Do childhood cancer and physical late effects increase worries about future employment in adulthood?

Abstract

Background: Experiences of childhood cancer and physical late effects can potentially increase various components of worries about employment among unemployed adult survivors of childhood cancer, but the nature of these effects on worries is unknown. Aims: This study aimed to describe worries about employment among unemployed adult survivors of childhood cancer through a comparison with those among the unemployed general population and to clarify the components of worries about employment affected by physical late effects. Method and results: Worries about employment were assessed using nine items in the International Survey of Youth Attitude conducted by the Japanese Cabinet Office. Physical late effects among unemployed survivors were evaluated by their attending physicians. Data from the unemployed general population were extracted from the International Survey of Youth Attitude. We used propensity score and multiple regression analysis to estimate the impact of childhood cancer and physical late effects on worries about employment. We surveyed 48 unemployed survivors and 286 members of the unemployed general population. Unemployed survivors reported significantly higher score of worries about health and physical well-being than did the unemployed general population (Cohen's f2 = 0.007). Meanwhile, unemployed survivors reported significantly lower scores of worries about work ability, interpersonal relationships at workplaces, age until which they can work, layoffs, income, job transfers, and possibility and continuity of employment than did the unemployed general population (Cohen's f2 = 0.002-0.018). Unemployed survivors with physical late effects reported significantly higher scores on all components of worries about employment than did those without physical late effects (Cohen's f2 = 0.137-1.304). Conclusion: Physical late effects rather than experiences of childhood cancer have large impacts on various worries about employment among unemployed survivors. It would be valuable to understand and assess systematically the impact of physical late effects on employment in unemployed survivors.