African-American women were more likely to stop working during the first 2 months of breast cancer treatment compared with non-Hispanic white peers, an analysis found. The study, published in Journal of Cancer Survivorship, assessed racial differences in quality of life and employment after breast cancer diagnosis.
Given differences in the types of jobs the two groups of women held, the size of the companies they worked for and the availability of paid sick leave, researchers suggest African-Americans who stop working due to breast cancer may have a greater risk of long-term employment issues.
Background and Goals
Research suggests African-American women more often are diagnosed with later stages of breast cancer than non-Hispanic white women. Yet past studies show conflicting results about which group reports worse health-related quality of life, HRQOL, or how satisfied a person is with their life in relation to the cancer.
Researchers leading the current study wanted to bring greater clarity to the matter. To do so, they explored racial differences in HRQOL after breast cancer diagnosis among African-American and non-Hispanic white women, focusing on whether the women continued, left or left and returned to work during treatment. Employment can have a strong impact on HRQOL because it affects income, health insurance coverage, social interaction and feelings of success.
Women were selected from a larger group already taking part in a study of health insurance and labor supply. The 548 women selected, 21 – 64, had jobs and health insurance coverage through their employer or their spouse’s. They joined the trial within 2 months of starting treatment.
Each woman was interviewed by phone three times during the study:
- at baseline, to compare what things were like before breast cancer treatment
- women were asked to explain their job situation just prior to diagnosis
- within 2 months of having surgery or starting chemotherapy or radiation therapy
- 9 months after starting treatment
The interviewers asked women about their physical and mental health, symptoms of depression, job status and percent change in hours worked per week. All interview questions were taken from questionnaires in standard use for research.
The researchers found that
- at both the 2 and 9 month marks African-American women were significantly less likely to be employed than non-Hispanic whites.
- for those who worked during treatment, the number of hours worked per week was nearly the same between groups
- African-Americans tended to be in worse physical health before and after diagnosis, and more depressed before diagnosis, than white women. At 2-months, African-Americans had better mental health than white peers
This study only included employed Virginian women under age 64. Because of age and work status, participants were more likely to be healthier and have financial resources at the time of the study. Since the women lived in one state, the findings may not apply to the general population.
Researchers did not collect data on specific courses of treatment or their side effects. More aggressive treatments may have a stronger impact on employment and HRQOL than others.
In addition, the different types of jobs held by the women — in terms of physical labor, pay and benefits — could not all be taken into account in this research.
What This Means for You
This study shows that during the first few months of treatment, African-American women were more likely to leave their jobs than white women. Because of differences in available sick leave and other health benefits, women who leave their jobs during treatment may be at risk of longer-term unemployment.
As an African-American woman with breast cancer, you may have concerns about treatment side effects and their impact on your ability to work. Share them with your care team and ask about ways to ease or prevent side effects. Social workers, patient navigators and your human resources manager at work also may be able to connect you with resources to help support you.
For resources and information about the impact of breast cancer on finances and employment, read our Guide to Understanding Financial Concerns.
Bradley, C, Wilk, A. Racial differences in quality of life and employment outcomes in insured women with breast cancer. Journal of Cancer Survivorship. 2014; (8): 49-59.