Employment Disruption and Financial Burden Associated with Gastrointestinal Cancers.

Abstract

Understanding the extent of employment disruption and the financial strain faced by individuals with GI cancer is crucial to develop targeted support services. We sought to investigate employment disruption and financial burden among patients with gastrointestinal cancer (GI) diagnosis. Patients diagnosed with GI cancer were identified using the MarketScan database. Multivariable Cox proportional hazards models were used to evaluate the risk of employment disruption among patients with a GI cancer diagnosis. A total of 11,832 individuals with GI cancer were included. Median patient age was 54 years (IQR: 49-59) with a majority of patients being male (n=7054; 59.6%). In the year following a GI cancer diagnosis, 13.8% (n=1638) of patients experienced employment disruption. Notably, individuals working in finance (HR 1.66, 95% CI 1.37-2.02), manufacturing (HR 1.19, 95% CI 1.01-1.42), and the transportation industry (HR 1.33, 95% CI 1.11-1.60) were at a higher risk of experiencing employment disruption. Patients with GI cancer had higher out-of-pocket (OOP) costs ($3250 [IQR: $1756-$5,255] vs. $453 [IQR: $142-$1189]), more workdays missed (50 [IQR: 28-$72] vs. 5 [IQR: 2-10]) (both p < 0.001) and a threefold higher risk of employment disruption (HR 3.16, 95% CI 2.96-3.38) compared with individuals without a GI cancer diagnosis. Patients with GI cancer are three times more likely to experience employment disruption and face significant financial burdens. Targeted measures, such as flexible work arrangements, job protection policies, and access to vocational rehabilitation services, are needed for patients with cancer.