Impact à court et à long terme du cancer sur l'emploi et les résultats financiers des adolescents et des jeunes adultes (AYAS) : Une vaste étude de registre cas-témoins basée sur la population aux Pays-Bas

Employment is considered a key aspect of a healthy life after cancer. Among other things, it enables adolescents and young adults to have a sense of normality (daily structure), regain their sense of identity and financial security, which has a positive impact on their overall health and quality of life. Unfortunately, many survivors report undesirable consequences of cancer disease and treatment. These include unemployment, lower income and career reorientation. As young survivors are at the beginning of their professional careers and may have little or no work experience, (re)integration into working life can be a major challenge for them.

To take a closer look at the professional and financial situation of survivors, researchers around Silvie Janssen compared survivors of cancer with age- and gender-matched people from the general population in the Netherlands. The individuals were compared in the year of cancer diagnosis, one year after and five years after to examine the short-term and long-term effects of cancer (and treatment). Special about this study is that the researchers did not use self-reported data of the survivors regarding their occupational and financial situation, but used objective register data from the Dutch Statistical Office.

What are the findings of the present study?

The study was able to show that young survivors of cancer are significantly less likely to be employed compared to the general population, both in short and long term. Survivors are also more likely to receive disability benefits. However, personal and household income did not differ between people with and without a history of cancer. It also showed that women are significantly more likely to be long-term unemployed than men. The type of treatment also has an influence on the occupational situation: more invasive therapies (chemotherapy, radiotherapy and hormone therapy) are associated with unemployment. This suggests that a greater treatment burden may also affect survivors in the long term. The results of this study are consistent with other international studies on survivors of cancer in adolescence or young adulthood that show impaired employment and financial situation.

What does this study not tell us?

Because this is registry data and the survivors were not interviewed themselves, we do not learn specific reasons for unemployment. Some may be forced into it because of the negative impact of their cancer (and treatment) or face employment discrimination, while others may consciously choose to change their employment status because their life and career perspectives have changed as a result of their experiences. The only thing that is certain is that survivors of cancer are more likely to be affected by unemployment than comparable people without a history of the disease.

What is the conclusion of the researchers?

Even on the basis of objective register data, it can be seen that survivors of cancer in adolescence or young adulthood are more likely to be unemployed than comparable people from the general population. Although financial support is available and taken up, the unemployed have a significantly lower income. Therefore, proactive, tailored guidance and counselling should be provided to survivors. Providing support in terms of employment and financial situation from the time of diagnosis could help survivors to find their way (back) into employment.