Unemployment risk at 2 and 4 years following colorectal cancer diagnosis: a population based study.
About half of colorectal patients are diagnosed less than 65 years of age and they have a relatively high cure rate. However, little is known about their employment and related risk factors. The aim of the current study was to clarify the association between colorectal cancer (CRC) and subsequent risk of being unemployed.



A historical prospective cohort study included baseline socio-demographic measurements of age, sex, ethnicity, residential socio-economic position and education from the 1995 Israeli National Census, cancer incidence between 2000 and 2007 and employment data between 1998 and 2011. Binary logistic regression analyses were used to assess odds ratios for unemployment, while controlling for socio-economic measurements and employment status at 2 years prior to diagnosis.



The final study population included 885 colorectal patients and 2646 healthy controls. After controlling for confounders, positive associations were found between stages II (odds ratio [OR] = 1.91, 95% confidence interval [CI]: 1.31-2.76 or III (OR = 1.70, 95% CI: 1.13-2.54) and increased risk for unemployment at 2 years. At 4 years follow-up, stages I (OR = 1.56, 95% CI: 1.11-2.19), II (OR = 1.57, 95% CI: 1.09-2.26) and III (OR = 2.28, 95% CI: 1.55-3.37) were associated with increased risk for unemployment. Higher risk was seen among rectal cancer patients and among patients aged ≤50 years old at the time of cancer diagnosis.



CRC patients are at increased long-term risk for unemployment, especially among rectal cancer and younger patients. The clinical ramifications of our findings emphasise the importance of an accurate evaluation and attention to unemployment status during the care of these patients.
The Department of Oncology, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, 91120, Israel; The Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center Mount Scopus, and Hebrew University-Hadassah Medical School, Mount Scopus, Jerusalem, Israel. Electronic address: ryakir@hadassah.org.il.
Yakir
Y
Rottenberg
The Department of Occupational Therapy, Tel Aviv University, P.O.B. Box 39040, Tel Aviv, 6997801, Israel.
Navah Z
NZ
Ratzon
School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, Israel.
Miri
M
Cohen
The Department of Oncology, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, 91120, Israel.
Ayala
A
Hubert
The Department of Oncology, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, 91120, Israel.
Beatrice
B
Uziely
Coronel Institute of Occupational Health, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Angela G E M
AG
de Boer
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology; D012307:Risk Factors; D014478:Unemployment / Q000706:statistics & numerical data*
Cancer survivors; Colorectal cancer; Employment