Work Situation After Breast Cancer: Results From a Population-Based Study

Background: Breast cancer may adversely affect work experience. We assessed whether there was evidence of discrimination at work, defined as negative or involuntary changes in employment situation (including changes in position, wages, and other conditions), associated with a breast cancer diagnosis in a population-based retrospective cohort study conducted in Quebec, Canada. Methods: The study was based on the consecutive series of women aged less then 60 years when first treated for breast cancer (identified through the Quebec Tumor Registry) and a random sample of frequency-matched women living in Quebec (identified from provincial health care files) who had never been diagnosed with cancer. Eligibility for the study was restricted to women who were employed at the time of diagnosis (for breast cancer survivors) or the same calendar period (for women in the comparison group). We conducted telephone interviews of eligible women 3 years after diagnosis for 646 survivors or after the matched calendar period for 890 women in the comparison group. Binomial regression was used to evaluate the relationship between having breast cancer and work situation. All statistical tests were two-sided. Results: Working conditions were similar between the two groups at the beginning of follow-up. After 3 years, slightly more survivors (21%) than women in the comparison group (15%) were unemployed (adjusted relative risk for being unemployed = 1.29, 95% confidence interval = 1.05 to 1.59), although most women who were not working (84% of unemployed survivors and 76% of unemployed women in the comparison group) said that the decision to stop working was their own. Among women still employed, no deterioration in working conditions was observed in either group. Conclusion: We found little evidence that women diagnosed with breast cancer experience discrimination at work. This information may be helpful for working women concerned about employment after breast cancer.