Psychosocial
Employment
Adult survivors of childhood cancer of all diagnostic categories are at elevated risk for unemployment 30, 43. They are twice as likely to be unemployed as healthy controls 43.
Risk factors for unemployment include 30, 43, 44:
- CNS tumour diagnosis:
- Brain tumor survivors have up to five-fold increased relative odds of unemployment compared to healthy controls and siblings
- Previous history of cranial radiation therapy
- Younger age at diagnosis
- Female
- Chronic medical conditions:
- The risk of having a chronic health condition increases substantially throughout adulthood such that by 30 years after the cancer diagnosis, 73.5% of young adults survivors report at least one chronic health condition and 42.4% have a severe, disabling or life-threatening condition
- Lower education
- Diminished cognitive functioning
- Motor impairment
- Diagnosed with epilepsy
Survivors of adult cancer have reported adverse effects on employment including dismissal, failure to hire, demotion, denial or promotion, and denial of benefits. Childhood cancer survivors are at risk for these same difficulties.
Employment and the ability to support oneself are key factors in living independently and psychosocial well-being. Unemployed childhood cancer survivors and those with a low annual income (less than $20,000) have more symptoms of depression, anxiety, distress, and lower quality of life when compared to survivors and siblings who are employed or at higher income levels 2, 30, 45.
Employment is often needed for health insurance and unemployment might cause difficulties for accessing appropriate and comprehensive health care.
