TY - JOUR
T1 - Employment Changes following Breast Cancer Diagnosis
T2 - The Effects of Race and Place
AU - Spencer, Jennifer C.
AU - Rotter, Jason S.
AU - Eberth, Jan M.
AU - Zahnd, Whitney E.
AU - Vanderpool, Robin C.
AU - Ko, Linda K.
AU - Davis, Melinda M.
AU - Troester, Melissa A.
AU - Olshan, Andrew F.
AU - Wheeler, Stephanie B.
N1 - Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press. All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - The financial implications of breast cancer diagnosis may be greater among rural and black women. Women with incident breast cancer were recruited as part of the Carolina Breast Cancer Study. We compared unadjusted and adjusted prevalence of cancer-related job or income loss, and a composite measure of either outcome, by rural residence and stratified by race. We included 2435 women: 11.7% were rural; 48.5% were black; and 38.0% reported employment changes after diagnosis. Rural women more often reported employment effects, including reduced household income (43.6% vs 35.4%, two-sided ?2 test P =. 04). Rural white, rural black, and urban black women each more often reported income reduction (statistically significant vs. urban white women), although these groups did not meaningfully differ from each other. In multivariable regression, rural differences were mediated by socioeconomic factors, but racial differences remained. Programs and policies to reduce financial toxicity in vulnerable patients should address indirect costs of cancer, including lost wages and employment.
AB - The financial implications of breast cancer diagnosis may be greater among rural and black women. Women with incident breast cancer were recruited as part of the Carolina Breast Cancer Study. We compared unadjusted and adjusted prevalence of cancer-related job or income loss, and a composite measure of either outcome, by rural residence and stratified by race. We included 2435 women: 11.7% were rural; 48.5% were black; and 38.0% reported employment changes after diagnosis. Rural women more often reported employment effects, including reduced household income (43.6% vs 35.4%, two-sided ?2 test P =. 04). Rural white, rural black, and urban black women each more often reported income reduction (statistically significant vs. urban white women), although these groups did not meaningfully differ from each other. In multivariable regression, rural differences were mediated by socioeconomic factors, but racial differences remained. Programs and policies to reduce financial toxicity in vulnerable patients should address indirect costs of cancer, including lost wages and employment.
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U2 - 10.1093/jnci/djz197
DO - 10.1093/jnci/djz197
M3 - Article
C2 - 31599949
AN - SCOPUS:85075499174
SN - 0027-8874
VL - 112
SP - 647
EP - 650
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 6
M1 - djz197
ER -