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. 2021 Jan;160(1):199-205.
doi: 10.1016/j.ygyno.2020.10.041. Epub 2020 Nov 9.

Employment disruption following the diagnosis of endometrial cancer

Roni Nitecki  1 , Shuangshuang Fu  2 , Carolyn Lefkowits  3 , Benjamin D Smith  4 , Larissa A Meyer  1 , Alexander Melamed  5 , Sharon H Giordano  2 , J Alejandro Rauh-Hain  6
Affiliations

Employment disruption following the diagnosis of endometrial cancer

Roni Nitecki et al. Gynecol Oncol. 2021 Jan.

Abstract

Background: Oncologic treatment has been associated with unemployment. As endometrial cancer is highly curable, it is important to assess whether patients experience employment disruption after treatment. We evaluated the frequency of employment change following endometrial cancer diagnosis and assessed factors associated with it.

Methods: A cohort of patients 18-63 years-old who were diagnosed with endometrial cancer (January 2009-December 2017) were identified in the Truven MarketScan database, an insurance claims database of commercially insured patients in the United States. All patients who were working full- or part-time at diagnosis were included and all employment changes during the year following diagnosis were identified. Clinical information, including use of chemotherapy and radiation, were identified using Common Procedural Terminology codes, and International Statistical Classification of Diseases codes. Cox proportional hazards models incorporating measured covariates were used to evaluate the impact of treatment and demographic variables on change in employment status.

Results: A total of 4381 women diagnosed with endometrial cancer who held a full-time or part-time job 12 months prior to diagnosis were identified. Median age at diagnosis was 55 and a minority of patients received adjuvant therapy; 7.9% received chemotherapy, 4.9% received external-beam radiation therapy, and 4.1% received chemoradiation. While most women continued to work following diagnosis, 21.7% (950) experienced a change in employment status. The majority (97.7%) of patients had a full-time job prior to diagnosis. In a multivariable analysis controlling for age, region of residence, comorbidities, insurance plan type and presence of adverse events, chemoradiation recipients were 34% more likely to experience an employment change (HR 1.34, 95% CI 1.01-1.78), compared to those who only underwent surgery.

Conclusion: Approximately 22% of women with employer-subsidized health insurance experienced a change in employment status following the diagnosis of endometrial cancer, an often-curable disease. Chemoradiation was an independent predictor of change in employment.

Keywords: Employment; Endometrial cancer; Survivorship.

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Conflict of interest statement

Declaration of Competing Interest Drs. Nitecki, Fu, Melamed, Lefkowits, Giordano and Rauh-Hain have nothing to disclose. Dr. Smith reports grants from Varian Medical Systems, other from Oncora Medical, outside the submitted work. Dr. Meyer reports grants from National Cancer Institute, during the conduct of the study; other from AstraZeneca, outside the submitted work.

Figures

Fig. 1.
Fig. 1.
Cohort identification for endometrial cancer patients who were employed full-or part-time at diagnosis.
See this image and copyright information in PMC

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