Unemployment risk and decreased income 2 and 4 years after thyroid cancer diagnosis: a population based study.

Unemployment risk and decreased income 2 and 4 years after thyroid cancer diagnosis: a population based study.

Thyroid. 2016 Jul 11;

Authors: Ratzon NZ, Uziely B, de Boer AG, Rottenberg Y

Abstract
BACKGROUND: Thyroid cancer (TC) is a disease of relatively young patients with a high cure rate. Decreased psychological and physical well-being lowers their work abilities. The aim of this study was to compare the risk for unemployment and decreasing income change among TC survivals to a matched non-cancer group at 2 and 4 years after diagnosis and to predict unemployment and income changes at 2 years and 4 years after diagnosis.
METHODS: A nested case control study was designed, with cohort inception and baseline measurement of people participating in the Israeli Central Bureau of Statistics 1995 National Census, and follow up until 2011. Cancer incidence and employment status were ascertained through the Israel Cancer Registry and Tax Authority, respectively. A matched group was sampled from the population in the census. Binary logistic regression analyses were used to assess odds ratios for study's outcomes, while controlling for age, gender, ethnicity, education years, socioeconomic position and status of employment at 2 years prior to diagnosis.
RESULTS: A total of 417 cases of TC and 1277 non-cancer matched group were included in the study after excluding persons who died during the study period. The mean age at the time of cancer diagnosis was 43.5 years in the group of TC and 43.8 years in the match group (p=0.6). A positive association between TC and risk of unemployment 2 years after diagnosis (OR=1.46, 95% CI: 1.09-1.95), decreased income 2 years after diagnosis (OR=1.61, 95% CI: 1.23-2.01) and at 4 years after diagnosis (OR=1.63, 95% CI: 1.25-2.13) were found after adjusting for potential confounders. In contrast, the association between TC and unemployment 4 years after diagnosis was found to weaken and actually lose significance (OR=1.30, 95% CI: 0.98-1.72).
CONCLUSIONS: TC survivorship is associated with subsequent unemployment at 2 years and decreased income at 2 and 4 years, while income decreasing may be a marker for shifting to part time work rather than full return for work. On a more practical note, the clinical ramifications of our findings suggest that intervention in order to enhance return to full work is required at this population.

PMID: 27400754 [PubMed - as supplied by publisher]

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