Childhood Cancer Survivors Face Higher Unemployment Risk

May 22 2006 - A review (*) published in the July 1, 2006 issue of CANCER shows that adults with a history of childhood cancer are more likely to be unemployed than the general population.

The article in the peer-reviewed journal of the American Cancer Society is claimed to be the first study to aggregate and analyze employment and childhood cancer survivor data from the most methodologically sound studies that have been published.

A.G.E.M. de Boer, Ph.D. from the Coronel Institute for Occupational Health, Academic Medical Center in Amsterdam and colleagues conducted a systematic summary and analyzed of data from 40 studies that investigated whether childhood cancer survivors had a greater risk of unemployment than the general population, and what factors might identify individuals and groups at risk.

Their report shows that employment problems vary between cancer types, with survivors of some types of cancer being up to five times more likely to be unemployed.

Other factors associated with an increased risk of unemployment were:

• living in America
• younger age, and
• female gender

While the prognosis is excellent for children diagnosed with cancer, with more than 7 in 10 now surviving more than 5 years and most of those surviving to adulthood, there may be secondary problems. These include:

• other cancers
• heart diseases
• hormone abnormalities
• infertility
• chronic fatigue
• depression

The researchers argue that such complaints can impair social development and well-being throughout life. Employment and professional career are important personal factors of self-image and confidence for most people, especially cancer survivors, but the consequences of cancer may rob them of that and many other social experiences.

Overall, analysis of the aggregated data indicated that adult survivors of childhood cancer were twice as likely to be unemployed than those without a history of childhood cancer. Analysis by cancer type showed that adults who had been treated for brain or other central nervous system tumors were five times more likely to be unemployed. However, blood-cell and bone marrow cancer survivors, and those who survived other types of cancer, did not have a statistically significant elevation of unemployment risk.

Other factors linked to higher unemployment rates were:

• nationality
• gender
• age at diagnosis, and
• physical and mental impairments

The analysis showed that Americans were three times more likely to be unemployed - but Europeans had no elevated risk of unemployment. Being female and a younger age at diagnosis were also predictors of a higher risk of unemployment.

The conclusion of the authors is that "interventions aimed at obtaining and maintaining employment are needed, especially for the vulnerable subgroups." They argue that intergventions "could mitigate the economic impact of surviving cancer and improve the quality of life of survivors."

* "Adult Survivors of Childhood Cancer and Unemployment: A Metaanalysis," A.G.E.M. de Boer, J.H.A.M. Verbeek, F.J.H. van Dijk, CANCER; Published Online: May 22, 2006 (DOI: 10.1002/cncr.21974); Print Issue Date: July 1, 2006.

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