Employment disruption following the diagnosis of endometrial cancer

Roni Nitecki, Shuangshuang Fu, Carolyn Lefkowits, Benjamin D. Smith, Larissa A. Meyer, Alexander Melamed, Sharon H. Giordano, J. Alejandro Rauh-Hain

Research output: Contribution to journalArticlepeer-review


Background: Oncologic treatment has been associated with unemployment. As endometrial cancer is highly curable, it is important to assess whether patients experience employment disruption after treatment. We evaluated the frequency of employment change following endometrial cancer diagnosis and assessed factors associated with it. Methods: A cohort of patients 18–63 years-old who were diagnosed with endometrial cancer (January 2009–December 2017) were identified in the Truven MarketScan database, an insurance claims database of commercially insured patients in the United States. All patients who were working full- or part-time at diagnosis were included and all employment changes during the year following diagnosis were identified. Clinical information, including use of chemotherapy and radiation, were identified using Common Procedural Terminology codes, and International Statistical Classification of Diseases codes. Cox proportional hazards models incorporating measured covariates were used to evaluate the impact of treatment and demographic variables on change in employment status. Results: A total of 4381 women diagnosed with endometrial cancer who held a full-time or part-time job 12 months prior to diagnosis were identified. Median age at diagnosis was 55 and a minority of patients received adjuvant therapy; 7.9% received chemotherapy, 4.9% received external-beam radiation therapy, and 4.1% received chemoradiation. While most women continued to work following diagnosis, 21.7% (950) experienced a change in employment status. The majority (97.7%) of patients had a full-time job prior to diagnosis. In a multivariable analysis controlling for age, region of residence, comorbidities, insurance plan type and presence of adverse events, chemoradiation recipients were 34% more likely to experience an employment change (HR 1.34, 95% CI 1.01–1.78), compared to those who only underwent surgery. Conclusion: Approximately 22% of women with employer-subsidized health insurance experienced a change in employment status following the diagnosis of endometrial cancer, an often-curable disease. Chemoradiation was an independent predictor of change in employment.

Original languageEnglish (US)
Pages (from-to)199-205
Number of pages7
JournalGynecologic oncology
Issue number1
StatePublished - Jan 2021


  • Employment
  • Endometrial cancer
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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