Working with Cancer: Health and Employment among Cancer Survivors
Menée aux Etats-Unis à partir de données portant sur 24 810 patients ayant survécu à un cancer, cette étude analyse l'association entre leur état de santé et leur situation professionnelle
Background : Cancer affects a growing proportion of US workers. Factors contributing to whether they continue or return to work after cancer diagnosis include: age, physical and mental health, health insurance, education, and cancer site. The purpose of this study was to assess the complex relationships between health indicators and employment status for adult cancer survivors. Methods : We analyzed pooled data from the 1997-2012 US National Health Interview Survey (NHIS). Our sample included adults with a self-reported physician diagnosis of cancer (n=24,810)) and adults with no cancer history (n=382,837). Using structural equation modeling (SEM), we evaluated the relationship between socio-demographic factors, cancer site, and physical and mental health indicators on the overall health and employment status among adults with a cancer history. Results : The overall model for cancer survivors fit the data well (χ2 (374)=3654.7, p <0.001; CFI = 0.98; RMSEA=0.04). Although black cancer survivors were less likely to report good-to-excellent health, along with Hispanic survivors they were more more likely to continue to work after diagnosis compared with their white counterparts. Health insurance status and educational level were strongly and positively associated with health status and current employment. Age and time since diagnosis were not significantly assocated with health status or employment, but there were significant differences by cancer site. Conclusion : A proportion of cancer survivors may continue to work because of employment-based health insurance, despite reporting poor health and significant physical and mental health limitations. Acute and long term health and social support are essential for the continued productive employment and quality of life of all cancer survivors.