Abstract PO-094: Financial hardship associations with presenteeism and absenteeism among survivors and informal caregivers during cancer treatment
Authors: Warner Echo L. , Rainbow Jessica G. , Sikorski Alla , Segrin Chris , Badger Terry 
Published: January 2022

Purpose: People with low perceived work performance and those who are absent from work may be at increased risk for negative employment and financial outcomes during cancer treatment. Thus, we evaluated associations between reports of financial hardship and cancer survivors' and caregivers' perceived work performance and absenteeism. Methods: Participants were surveyed during a larger study on symptom management in survivor-caregiver dyads. We limited to respondents who were employed (N=165). Survey variables included employment status, work performance, sociodemographics, perceived work performance in the prior week, performance in the prior year, and absences from work in the prior week using items from the World Health Organization Health and Work Questionnaire, and financial hardship. Financial hardship included four questions asking whether participants' income met their financial needs, adequacy of financial resources to pay for needs, and for caregivers, whether caregiving had caused financial strain. We summarized sociodemographics and conducted regression analyses to evaluate associations between presenteeism and absenteeism and financial hardship, controlling for sociodemographic factors. Results: On average, caregivers were 50.0 years (Standard Deviation (SD): 13.4) and survivors were 53.9 years (SD: 10.4). The most common relationship between survivors and caregivers was caregivers being spouses (41.7%) and children (22.9%). Caregivers reported working at higher rates (53.9% vs 22.1%, p&lt;0.001) and more hours than survivors (Mean=34.8 vs 33.6 hours, p=0.77). Survivors reported their job performance as 79.5% while caregivers reported theirs as 83.1% on a 0-100% scale. In the week prior, survivors reported absence from work for 0.95 hours while caregivers reported 0.84 hours. In the year prior to diagnosis, survivors and caregivers reported higher than current performance (84.4% and 85.2%, respectively). Caregivers whose finances were adequate to pay for the things they needed for caregiving reported 5.8% higher job performance in the prior year compared to those whose finances did not cover their caregiving expenses (95% Confidence Interval: 0.17-11.5, p=0.04), when controlling for sex, ethnicity, race, income, and education. Conclusions: Cancer patients and caregivers suffer work performance problems during cancer treatment, and this may influence their quality of life. Spouses and children of cancer survivors missed work and reported not working up to their prior performance level. Interventions to address symptom management and psychological distress may decrease absenteeism, promote higher perceived job performance, and allow more survivors and their caregivers to maintain or return to stable employment. Young adult cancer survivors and caregivers, who are still establishing themselves in careers and financially, may especially benefit from these interventions and flexible workplace policies.

Citation Format: Echo L. Warner, Jessica G. Rainbow, Alla Sikorski, Chris Segrin, Terry Badger. Financial hardship associations with presenteeism and absenteeism among survivors and informal caregivers during cancer treatment [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-094.