Job Loss after Cancer Diagnosis among Working-Age Cancer Survivors

Background: Cancer survivors have a higher risk of job loss than individuals in the general population. We aimed to investigate the employment status of cancer survivors in Japan. Methods: In this retrospective cohort study, we analyzed data from the JMDC, Inc. from January 2007 to September 2023 (diagnosis period). Individuals aged 18–55 years, with cancer diagnoses, undergoing treatment; and a control group without cancer, heart disease, stroke, or mental disorders were included. The primary outcome was comparative job loss cumulative incidence between groups. As a secondary outcome, we evaluated factors associated with job loss for all cancer survivors. Cox proportional hazards models were used for analysis. Results: This study included 112,964 cancer survivors (average age, 41.3 years; SD 9.08); 51.5% were women. Job loss cumulative incidence among cancer survivors 5 years after a cancer diagnosis was 76.2%, and the hazard ratio [95% confidence interval] was significantly higher than that in the control group (1.40 [1.38–1.41]). In all cancer survivors, hazard ratios were higher for men (1.64 [1.62–1.67]) and those aged >50 years (1.61 [1.58–1.65]). Job loss-related factors for all cancer survivors included female sex; brain tumors, pancreatic, skin, or female genital cancers; and ongoing chemotherapy and radiation therapy. Conclusions: Cancer survivors had higher job loss risks than the controls at 1 and 5 years post-diagnosis. Being female and having specific types of cancer may be job-loss-related factors. Impact: Cancer survivors face a high risk of job loss; thus, support for continued employment should reflect treatment conditions.