Job Supports and Job Retention Among Working Patients With Colorectal Cancer

Serious illness can cause substantial economic hardship, exacerbated by illness- or treatment-related job loss. Colorectal cancer (CRC) is a common, serious illness with a rising incidence among younger, working-age patients. Research suggests that job supports may help working patients with CRC retain their jobs and alleviate financial burden. A session at the American Society of Clinical Oncology (ASCO) Annual Meeting examined how job supports affected job retention among patients with CRC.

For the study, researchers surveyed Stage III CRC patients from Detroit and Georgia SEER registries from 2011-2014. Job retention was the outcome measure. Availability of job support benefits (ie, employer-based health insurance, flexible schedule, paid sick leave, extended sick leave, disability, unpaid leave) was the primary independent, and variable. They assessed associations between social determinants, environment, job supports, and job retention, using a multivariate logistic regression model, first controlling only for patient-level social and environmental covariates and then adding in job supports.

Only the 546 patients who were working at the time of diagnosis were included in this study. Forty-five percent of working patients reported that they stopped working altogether as a result of cancer diagnosis and treatment. In the individual- and area-level adjusted model, only education and household income were significantly associated with job retention. In the fully adjusted model including job support benefits, education and income were no longer statistically significant and only employer-based health insurance (OR = 2.63; 95% confidence interval [CI] = 1.34-5.14; P < 0.01), flexible work schedule (OR = 6.19; 95% CI = 3.56-10.78; P < 0.01) and paid sick leave (OR = 2.26; 95% CI = 1.11-4.61; P = 0.03) were significantly associated with job retention.

Ultimately, they found that nearly half of working patients were unable to retain their jobs due to CRC diagnosis and treatment. Employer-based health insurance, flexible work schedule, and paid sick leave were associated with significantly greater likelihood of job retention. Researchers noted that an investment in job support benefits could provide long-term societal dividends by enabling job retention and reducing financial burden, especially among young working patients.