![[ Visit Client Website ]](images/banner.gif)
Employment conditions are established as a determinant of health outcomes, and the impact of cancer history on employment outcomes and return to work is well documented. However, limited research has explored the influence of work conditions on the course of cancer treatment among employed survivors. Employment characteristics, such as limited or no paid leave, inflexible work schedules, and job insecurity may influence treatment decisions, medical appointment attendance and receipt of recommended treatment, especially among survivors in low-wage jobs. Using baseline data from a longitudinal pilot study of breast cancer survivors, the aims of this study are to describe how working women with breast cancer manage the cancer-work interface and determine employment factors that may influence treatment decisions and medical appointment and treatment adherence.
Methods
The study employs a mixed methods design, (interviewer-assisted surveys, qualitative interviews, medical chart abstraction) to collect data at baseline, 3, 6, 9, and 12 months. This poster presents preliminary findings from baseline interviews, conducted within three months of diagnosis. Participants are being recruited from the University of Maryland Greenebaum Comprehensive Cancer Center. Eligible participants are adult women diagnosed with a new, primary breast cancer (stage 0-4), who are working at least 20 hours a week at diagnosis. Surveys assess demographics, employment experiences, and barriers to treatment. For the purpose of this abstract, we report preliminary data from the current sample of 13 (of N =50) participants; current enrollees are primarily Black (62%), middle aged (mean=49 years), and educated (69% with some college or more).
Results
All women (N=13) were working full time at the time of diagnosis. However, at the time of the baseline interview four women (31%) had made changes to their employment due to cancer. Two were no longer employed, one was on extended leave of absence, and one woman reduced her work hours. The most common reasons for continuing to work were: financial comfort, to pay bills, and because work was a big part of their lives. All women had access to some health insurance. Eleven (85%) participants disclosed their cancer diagnosis to someone at work. As strategies to manage the cancer-work interface, six women (46%) women took extended paid time off due to diagnosis and treatment, four (31%) took unpaid time; five (38%) made changes to their work schedule, such as reducing the number of work hours per week (n=4), changing the time or days they worked (n=1), or changing to a more flexible work schedule (n=2). Few women delayed treatment for work (n=1, 8%), and none reported ever deciding not to get all of the medical care or tests recommended by their doctors.
Conclusions & Implications
During the first three months of diagnosis, women are likely to follow the recommendations of their cancer care team, and many make considerable workplace adjustments to continue to work through breast cancer treatment. Additional research is needed to determine the impact of these adjustments on well-being and employment over time. As recruitment is ongoing, updated data will be presented as enrollment continues.