Impact of gender and employment type on job loss among cancer survivors.

OBJECTIVE: To identify factors associated with cancer-related job loss following cancer diagnosis. METHODS: A multicentre cross-sectional survey was conducted among adult cancer survivors employed at the time of cancer diagnosis. Hierarchical multivariate logistic regression was used to examine the association of gender and employment type with job loss after cancer diagnosis and if the interaction between gender and employment type predicted job loss. RESULTS: Of 1618 patients recruited, 1483 returned questionnaires (91.7% response rate). Data from 708 patients were eligible for analyses. Approximately 21% of patients had lost their job within 10 years of diagnosis. Patients who had undergone chemotherapy were more likely to lose their jobs than those who had not (OR = 3.24, 95% CI 2.13-4.91). Women were more likely to lose their jobs than men (OR = 2.58, 95% CI 1.48-4.50). Temporary employees were more likely to lose their jobs than regular employees (OR = 2.62, 95% CI 1.72-3.99). After controlling for demographic and clinical characteristics, no interaction effects between gender and employment type were observed (P = 0.44). CONCLUSIONS: Women and temporary employees are more vulnerable to cancer-related job loss. Clinicians need greater awareness of the risk of patient job loss, and they need to assess patients' employment types and provide appropriate support to balance treatment schedules and work.

[Proactive Efforts by Medical Establishments to Support Working Cancer Patients and Formation of Comprehensive Employment Support Networks in Local Communities].

As part of proactive efforts to support working cancer patients at medical establishments, patients were given advice not to quit working after diagnosis and invited to a cancer counseling and support center. Further, medical treatment plans focusing on treatment period were presented prior to the start of treatment. These plans can be useful for cancer patients who seek support from their employers about changing their working conditions during treatment. Although these active support initiatives for newly diagnosed working cancer patients tended to contribute to a decrease in the rate of early job termination, the number of cancer patients who quit their work did not decrease significantly. There was a limit to work-related support at the clinical site. It is essential for many professionals to collaborate, such as clinicians, occupational health staff and working support professionals in the promotion of measures for balancing work and treatment for cancer patients. In the Tokai area, we set up the Cancer and Employment Workshop in 2015. We have been working to establish a local network to comprehensively support these patients.

Job resignation after cancer diagnosis among working survivors in Japan: timing, reasons and change of information needs over time.

OBJECTIVE: Despite advances in work-related policies for cancer survivors, support systems for working survivors in healthcare settings in Japan remain underdeveloped. We aimed to reveal (i) the present situation of cancer survivors' job resignation, the timing of resignation, and reasons for resignation; (ii) healthcare providers' screening behaviors of cancer survivors' work-related difficulties and (iii) changes to cancer survivors' information/support needs over time since diagnosis. METHODS: We conducted an anonymous, cross-sectional survey using a convenience sample of re-visiting outpatients at three cancer centers in Japan in 2015. The questionnaire covered participants' demographic and clinical characteristics, change to job status, timing of and reasons for job resignation, screening experience regarding work-related difficulties by healthcare providers, and information/support needs at four distinct timings (at diagnosis, between diagnosis and initial treatment, between initial treatment and return-to-work, and after return-to-work). The results of 950 participants were eligible for statistical analysis. RESULTS: Only 23.5% of participants were screened about work-related issues by healthcare providers despite 21.3% participants reporting resigning at least once. Among participants who resigned, 40.2% decided to do so before initial treatment began. Regarding reasons for resignation, self-regulating and pessimistic reasons were ranked highly. Respondents' work-related information and support needs were observed to change over time. While treatment-related information (schedule and cost) was ranked highly at diagnosis, the need for more individually tailored information and support on work increased after treatment began. CONCLUSIONS: This study provides important basic data for developing effective support systems for working survivors of cancer in hospital settings.