71274 - Earnings and work loss after colon and rectal cancer: A Swedish nationwide matched cohort study

Abstract Introduction Colorectal cancer is common and prognosis improving. Thus, survivorship including financial consequences after treatment is important. The aim of this study was to assess financial toxicity in working-age patients with colon and rectal cancer relative to matched comparators. Method The study utilised data from the Swedish national research database CRCBaSe that is generated from the Swedish ColoRectal Cancer Register and links several national registers. A retrospective population-based nation-wide cohort study on financial toxicity (i.e., earnings, disposable income, work loss) in survivors of stage I-III colorectal cancer treatment was undertaken. Median regression analyses were used to compare incomes and logistic regression for probability of work loss. Result A cohort of 8 863 colorectal cancer survivors (all diagnosed prior to 2017) with 52 138 matched comparators could be analysed. Although a clear reduction in earnings was observed the year of diagnosis, disposable income was unaltered. Earnings never fully recovered during the 5-year follow-up. The probability of work loss increased the year of diagnosis and never fully recovered. Probability of work loss appeared similar between colon and rectal cancer survivors, but the risk was most pronounced among patients with rectal cancer who had received neoadjuvant therapy. Discussion This study shows that despite a developed well-fare system providing maintained disposable income for colorectal cancer survivors, financial toxicity, particularly risk of work loss, occurs among survivors of colorectal cancer.