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UPJ INSIGHT Employment and Labor Force Participation Among Prostate Cancer Survivors
By: David H. Howard, PhD, Emory University, Atlanta, Georgia; Ingrid J. Hall, PhD, MPH, Centers for Disease Control and Prevention, Atlanta, Georgia | Posted on: 20 Apr 2023
Howard DH, Hall IJ. Employment and labor force participation among prostate cancer survivors. Urol Pract. 2023;10(2):178-185.
Study Need and Importance
Employment can help cancer patients maintain and improve physical and mental health. Prior studies on the employment effects of a prostate cancer diagnosis have found mixed results. We sought to analyze the effect of prostate cancer on employment using more recent data.
What We Found
Employment rates were similar between prostate cancer survivors and matched controls (60%), but survivors were slightly more likely to be not working due to disability (see Table). Survivors had more bed days than comparison males and missed more workdays.
Table. Differences in Employment-related Outcomes Between Prostate Cancer Survivors and Comparison Males
| Prostate cancer survivors, % | Comparison males, % | Adjusted differencea (95% CI) | |
|---|---|---|---|
| Employedb | 60.4 | 60.6 | 0.6 (−5.2, 6.3) |
| Not employed | |||
| Retired | 15.4 | 17.9 | −2.8 (−6.9, 1.3) |
| Disabled | 16.7 | 13.3 | 2.7 (−1.2, 6.5) |
| Otherb | 7.5 | 8.2 | −0.6 (−3.5, 2.3) |
| Labor force participation | 67.3 | 67.3 | 0.7 (−4.7, 6.1) |
| Bed daysc | 8.0 | 5.7 | 2.8 (2.0, 3.6) |
| Missed workdaysd | 7.4 | 3.3 | 4.5 (3.6, 5.3) |
| Abbreviation: CI, confidence interval. Results are weighted to be representative of the civilian, noninstitutionalized population. aAdjusted for comorbidities. bWorked for pay in the week prior to the survey. The “Other” category includes men who are looking for work and on family leave. cRespondents were asked, “How many days did illness or injury keep you in bed more than half of the day?” in the prior year. dOnly includes respondents who worked last week. |
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Limitations
Differences in outcomes between prostate cancer survivors and men in the control group may be biased by unobserved differences in characteristics related to employment. The data capture the employment outcomes of the sample at a single point in time, and we were not able to adjust estimates for pre-diagnosis employment or describe individuals’ trajectory of employment outcomes relative to the date of diagnosis.
Interpretation for Patient Care
The downstream effects of prostate cancer and cancer-directed treatment do not substantially impair men’s ability to continue to work. Employment considerations need not be a major factor in screening- and treatment-related decisions.
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