In a matched-cohort study reported in JAMA Network Open, Iwakura et al found that women with breast or gynecologic cancer had a higher risk of job resignation compared with their unaffected counterparts, especially among those who were older, had lower income, or had a history of depression.
“These findings highlight the need for targeted workplace support to help retain women with cancer in the workforce,” the investigators commented.
Study Details
The study included working women who were aged between 15 and 58 years and insured by the Japan Health Insurance Association.
A total of 99,964 patients who were newly diagnosed with cancer (breast: n = 59,452; cervical: n = 14,713; uterine: n = 16,933; ovarian: n = 8,866) were matched in a 1:10 ratio to 999,640 women without these cancers (n = 594,520, 147,130, 169,330, and 88,660, respectively). Nearly a third of those with cancer (n = 32,123) were working in the medical, health-care, or welfare sector.
All-cause resignation was evaluated as the primary endpoint. The investigators identified a composite of resignation and death, both assessed during a 2-year follow-up, as the secondary endpoint.
Job Resignation in Women With Cancer
The investigators reported significantly higher resignation rates for women with cancer vs controls (breast: 18.2% vs 16.5%, hazard ratio [HR] = 1.18, 95% confidence interval [CI] = 1.16–1.20; cervical: 22.4% vs 18.7%, HR = 1.31, 95% CI = 1.26–1.36; uterine: 18.7% vs 16.4%, HR = 1.24, 95% CI = 1.19–1.29; ovarian: 22.6% vs 17.9%, HR = 1.44, 95% CI = 1.37–1.51). Regarding the composite outcome of resignation and death, there appeared to be an increased risk for all cohorts; the hazard ratios ranged from 1.25 (95% CI = 1.22–1.27; breast cancer) to 1.81 (95% CI = 1.73–1.89; ovarian cancer). Across all four cancer cohorts, the risk of resignation seemed to be higher among women with older age, lower income, and a history of depression.
“Tailoring support to women’s mental health, financial circumstances (including tenure-based benefits), and industry demands may enhance work-treatment balance and job continuity for women with breast and gynecologic cancers in Japan,” the investigators concluded. “Despite national differences in systems like retirement benefits, these insights can help inform global strategies to support working women with these cancers.”
Kyoko Nomura, MD, MPH, PhD, of Akita University Graduate School of Medicine, Japan, is the corresponding author of the JAMA Network Open article.
Disclosure: The study was funded by a grant from the Japan Health Insurance Association. For full disclosures of the study authors, visit jamanetwork.com.
