Unemployment Status Subsequent to Cancer Diagnosis and Therapies: A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: In the future, numbers of cancer survivors will increase due to early detection and new therapies, but it is important to consider the long-term consequences of disease and treatment. The purpose of this study is to assess the impact of cancer and treatment on the employment status of cancer survivors. Implementing a strict selection of articles to be analyzed, in order to mitigate the interference of publication and selection bias on the final results, we highlighted how cancer, treatments, and related disabilities are risk factors for unemployment. We believe that the negative influence of cancer on people’s lives, including in terms of employment status with consequential fallout for morbidity and mortality, needs to be addressed by promoting health and social welfare support programs from diagnosis to follow-up, substantiating patient involvement in treatment choices. ABSTRACT: The purpose of our study is to examine whether cancer and treatments are associated with job loss or changes in employment status. Eight prospective studies were included in the systematic review and meta-analysis, with a population aged 18–65 years, analyzing treatment regimen and psychophysical and social status in post-cancer follow-up of at least 2 years. In the meta-analysis, a comparison was made between recovered unemployed cases and cases from a standard reference population. Results are summarized graphically using a forest plot. We showed that cancer and subsequent treatment are risk factors for unemployment with an overall relative risk of 7.24 (lnRR: 1.98, 95% CI: 1.32–2.63) or for change in employment status. Individuals undergoing chemotherapy and/or radiation treatment and those with brain and colorectal cancers are more likely to develop disabilities that negatively affect the risk of unemployment. Finally, variables such as low level education, female sex, older age, and being overweight before starting therapy are associated with higher risk of unemployment. In the future, it will be necessary for people with cancer to have access to specific health, social welfare, and employment support programs. In addition, it is desirable that they become more involved in their choice of therapeutic treatment.