Employment After Curative Breast Cancer Treatment: A Prospective Cohort Study

In a prospective New York City cohort of 489 women employed before diagnosis and treated for stage I–III breast cancer, 68.6% were working four months after treatment ended. Employment increased to 76.1% at one year and 77.3% at two years; access to sick leave and employer accommodations were associated with working at four months.

68.6% were working four months after treatment.
Employment rose to 77.3% by two years.
Sick leave and employer accommodation were positively associated with work.
Findings are observational and from New York City.

The Breast Cancer and the Workforce study followed women aged 18–64 who were employed before a stage I–III breast cancer diagnosis and received treatment in New York City. Participants completed surveys at baseline and four months after treatment; work status was reassessed at one and two years. Researchers also compared four-month employment with peers without cancer and used multivariable logistic regression to examine predictors of working.

Of 489 participants, 68.6% were working four months after treatment, rising to 76.1% at one year and 77.3% at two years. Older age, chemotherapy, and greater job demands were inversely associated with working at four months. Higher income, access to sick leave, and an accommodating employer were positively associated. Compared with same-race and ethnicity peers without cancer, Black, Chinese, and Latina participants had lower employment at four months; race and ethnicity were not associated with employment in the adjusted analysis.

The findings identify workplace conditions as potential targets for more equitable survivorship support. They are observational associations from a cohort in one US city and do not establish that workplace accommodations cause improved employment outcomes.

In practice

For women who were employed before diagnosis and treated for stage I–III breast cancer, employment often remained disrupted in the months after treatment: about 31% were not working at four months, although employment increased over two years. Sick leave access and an accommodating employer were associated with working, but the cohort study cannot show these factors caused employment retention. The findings may inform survivorship discussions about work-related support; they do not establish a specific intervention or justify a change in clinical management.

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Source

JNCI: Journal of the National Cancer Institute: Employment after curative breast cancer treatment: the breast cancer and the workforce cohort study ↗

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