title: Employment among survivors of lung cancer and colorectal cancer.
abstract: OBJECTIVE
  To identify the frequency of and factors associated with changes in employment among cancer survivors.
  
  
  METHODS
  This prospective cohort study took place in the context of the population-based Cancer Care Outcomes Research and Surveillance Consortium. Patients with nonmetastatic lung or colorectal cancer who survived approximately 15 months after diagnosis without cancer recurrence provided their self-reported employment status, employment experiences, and changes in insurance coverage at 4 and 15 months after diagnosis. Multiple logistic regression was used to relate sociodemographic and disease factors to the probability of labor force departure.
  
  
  RESULTS
  Among 2,422 eligible patients, employment declined from 3% to 31% over the 15 months after cancer was diagnosed. Labor force departures attributable to cancer occurred in 17% of those employed at baseline. Factors associated with significantly higher rates of labor force departure were lung versus colon cancer, stage III versus I or II disease, lower educational and income levels, and, among colorectal patients, older age. Married women were significantly more likely than unmarried women to leave the workforce. Only 2% of patients lacked health insurance during the study period.
  
  
  CONCLUSIONS
  Most employed patients with nonmetastatic lung or colorectal cancer return to work, but approximately one sixth of patients leave the workforce, particularly those with worse prognoses or lower socioeconomic status. Potential economic effects must be considered in management decisions about cancer.
authors.affiliation: Institute for Clinical Evaluative Sciences and University of Toronto, Toronto, Ontario, Canada. craig.earle@ices.on.ca
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
authors.forename: Yves
authors.initials: Y
authors.lastname: Chretien
authors.forename: Carl
authors.initials: C
authors.lastname: Morris
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
authors.forename: Robert
authors.initials: R
authors.lastname: Wallace
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000191:economics*; D004651:Employment; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics*; D008297:Male; D008393:Marriage; D008875:Middle Aged; D012923:Social Class; D017741:Survivors