Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors
Open accessAbstract
Background: The impact of cancer and its treatment on employment and financial burden in adolescents/young adults (AYAs) is not fully known. Methods: Eligibility for this cross‐sectional study of AYA cancer survivors included the diagnosis of a malignancy between ages 18 and 39 years and survey completion within 1 to 5 years from diagnosis and ≥1 year after therapy completion. Participants were selected randomly from the tumor registries of 7 participating sites and completed an online patient‐reported outcomes survey to assess employment and financial concerns. Treatment data were abstracted from medical records. Data were analyzed across diagnoses and by tumor site using logistic regression and Wald‐based 95% confidence intervals adjusting for age (categorized), sex, insurance status, education (categorized), and treatment exposures. Results: Participants included 872 survivors (breast cancer, n = 241; thyroid cancer, n = 126; leukemia/lymphoma, n = 163; other malignancies, n = 342). Exposure to chemotherapy in breast cancer survivors was associated with an increase in self‐reported mental impairment in work tasks (odds ratio [OR], 2.66) and taking unpaid time off (OR, 2.62); survivors of “other” malignancies reported an increase in mental impairment of work tasks (OR, 3.67) and borrowing >$10,000 (OR, 3.43). Radiation exposure was associated with an increase of mental impairment in work tasks (OR, 2.05) in breast cancer survivors, taking extended paid time off work in thyroid cancer survivors (OR, 5.05), and physical impairment in work tasks in survivors of “other” malignancies (OR, 3.11). Finally, in survivors of “other” malignancies, having undergone surgery was associated with an increase in physical (OR, 3.11) and mental impairment (OR, 2.31) of work tasks. Conclusions: Cancer treatment has a significant impact on AYA survivors’ physical and mental work capacity and time off from work.
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More than 60% of adolescents and young adults experience adverse physical, psychosocial, or behavioral outcomes months or years after cancer treatment.
“Over 60% of adolescents and young adults will suffer adverse physical, psychosocial, and/or behavioral outcomes months or years after completion of cancer treatment [3–6].”
From A Hope-based intervention to address disrupted goal pursuits and quality of life among young adult cancer survivors (2020) · cites this paper as [4]
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- Authors
- Ketterl, T. G., Syrjala, K. L., Casillas, J., Jacobs, L. A., Palmer, S. C., McCabe, M. S., Ganz, P. A., Overholser, L., Partridge, A., Rajotte, E. J., Rosenberg, A. R., Risendal, B., Rosenstein, D. L., & Baker, K. S.
- Affiliations
- Seattle Children's Hospital (US)
- Fred Hutch Cancer Center (US)
- University of California, Los Angeles (US)
- Abramson Cancer Center (US)
- Memorial Sloan Kettering Cancer Center (US)
- University of Colorado Cancer Center (US)
- Dana-Farber Cancer Institute (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Ketterl, Tyler G.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2019-02
- Volume
- 125
- Issue
- 11
- Pages
- 1908-1917
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC6508988
- OpenAlex
- W2911580731
- Cited by
- 104
- References
- 17
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 10 · 2023: 22 · 2022: 15 · 2021: 14 · 2020: 11 · 2019: 3
- FWCI
- 11.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Cancer Institute (5P30 CA015704, CA201179, CA204378, CA215134)
- Livestrong Foundation
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- adolescent and young adult cancer survivors, employment, financial burden, work capacity, chemotherapy, radiotherapy, breast cancer, thyroid cancer, leukemia and lymphoma, patient-reported outcomes
- MeSH terms
- Patient Reported Outcome Measures, Cancer Survivors, Adolescent, Adult, Cross-Sectional Studies, Female, Financing, Personal, Humans, Male, Neoplasms, Unemployment, Logistic Models, Cost of Illness, Young Adult
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