Unemployment risk 2years and 4years following gastric cancer diagnosis: a population-based study.

Abstract

The needs of gastric cancer survivors have received limited attention. Returning to work after gastric cancer has not yet been described in a population-based study. We aimed to examine the unemployment risk at 2 and 4years after gastric cancer. The present historical prospective cohort study included baseline measurements from the Israeli Central Bureau of Statistics 1995 National Census, with follow-up until 2011. A group with gastric cancer and an age-, sex-, and ethnicity-matched control group were sampled from the census population. Binary logistic regression analyses were used to assess odds ratios (ORs) for the study outcomes, controlling for socioeconomic factors, and employment status at 2years before diagnosis. Data for 152 gastric cancer cases and 464 matched controls were analyzed. Those who died during the study period were excluded. Two years after diagnosis, 53.3% of gastric cancer survivors and 43.8% of controls were unemployed (p=0.04); 4years after diagnosis, 53.9% of survivors, and 47.2% of controls were unemployed (p=0.15). In the adjusted models, gastric cancer was only associated with unemployment 2years after diagnosis (OR=1.47, 95% confidence interval [CI]=1.02-2.12). This association weakened and lost significance 4years after diagnosis (OR=1.42, 95% CI=0.89-2.28). Gastric cancer was not associated with decreased income at 2 (OR=1.48, 95% CI=0.91-1.48) or 4years (OR=1.65, 95% CI=0.99-2.74) after diagnosis. Gastric cancer survivorship was associated with unemployment 2years after diagnosis. Longer-term survivors may have the prospect of returning to work. For patients with cancer, returning to work may be an indicator for returning to a normal lifestyle after serious illness. This study highlights the need for early social support in gastric cancer survivors to promote faster recovery.