Female AYAs Experience Financial Hardship Associated with Cancer-Related Employment Disruption

The financial hardship associated with cancer-related employment disruption among female adolescent and young adults (AYAs) can be sizable according to a study published in Cancer, especially among women diagnosed at a younger age, Hispanic women, and those with caregiving responsibilities.¹

Given these findings, assistance returning to work following treatment as well as workplace accommodation policies present as important opportunities to lessen financial hardship and improve cancer survivorship care among this vulnerable patient population.

“Our study addresses the burden of employment disruption and financial hardship among young women with cancer—a group who may be at particular risk for poor financial outcomes after cancer given their age and gender,” Clare Meernik, MPH, of the University of North Carolina at Chapel Hill, said in a press release.² “Our findings highlight the need for effective interventions to promote job maintenance and transition back to the workforce after cancer treatment, as well as increased workplace accommodations and benefits, to improve cancer outcomes for young women.”

Responses to an online survey were collected from AYA cancer survivors identified through the North Carolina Central Cancer Registry and the Kaiser Permanente Northern/Southern California tumor registries. Of note, disrupted unemployment was defined as reducing hours, taking temporary leave, or stopping work entirely due to cancer. Financial hardship was defined as material conditions or psychological distress which developed because of cancer.

Of 1328 women eligible for study who were employed at the time of their diagnosis, women were a median age of 34 years at the time of diagnosis and 7 years from diagnosis at the time of the survey. Overall, approximately 32% of the cohort experienced employment disruption.

A considerable percentage of the patients studied reported financial hardship related to material conditions (27%) or psychological distress (50%). Further, in adjusted analyses, women with disrupted employment experienced a 17% higher burden of material conditions (95% CI, 10%-23%) and an 8% higher burden of psychological distress (95% CI, 1%-16%) compared with those who did not experience a disruption.

“The relationship between employment disruption and material conditions was particularly pronounced among women diagnosed at a younger age (aged <35 years) and Hispanic women, whereas the relationship between employment disruption and psychological distress was stronger among women aged 30 to 34 years, those who were 6 to 9 years after their diagnosis, and those acting as caregivers,” the authors added. “The findings of the current study also highlighted the severity of material conditions related to employment disruption: 24% of women with disruption borrowed or went into debt of at least $10,000 and 9% borrowed or went into debt of at least $25,000 compared with 9% and 2.5%, respectively, among women with no disruption.”

According to the investigators, the development of survivorship care interventions that promote self-management and assist with transitioning back to or remaining in the workforce following a diagnosis of cancer may help to alleviate or prevent the effects of employment disruption on financial hardship. Moreover, the effects of cancer-related employment disruption could also be diminished or prevented altogether with the implementation of more flexible work accommodations and sick leave policies.

Moving forward, researchers suggested future studies that examine employment and financial outcomes among AYA cancer survivors would benefit by assessing more detailed information regarding factors such as dependent status at the time of diagnosis, household income, health insurance throughout treatment, employer-provided sick leave benefits and other disability insurance, demands of unpaid caregiving roles, and a variety of indicators of financial hardship. Information such as this could be used to inform potential targets of intervention.

References:

1. Meernik C, Kirchhoff AC, Anderson C, et al. Material and Psychological Financial Hardship Related to Employment Disruption Among Female Adolescent and Young Adult Cancer Survivors. Cancer. doi: 10.1002/cncr.33190

2. Study Examines Cancer’s Effects on Young Women’s Employment and Finances [news release]. Published October 12, 2020. Accessed October 13, 2020. https://newsroom.wiley.com/press-releases/press-release-details/2020/Study-Examines-Cancers-Effects-on-Young-Womens-Employment-and-Finances/default.aspx