Adult survivors of childhood cancer and unemployment

May 23 2006

Adults with a history childhood cancer are more likely than the general population to be unemployed, according to a new review.

Published in the July 1, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the report reveals that employment problems differed by cancer type, with survivors of some cancer types up to five times more likely to be out of work. Among other factors associated with increased risk of unemployment were living in America, younger age, and female gender. This is the first study to aggregate and analyze employment and childhood cancer survivor data from the most methodologically sound studies published.

The prognosis for children diagnosed with cancer is excellent. More than seven in ten pediatric cancer patients now survive more than five years and most of those survive to adulthood. Survival is not without secondary problems, such as other cancers, heart diseases, hormone abnormalities, infertility, chronic fatigue and depression. These complaints can be lifelong impairments to social development and well-being. For most people, and in particular cancer survivors, employment and professional career are important personal factors of self-image and confidence. For survivors, cancer may rob them of that and many other social experiences.

A.G.E.M. de Boer, Ph.D. of the Coronel Institute for Occupational Health, Academic Medical Center in Amsterdam and colleagues systematically summarized and analyzed data from 40 studies that investigated the questions of whether childhood cancer survivors have a greater risk of unemployment than the general population, and what factors may identify at risk individuals and groups.

Analysis of the aggregated data showed that overall, adults who survived cancer as a child were twice as likely to be unemployed than adults without a history of childhood cancer. On analysis by cancer type, adults treated for brain or other central nervous system tumors were five times more likely to be unemployed. However, blood-cell and bone marrow cancer survivors had an elevated risk unemployment that did not reach statistical significance. Similarly, other cancers had no elevated risk.

Analysis of other factors indicated that nationality, gender, age at diagnosis, and physical and mental impairments were all linked to higher unemployment rates. For example, Americans were three times more likely to be unemployed, while Europeans had no elevated work risk. Females and younger age at diagnosis also predicted higher risk of failing to find work.

The authors conclude that "interventions aimed at obtaining and maintaining employment are needed, especially for the vulnerable subgroups." Interventions, they argue, "could mitigate the economic impact of surviving cancer and improve the quality of life of survivors."