title: Recent employment trend of childhood cancer survivors in Japan: a cross-sectional survey.
abstract: BACKGROUND
  Previous research has shown that some adult childhood cancer survivors (CCSs) have experienced employment difficulties. However, the actual employment status of CCSs in Japan has not been studied.
  
  
  METHODS
  The participants were selected from the membership directory of Heart Link mutual-aid health insurance and recruited by the Childhood Cancer Patients' Network. We conducted a cross-sectional survey (a self-rated questionnaire on employment) via postal mail or an email communication with a link to an Internet website. We explored the association between the characteristics of CCSs who require disability qualification and having experienced unemployment. The adjusted odds ratios (ORs) for the factors with an outcome of interest were estimated with logistic regression analysis.
  
  
  RESULTS
  In total, 44 CCSs indicated that they had a disability qualification. The significant independent factors related to needing a disability qualification were late effects [OR 12.3; 95 % confidence interval (CI) 3.37-45.2], brain tumors (OR 9.55; 95 % CI 1.90-48.0), and being a high school graduate (OR 9.86; CI 2.67-36.4). The unemployment rate was 15.9 % among CCSs, excluding homemakers and students. Approximately 70 % of unemployed CCSs had some late effects; independent factors related to unemployment were late effects (OR 6.22; 95 % CI 1.80-21.40), dropping out of school (OR 8.46; 95 % CI 1.66-43.10), and brain tumors (OR 2.73; 95 % CI 0.83-8.96). Most unemployed CCSs were likely to seek work, despite their health problems.
  
  
  CONCLUSIONS
  The unemployment rate is not high in Japan, but some CCSs need extended disability qualification. The independent factors related to unemployment were late effects and dropping out of school.
authors.affiliation: Department of Pediatrics, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan, yaishida2009@yahoo.co.jp.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Mitsue
authors.initials: M
authors.lastname: Hayashi
authors.forename: Fumiko
authors.initials: F
authors.lastname: Inoue
authors.forename: Miwa
authors.initials: M
authors.lastname: Ozawa
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult