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Impact of adjuvant chemotherapy on long‐term employment of survivors of early‐stage breast cancer
Author(s) -
Jagsi Reshma,
Hawley Sarah T.,
Abrahamse Paul,
Li Yun,
Janz Nancy K.,
Griggs Jennifer J.,
Bradley Cathy,
Graff John J.,
Hamilton Ann,
Katz Steven J.
Publication year - 2014
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28607
Subject(s) - medicine , survivorship curve , breast cancer , epidemiology , stage (stratigraphy) , cancer , cohort , population , cohort study , odds ratio , demography , environmental health , paleontology , sociology , biology
BACKGROUND Many women with early‐stage breast cancer are working at the time of diagnosis and survive without disease recurrence. The short‐term impact of chemotherapy receipt on employment has been demonstrated, but the long‐term impact merits further research. METHODS The authors conducted a longitudinal multicenter cohort study of women diagnosed with nonmetastatic breast cancer between 2005 and 2007, as reported to the population‐based Los Angeles and Detroit Surveillance, Epidemiology, and End Results program registries. Of 3133 individuals who were sent surveys, 2290 (73%) completed a baseline survey soon after diagnosis and of these, 1536 (67%) completed a 4‐year follow‐up questionnaire. RESULTS Of the 1026 patients aged < 65 years at the time of diagnosis whose breast cancer did not recur and who responded to both surveys, 746 (76%) worked for pay before diagnosis. Of these, 236 (30%) were no longer working at the time of the follow‐up survey. Women who received chemotherapy as part of their initial treatment were less likely to be working at the time of the follow‐up survey (38% vs 27%; P = .003). Chemotherapy receipt at the time of diagnosis (odds ratio, 1.4; P = .04) was found to be independently associated with unemployment during survivorship in a multivariable model. Many women who were not employed during the survivorship period wanted to work: 50% reported that it was important for them to work and 31% were actively seeking work. CONCLUSIONS Unemployment among survivors of breast cancer 4 years after diagnosis is often undesired and appears to be related to the receipt of chemotherapy during initial treatment. These findings should be considered when patients decide whether to receive adjuvant chemotherapy, particularly when the expected benefit is low. Cancer 2014;120:1854–1862 . © 2014 American Cancer Society .