Thyroid Cancer Diagnosis Affects Employment, Income

Survivors of thyroid cancer had a higher risk of unemployment at 2 years post-diagnosis and decreased income at both 2 and 4 years, according to the results of an abstract published in conjunction with the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting (abstract e20618).

“The clinical ramifications of our findings suggest that intervention in order to enhance return to full work is required in this population,” wrote researchers led by Beatrice Uziely, of the department of occupational therapy, Tel Aviv University, in their discussion of the results.

Uziely and colleagues conducted a prospective study looking at cancer incidence and employment status. They used data from the Israeli Central Bureau of Statistics 1995 National Census and follow-up until 2011. A matched group in a ratio of 4:1, according to age and ethnicity, was sampled from the census population.

The study included 481 people with thyroid cancer and 1,459 non-cancer healthy control patients.

Results showed that after controlling for confounding factors, patients with thyroid cancer had a 41% increased risk for unemployment at 2 years (hazard ratio [HR] = 1.41; 95% CI, 1.07–1.86). In addition, patients with a thyroid cancer diagnosis had a 55% risk for decreased income at 2 years (HR = 1.55; 95% CI, 1.20–2.01) and a 66% risk at 4 years (HR = 1.66; 95% CI, 1.28–2.15).

By 4 years post-diagnosis, the association between a thyroid cancer diagnosis and unemployment weakened and lost significance (HR = 1.27; 95% CI, 0.97–1.66).

Uziely and colleagues noted that income decreasing “may be a marker for shifting to part-time work rather than full return for work.”

These results echo those of a study published in 2013 in Clinical Thyroidology that looked at the rate of bankruptcy among people aged 21 to 90 from the Western District of Washington State taken from the SEER database.

Results of the study showed that the risk of bankruptcy was highest among patients with a thyroid cancer diagnosis at a rate of 9.3 per 1,000 person-years, equating to an HR of 3.46. In their conclusions, the authors of the paper posited that “patients with thyroid cancer might have lower rates of employment, lower wages, lower household income, and less access to health insurance.”