Employment and workdays lost among spouses of cancer survivors: Intersection with gender across cancer treatment status.

Abstract

Cancer patients and survivors have high care needs, often provided by a spouse or partner. The purpose of this study was to elucidate how employment and work loss patterns differed across cancer history/treatment status and gender. Using nationally representative data from the Medical Expenditure Panel Survey (2011, 2016, and 2017), the authors linked data across married participants and categorized them by spouses' cancer treatment status (no cancer history, on treatment for cancer, off treatment for cancer). Multivariable logistic and zero-inflated negative binomial regressions were used to assess the associations among cancer history/treatment status, gender, and employment outcomes (employment status and workdays lost to care for self or others). For men, employment did not differ significantly by cancer history/treatment status (on treatment: odds ratio [OR], 0.58; 95% confidence interval [CI], 0.33-1.02, off treatment: OR, 0.84; 95% CI, 0.62-1.14 vs. no cancer history). For women, employment was not significantly different when the spouse was on treatment for cancer compared to no cancer history (OR, 0.78; 95% CI, 0.33-1.86]) but was significantly increased for women whose spouse was off treatment (OR, 1.39; 95% CI, 1.05-1.84). Among employed participants, women whose spouse was on cancer treatment were nine times more likely to take days off work to provide care (OR, 9.52; 95% CI, 3.94-23.03) and took more than three times as many days off to care for others (OR, 3.21; 95% CI, 2.07-4.97) as men whose spouse had no cancer history. Wives of cancer survivors are at increased risk of work loss, with implications for their financial and psychological well-being. Employers, policymakers, and clinicians have opportunities to support working caregivers.