Abstract A114: Changes in employment status and productivity after a cancer diagnosis as markers of long-term financial well-being
Authors: Jaffe Shoshana Adler , Anderson Jessica , Dailey Yvonne , Guest Dolores , Sussman Andrew , Meisner Angela , Wiggins Charles , McDougall Jean 
Published: September 2020

Abstract
Background: Cancer and its treatment interfere with employment, often leading to prolonged leave, changes in hours, and reduced productivity. Socioeconomic disparities in employment outcomes have been documented previously, but the relationship between employment outcomes following a cancer diagnosis and long-term financial well-being (FWB) is poorly understood. The objectives of this analysis were to identify patient sociodemographic characteristics associated with negative changes in employment and productivity and to explore the relationship between these changes and FWB. Methods: In this cross-sectional study, working-age individuals diagnosed with stage I-III breast, colorectal, or prostate cancer were sampled from the New Mexico Tumor Registry. Participants completed a survey about their economic experience at three different time points (the year prior to cancer diagnosis, the year after diagnosis, and at the time of the survey). Changes in self-reported employment status and productivity were ascertained using validated questions from the Medical Expenditure Panel Survey Experiences with Cancer Supplement. FWB was characterized using the Financial Well-Being Scale (0-100) from the Consumer Financial Protection Bureau. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between sociodemographic characteristics and employment changes or productivity. Multivariable linear regression with propensity score weighting was used to model the relationship between changes in employment, changes in productivity, and FWB. Results: A total of 292 employed cancer survivors completed the survey (median age 51, female 68%, Hispanic 37%, rural 33%). Survivors who reported a change in employment (n=236, 80%), were more likely to be Hispanic v. non-Hispanic white (OR 2.01, 95% CI 1.02, 3.96) or unmarried females v. married males (OR 3.80, 95% CI 1.40,10.3). In addition, survivors reporting a change in employment had, on average, a 7-point lower FWB score (estimate=-6.93, 95% CI -11.0,-2.78) after adjusting for age, comorbidities, marital status, and income. A reduction in productivity at work (n=223, 77%) was more common among unmarried females (OR 4.90, 95% CI 1.86, 13.0) and married females (OR 2.18, 95% CI 1.09, 4.35) compared to married males. In addition, survivors reporting a change in productivity had, on average, a 5-point lower current FWB score (estimate=-5.10, 95% CI -9.33,-0.88) than individuals who did not experience a change in productivity, adjusted for age, comorbidities, marital status and insurance. Disparities in the likelihood of changes in employment or productivity were not observed between rural and urban cancer survivors. Conclusion: Hispanic and female cancer survivors may be particularly vulnerable to negative employment outcomes following a cancer diagnosis. These disparities are important because changes in employment and productivity appear to have detrimental, long-term effects on FWB.
Citation Format: Shoshana Adler Jaffe, Jessica Anderson, Yvonne Dailey, Dolores Guest, Andrew Sussman, Angela Meisner, Charles Wiggins, Jean McDougall. Changes in employment status and productivity after a cancer diagnosis as markers of long-term financial well-being [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A114.