233 women aged ≤63 years were identified who were working full time or part time when they were diagnosed with breast cancer between 1998 and 2002. All changes in employment during the year after a breast cancer diagnosis were identified. Using a Cox proportional hazards model that incorporated time-varying treatment variables, the authors evaluated the impact of chemotherapy and radiation therapy on the likelihood of experiencing an employment disruption.

RESULTS:

Although most women (93%) continued to work, chemotherapy recipients were more likely than nonrecipients to go on long-term disability, stop working, or retire (hazards ratio, 1.8; P < .01). Women aged ≥54 years were more likely to experience a change in employment than women aged ≤44 years (P < .01). Radiation therapy did not influence employment (P = .22).

CONCLUSIONS:

In this population of employed, insured women, chemotherapy had a negative impact on employment. This finding may aid treatment decision making and could foster the development of interventions that support a patient's ability to continue working after treatment. It also reinforces the need to assess the impact of treatments, especially new treatments, on patient-centered outcomes such as employment. Cancer 2009. © 2009 American Cancer Society.

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