Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study.
The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population-based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5-year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non-manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81-0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28-0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15-fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77-0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01-1.85)) and also similarly for non-manual occupations (1.90 (1.37-2.62)). Survivors of retinoblastoma (1.55 (1.20-2.01)) and 'other' neoplasm group (1.62 (1.30-2.03)) were also more likely to be in non-manual occupations than expected.
Department of Public Health, Epidemiology and Biostatistics, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Clare
0000-0003-1099-163X
C
Frobisher
Department of Public Health, Epidemiology and Biostatistics, WAVES study office, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Emma R
ER
Lancashire
Department of Oncology, Birmingham Children's Hospital, NHS Foundation Trust, Steelhouse Lane, Birmingham, B4 6NH, United Kingdom.
Helen
H
Jenkinson
Department of Public Health, Epidemiology and Biostatistics, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
David L
DL
Winter
Department of Public Health, Epidemiology and Biostatistics, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Julie
J
Kelly
Department of Public Health, Epidemiology and Biostatistics, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Raoul C
RC
Reulen
Department of Public Health, Epidemiology and Biostatistics, Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
Michael M
MM
Hawkins
D000293:Adolescent; D000328:Adult; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009790:Occupations / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
childhood cancer; economic status; employment; occupation; social outcome; survivorship