title: The impact of cancer diagnosis on employment: is there a difference between rural and urban populations?
abstract: OBJECTIVE
  To determine if living in a rural or urban area influences the impact of cancer diagnosis on employment.
  
  
  METHODS
  Surveys that asked about changes in employment status related to a cancer diagnosis or treatment were sent to 2,005 cancer survivors enrolled in the Vermont Cancer Survivor Surveillance Registry. Data on cancers were obtained from hospital cancer registries. Respondents indicating that they were working at the time of diagnosis were included in this study for a total of 1,155 participants. Associations between rural or urban residence and changes in employment were assessed by chi-square tests and logistic regression.
  
  
  RESULTS
  There were no statistically significant differences in the proportions of rural and urban survivors working fewer hours, experiencing a career change or unable to work. However, a larger proportion of rural than urban patients retired early after their diagnosis (11.1 vs. 7.2%, p = 0.031). There were also fewer rural patients that reported that they went on paid disability during cancer treatment (12.3 vs. 17.0%, p = 0.030).
  
  
  CONCLUSIONS
  While many patients will return to work after treatment for a cancer diagnosis, it appears that rural patients may be less likely to receive paid disability and more likely to retire early. It is possible that rural populations engage in more physically demanding jobs that they are unable to continue after their cancer treatment. Additionally the types of manual labor available in rural areas rarely offer disability benefits, increasing the impact of cancer diagnosis for this population.
  
  
  CONCLUSIONS
  A cancer diagnosis may have a greater impact on employment among rural residents. Cancer programs should recognize this disparity and enhance return to work and disability counseling in patients from rural areas.
authors: University of Vermont, Burlington, VT, USA, michelle.sowden@vtmednet.org.
authors: Michelle
authors: M
authors: Sowden
authors: Pamela
authors: P
authors: Vacek
authors: Berta M
authors: BM
authors: Geller
mesh_terms: D000328:Adult; D000368:Aged; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D012424:Rural Population; D018582:Sick Leave; D017741:Survivors; D014505:Urban Population