title: Annual Economic Burden of Productivity Losses Among Adult Survivors of Childhood Cancers.
abstract: OBJECTIVE
  Although adult survivors of childhood cancers have poorer health and greater health limitations than other adults, substantial gaps remain in understanding the economic consequences of surviving childhood cancer. Therefore, we estimated the economic burden of productivity losses among adult survivors of childhood cancers.
  
  
  METHODS
  We examined health status, functional limitations, and productivity loss among adult survivors of childhood cancers (n = 239) diagnosed at ≤14 years of age compared with adults without a history of cancer (n = 304 265) by using the 2004-2014 National Health Interview Survey. We estimated economic burden using the productivity loss from health-related unemployment, missed work days, missed household productivity, and multivariable regression models controlling for age, sex, race/ethnicity, education, comorbidities, and survey year.
  
  
  RESULTS
  Childhood cancer survivorship is associated with a substantial economic burden. Adult survivors of childhood cancers are more likely to be in poorer health, need assistance with personal care and routine needs, have work limitations, be unable to work because of health, miss more days of work, and have greater household productivity loss compared with adults without a history of cancer (all P < .05). The annual productivity loss for adult survivors of childhood cancer is $8169 per person compared with $3083 per person for individuals without a history of cancer.
  
  
  CONCLUSIONS
  These findings underscore the importance of efforts to reduce the health and economic burden among adult survivors of childhood cancer. In addition, this study highlights the potential productivity losses that could be avoided during adulthood from the prevention of childhood cancer in the United States.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and irm2@cdc.gov.
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Zahava
authors.initials: Z
authors.lastname: Berkowitz
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Rim
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000191:economics*; D017741:Survivors; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult