Occupational outcomes of adult childhood cancer survivors: A report from the childhood cancer survivor study.
BACKGROUND
The authors examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher-skill occupations than a sibling comparison and whether certain survivors were at higher risk for lower-skill jobs.


METHODS
The authors created 3 mutually exclusive occupational categories for participants aged ≥ 25 years: Managerial/Professional, Nonphysical Service/Blue Collar, and Physical Service/Blue Collar. The authors examined currently employed survivors (4845) and their siblings (1727) in multivariable generalized linear models to evaluate the likelihood of being in 1 of the 3 occupational categories. Multinomial logistic regression was used among all participants to examine the likelihood of these outcomes compared to being unemployed (survivors, 6671; siblings, 2129). Multivariable linear models were used to assess survivor occupational differences by cancer-  and treatment-related variables. Personal income was compared by occupation.


RESULTS
Employed survivors were less often in higher-skilled Managerial/Professional occupations (relative risk, 0.93; 95% confidence interval 0.89-0.98) than their siblings. Survivors who were black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Managerial/Professional occupations than other survivors. In multinomial models, female survivors' likelihood of being in full-time Managerial/Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors' personal income was lower than siblings within each of the 3 occupational categories in models adjusted for sociodemographic variables.


CONCLUSIONS
Adult childhood cancer survivors are employed in lower-skill jobs than siblings. Survivors with certain treatment histories are at higher risk for lower-skill jobs and may require vocational assistance throughout adulthood.
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. akirchho@fhcrc.org
Anne C
AC
Kirchhoff
Kevin R
KR
Krull
Kirsten K
KK
Ness
Elyse R
ER
Park
Kevin C
KC
Oeffinger
Melissa M
MM
Hudson
Marilyn
M
Stovall
Leslie L
LL
Robison
Thomas
T
Wickizer
Wendy
W
Leisenring
D000328:Adult; D000368:Aged; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy; D009790:Occupations; D044469:Racial Groups; D012737:Sex Factors; D035781:Siblings; D012924:Social Conditions; D017741:Survivors
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