Systematic Review and Meta-Analyses of Time-Use, Productivity, and Labor Outcomes Among Unpaid Cancer Caregivers.

PURPOSE: Unpaid caregivers provide essential support for people with cancer, yet the economic burden of this labor is not well quantified. This study provides pooled estimates of caregiving time and productivity outcomes to better understand the impact of unpaid caregiving on caregivers' economic well-being.

METHODS

We systematically searched PubMed and EBSCO databases in June 2025 for peer-reviewed studies reporting primary or secondary data on six prespecified caregiver outcomes related to labor and time-use. Eligible studies focused on adult cancer care and included precision measures. After screening 3,904 records and reviewing 106 full-text articles, 59 studies from 16 countries were included in the meta-analyses. Where required for comparability, outcomes were standardized to a 35-hour work week and 250 workdays per year.

RESULTS

Caregivers provided an estimated 45 hours of unpaid care each week (95% CI, 31 to 58). Among employed caregivers, working hours declined by 13% (95% CI, 9 to 18). Caregivers were absent for 5% of working days (95% CI, 4 to 6) and experienced a 24% loss in workplace productivity (95% CI, 20 to 28). In addition, 30% reported reduced job responsibilities (95% CI, 24 to 37) and 1% exited employment (95% CI, -3 to 5). Burdens were greater among caregivers of people with advanced cancer and during palliative care. Women consistently reported greater labor and productivity impacts than men.

CONCLUSION

Unpaid caregivers of people with cancer face substantial time- and labor-related burdens that may affect their financial stability and long-term well-being. These findings highlight the need for supportive polices and workplace practices that protect caregiver well-being and economic security throughout the cancer care continuum. They also offer essential evidence to inform policies and interventions that protect caregiver well-being, economic stability, and long-term participation in the workforce.