Job Loss after Cancer Diagnosis among Working-Age Cancer Survivors.
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BACKGROUND: Cancer survivors have a higher risk of job loss than individuals in the general population. We aimed to investigate the employment status of cancer survivors in Japan. METHODS: In this retrospective cohort study, we analyzed data from the JMDC, Inc. from January 2007 to September 2023 (diagnosis period). Individuals aged 18 to 55 years with cancer diagnoses and undergoing treatment and a control group without cancer, heart disease, stroke, or mental disorders were included. The primary outcome was comparative job loss cumulative incidence between groups. As a secondary outcome, we evaluated factors associated with job loss for all cancer survivors. Cox proportional hazards models were used for analysis. RESULTS: This study included 112,964 cancer survivors (average age, 41.3 years; SD 9.08); 51.5% were women. Job loss cumulative incidence among cancer survivors 5 years after a cancer diagnosis was 76.2%, and the HR (95% confidence interval) was significantly higher than that in the control group (1.40; 1.38-1.41). In all cancer survivors, HRs were higher for men (1.64; 1.62-1.67) and those aged >50 years (1.61; 1.58-1.65). Job loss-related factors for all cancer survivors included female sex; brain tumors, pancreatic, skin, or female genital cancers; and ongoing chemotherapy and radiotherapy. CONCLUSIONS: Cancer survivors had higher job loss risks than the controls at 1 and 5 years after diagnosis. Being female and having specific types of cancers may be job loss-related factors. IMPACT: Cancer survivors face a high risk of job loss; thus, support for continued employment should reflect treatment conditions.