Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Risk of employment separation among workers with head and neck cancer: a longitudinal cohort study in Turin.
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Farina Elena, Licitra Lisa, Mercalli Franco, Massari Stefania, Marinaccio Alessandro, Gariazzo Claudio, Taiano Luca, Foggetti Rosaria, Zengarini Nicolás, Trama Annalisa, BD4QoL working group
Аннотация
PURPOSE: Returning to work after cancer offers important psychological and economic benefits. However, individuals with head and neck (H&N) cancer face a higher risk of leaving the workforce due to the functional consequences of treatments. This study examined the association between H&N cancer and job separation within 2 years of diagnosis and identified patient profiles at higher risk.
METHODS: An integrated database was created by linking the Turin Longitudinal Study, the regional Mandatory Communications archive, and the national INPS archive. Incident H&N cancer cases were identified through hospital discharge records, and employment status was defined using occupational data. Each worker with H&N cancer was matched with four cancer-free workers of similar sociodemographic characteristics (non-cases). Patient profiles were defined through latent class analysis. Robust Poisson models were used to estimate the risk of job separation.
RESULTS: Between 2008 and 2020, 255 employed individuals were diagnosed with H&N cancer. They showed a twofold higher risk of job separation compared with matched non-cases (RR = 2.00, 95% CI: 1.59-2.51). Some profiles were more likely to exit the workforce, particularly workers with more severe disease (RR = 2.14, 95% CI: 1.04-4.42) or with lower education and higher socioeconomic deprivation (RR = 1.74, 95% CI: 1.02-2.95).
CONCLUSIONS: H&N cancer diagnosis substantially increases the likelihood of job separation, particularly among socioeconomically disadvantaged workers.
IMPLICATIONS FOR CANCER SURVIVORS: Identifying vulnerability profiles is essential for developing targeted return-to-work strategies. Integrated health and administrative data can support tailored interventions that better address survivors' long-term employment needs.
METHODS: An integrated database was created by linking the Turin Longitudinal Study, the regional Mandatory Communications archive, and the national INPS archive. Incident H&N cancer cases were identified through hospital discharge records, and employment status was defined using occupational data. Each worker with H&N cancer was matched with four cancer-free workers of similar sociodemographic characteristics (non-cases). Patient profiles were defined through latent class analysis. Robust Poisson models were used to estimate the risk of job separation.
RESULTS: Between 2008 and 2020, 255 employed individuals were diagnosed with H&N cancer. They showed a twofold higher risk of job separation compared with matched non-cases (RR = 2.00, 95% CI: 1.59-2.51). Some profiles were more likely to exit the workforce, particularly workers with more severe disease (RR = 2.14, 95% CI: 1.04-4.42) or with lower education and higher socioeconomic deprivation (RR = 1.74, 95% CI: 1.02-2.95).
CONCLUSIONS: H&N cancer diagnosis substantially increases the likelihood of job separation, particularly among socioeconomically disadvantaged workers.
IMPLICATIONS FOR CANCER SURVIVORS: Identifying vulnerability profiles is essential for developing targeted return-to-work strategies. Integrated health and administrative data can support tailored interventions that better address survivors' long-term employment needs.