title: Functional impairment and the economic consequences of female breast cancer.
abstract: Recent trends in breast cancer diagnosis and mortality suggest that long-term survivors are now more likely to be functionally impaired and, hence, more likely to experience adverse economic outcomes. This study tests whether women who have survived breast cancer for at least five years exhibit more, or more severe, functional impairments than otherwise similar women without breast cancer. It also tests whether women with more severe impairments experience poorer economic outcomes attributable to their functional status. A group of 105 breast cancer survivors was interviewed to obtain data on health and economic changes in the five-year period since diagnosis and initial treatment. An age- and work-matched group of 105 women without cancer was also interviewed to obtain the same data over the same time period. Key changes in the functional status of the subjects as well as economic outcomes such as changes in market earnings, household income, and insurance coverage were measured. Whether impairment is more severe in the breast cancer group than the comparison group was then tested statistically; whether economic outcomes are more adverse in more impaired than less impaired women regardless of their breast cancer status was also tested. The analysis turned up statistically significant evidence in regard to each of these relationships. Breast cancer survivors were more likely than controls to be functionally impaired at the five-year benchmark. Impaired women, in turn, were more likely to reduce work effort and experience downturns in market earnings, among other things. Policy and research implications are discussed.
authors.affiliation: H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa 33612-9497, USA. chirikos@moffitt.usf.edu
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Chirikos
authors.forename: Anita
authors.initials: A
authors.lastname: Russell-Jacobs
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001943:Breast Neoplasms / Q000191:economics* / Q000503:physiopathology / Q000534:rehabilitation*; D002173:Cancer Care Facilities; D015897:Comorbidity; D006233:Persons with Disabilities / Q000145:classification* / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000453:epidemiology; D011788:Quality of Life; D012494:Sampling Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000145:classification* / Q000706:statistics & numerical data; D014481:United States; D016387:Women's Health