Abstract
Men with localized prostate cancers are insured for undergoing radical radiotherapy or prostatectomy. However, limited information is available on the influence of cancer treatments on patients’ employment status in Japan. Therefore, in this web-based survey, we aimed to compare the effects of post-treatment changes on the annual income of patients with prostate cancer after undergoing radical radiotherapy and prostatectomy and to identify the risk factors associated with the decrease in annual income. We investigated the clinical characteristics and demographics including pre-treatment working status, self-employment, non-regular employment, working for wage or salary, and joblessness of patients with localized prostate cancer. Multivariable logistic regression was performed to analyze the effects of various factors on the change in the annual income of self-employed and non-regularly employed workers. Seventy-eight eligible patients with localized prostate cancer had undergone radiotherapy, and 128 patients had undergone prostatectomy. Among self-employed and non-regularly employed workers, post-treatment income decline rates in those who underwent radiotherapy were smaller but not significant (12% vs. 42%, P = 0.074). Multivariable logistic regression analysis revealed that initial treatment for prostate cancer was the only significant risk factor for the post-treatment income decline among self-employed and non-regularly employed workers. Radiotherapy was associated with a smaller decrease in income (odds ratio, 0.22; 95% confidence interval, 0.052–0.95; P = 0.042). Our novel results implied the effectiveness of radiotherapy in preventing post-treatment income decline among patients with prostate cancer based on specific employment status: self-employed or non-regularly employed.
Highlights
Prostate cancer is the most common cancer in men; in Japan, approximately 90,000 new cases were identified in 2017 [1]
We examined the association of initial radical therapies for prostate cancer, i.e., radiotherapy or surgery, with the change in their annual income before and after their therapies
Among all enrolled patients with localized prostate cancer, we identified 78 who underwent radical radiotherapy and 128 patients who underwent surgery; their baseline demographic and clinical factors were not significantly different (Table 1)
Summary
Prostate cancer is the most common cancer in men; in Japan, approximately 90,000 new cases were identified in 2017 [1]. Men with localized prostate cancer are often suitable for multiple treatment choices such as prostatectomy and radiotherapy. Patients living in Japan are eligible for financial assistance from a public medical insurance system for their medical expenses [4]. These patients experience a change in their income because of problems such as absenteeism, impaired productivity, early retirement, or compensation at work, which vary depending on their employment situations. We conducted an Internet-based survey on the effect of radical treatments (radiotherapy and prostatectomy) for localized prostate cancer on the change in patients’ annual income before and after their diagnoses
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