Workplace productivity losses due to cancer: findings from an Australian longitudinal population survey (2009-2021).
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BACKGROUND: Cancer survivors face ongoing health challenges that can reduce work capacity, yet the economic impact of workplace productivity losses remains underexamined. We aim to estimate workplace productivity losses, specifically absenteeism and presenteeism, among Australian cancer survivors and quantified associated wage costs. METHODS: We analyzed four waves (2009-2021) of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, including adults aged ≥15 years in the labor force reporting cancer, non-cancer serious illness, or no serious illness. Absenteeism (annual days off work) was modeled using zero-inflated Poisson regression, and presenteeism (self-reported reduced work performance) using logistic regression, adjusting for sociodemographic, health, and employment factors. Sensitivity analyses explored alternative absenteeism definitions. RESULTS: Cancer survivors had a 33% higher rate of absenteeism (Incidence Rate Ratio [IRR]: 1.33; 95% CI: 1.31-1.35, p-value < 0.001) and approximately double the odds of presenteeism (Adjsusted Odds Ratio [aOR] : 2.04; 95% CI: 1.71-2.43; p-value < 0.001) compared with individuals without serious illness. Estimated average annual absenteeism-related wage loss was AU$1425.45, predominantly among working-age adults (25-64 years). CONCLUSION: Cancer imposes substantial workplace productivity losses with significant economic implications. Findings support the development of evidence-based workplace policies and targeted occupational health interventions to sustain employment and reduce economic burden among cancer survivors.