Occupational outcomes of adult childhood cancer survivors

• Published in: Cancer 2011-07, Vol.117 (13), p.3033-3044
• Main Authors: Kirchhoff, Anne C., Krull, Kevin R., Ness, Kirsten K., Park, Elyse R., Oeffinger, Kevin C., Hudson, Melissa M., Stovall, Marilyn, Robison, Leslie L., Wickizer, Thomas, Leisenring, Wendy
• Format: Article
• Language: English
• Subjects: female; late effects; neoplasms; occupations; socioeconomic factors; survivors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.25867

BACKGROUND: The authors examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher‐skill occupations than a sibling comparison and whether certain survivors were at higher risk for lower‐skill jobs. METHODS: The authors created 3 mutually exclusive occupational categories for participants aged ≥25 years: Managerial/Professional, Nonphysical Service/Blue Collar, and Physical Service/Blue Collar. The authors examined currently employed survivors (4845) and their siblings (1727) in multivariable generalized linear models to evaluate the likelihood of being in 1 of the 3 occupational categories. Multinomial logistic regression was used among all participants to examine the likelihood of these outcomes compared to being unemployed (survivors, 6671; siblings, 2129). Multivariable linear models were used to assess survivor occupational differences by cancer‐  and treatment‐related variables. Personal income was compared by occupation. RESULTS: Employed survivors were less often in higher‐skilled Managerial/Professional occupations (relative risk, 0.93; 95% confidence interval 0.89‐0.98) than their siblings. Survivors who were black, were diagnosed at a younger age, or had high‐dose cranial radiation were less likely to hold Managerial/Professional occupations than other survivors. In multinomial models, female survivors' likelihood of being in full‐time Managerial/Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors' personal income was lower than siblings within each of the 3 occupational categories in models adjusted for sociodemographic variables. CONCLUSIONS: Adult childhood cancer survivors are employed in lower‐skill jobs than siblings. Survivors with certain treatment histories are at higher risk for lower‐skill jobs and may require vocational assistance throughout adulthood. Cancer 2011. © 2011 American Cancer Society. Adult childhood cancer survivors are employed in lower‐skill jobs than their siblings. Female survivors and survivors with a history of cranial radiation are at particular risk.