Short- and long-term impact of cancer on employment and financial outcomes of adolescents and young adults (AYAs): a large population-based case-control registry study in the Netherlands

S. H.M. Janssen, D. J. van der Meer, M. C.H.J. van Eenbergen, E. Manten-Horst, W. T.A. van der Graaf, O. Husson*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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Abstract

Background: Adolescent and young adult (AYA) cancer survivors, 18-39 years at initial cancer diagnosis, often self-report negative consequences of cancer (treatment) for their career. Less is known, however, about the objective impact of cancer on employment and financial outcomes. This study examines the employment and financial outcomes of AYA cancer survivors with nationwide population-based registry data and compares the outcomes of AYAs with cancer with an age- and sex-matched control population at year of diagnosis, 1 year later (short-term) and 5 years later (long-term). Patients and methods: A total of 2527 AYAs, diagnosed in 2013 with any invasive tumor type and who survived for 5 years, were identified from the Netherlands Cancer Registry (clinical and demographic data) and linked to Statistics Netherlands (demographic, employment and financial data). AYAs were matched 1: 4 with a control population based on age and sex (10 108 controls). Analyses included descriptive statistics, chi-square tests, independent samples t-tests, McNemar tests and logistic regression. Results: AYA cancer survivors were significantly less often employed compared with their controls 1 year (76.1% versus 79.5%, P < 0.001) and 5 years (79.3% versus 83.5%, P < 0.001) after diagnosis, and received more often disability benefits (9.9% versus 3.1% 1 year after diagnosis, P < 0.001; 11.2% versus 3.8% 5 years after diagnosis, P < 0.001). Unemployed AYAs were more often diagnosed with higher disease stages (P < 0.001), treated with chemotherapy (P < 0.001), radiotherapy (P < 0.001) or hormone therapy (P < 0.05) and less often with local surgery (P < 0.05) compared with employed AYAs 1 and 5 years after diagnosis. Conclusion: Based on objective, nationwide, population-based registry data, AYAs’ employment and financial outcomes are significantly affected compared with age- and sex-matched controls, both short and long-term after cancer diagnosis. Providing support regarding employment and financial outcomes from diagnosis onwards may help AYAs finding their way (back) into society.

Original languageEnglish
Article number100521
JournalESMO Open
Volume7
Issue number4
Early online date27 Jun 2022
DOIs
Publication statusPublished - 1 Aug 2022

Bibliographical note

Funding Information:
This work was supported by an infrastructural grant from the Dutch Cancer Society [grant number 11788 COMPRAYA study], a VIDI grant from the Netherlands Organization for Scientific Research [grant number VIDI198.007] and Janssen-Cilag B.V.

Funding Information:
The authors would like to thank the Netherlands Cancer Registry (NCR), for the collection and their permission to use the demographic and clinical data of the AYA cancer survivors. The authors would like to thank Statistics Netherlands (CBS) as well, for the collection and their permission to use the demographic data and data regarding employment and finances of all AYAs and controls. This work was supported by an infrastructural grant from the Dutch Cancer Society [grant number 11788 COMPRAYA study], a VIDI grant from the Netherlands Organization for Scientific Research [grant number VIDI198.007] and Janssen-Cilag B.V. The authors have declared no conflicts of interest. Restrictions apply to the availability of the NCR and CBS data described in this paper. Both parties need to give permission to access the data. Ethical review and approval were waived. NCR and CBS data are collected for registration purposes. The NCR and CBS both reviewed and approved the study protocols.

Publisher Copyright:
© 2022 The Authors

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