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 - Funding Information:
The CBCS Phase III was supported by the University Cancer Research Fund of North Carolina and the National Cancer Institute Specialized Program of Research Excellence in Breast Cancer (NIH/NCI P50-CA58223). Additional support has been obtained from the National Cancer Institute (P01CA151135) and the Susan B. Komen Foundation (CCR 15333140). The contents are solely the responsibility of the authors and do not necessarily represent the official view of the funders.
Funding Information:
This research was supported, in part, by the University of North Carolina’s Cancer Care Quality Training Program (T32 CA116339) funded by the National Cancer Institute. It was also supported by the Cancer Prevention and Control Research Network (Cooperative Agreement Number U48-DP005017; 3 U48 DP005000-01S2, 3 U48 DP005014-01S2, 3 U48 DP005013-01S1A3, 5 U48 DP005006-05) funded by the Centers for Disease Control and Prevention, Prevention Research Centers Program, and the National Cancer Institute. Melinda Davis was supported by an NCI K07 award (1K07CA211971-01A1).
Funding Information:
SBW receives unrelated grant funding to her institution from Pfizer. The other authors have no disclosures.
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
VL - 112
SP - 647
EP - 650
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
SN - 0027-8874
IS - 6
M1 - djz197
ER -