Objectives: Employment disruption in the gynecologic cancer population may be substantial, particularly during a recession. Our objective was to evaluate factors associated with unemployment among gynecologic cancer patients in a nationally representative survey. Methods: A retrospective cohort of women ages 18-64 reporting employment currently or in the past, denying retirement, and endorsing care related to a gynecologic malignancy was identified in the 2007-2017 Medical Expenditure Panel Survey (MEPS). Survey weights were applied to generate national estimates of unemployment and job disruption (job change or loss) among the study cohort compared to the overall US population. We considered patient characteristics and healthcare utilization. Adjusted Wald statistics were used to compare employment outcomes between groups. Weighted multivariable logistic regression was utilized to assess factors independently associated with unemployment. Results: Of the 839 respondents with a gynecologic malignancy, 516 reporting current or past employment were identified. This cohort represents an estimated yearly average population of 434,000 (95% CI 370,000-498,000) that is mostly Caucasian (87%) with a mean age of 44.6 years. Compared to the overall US population, gynecologic cancer patients reported more non-cancer comorbidities (1.3 vs. 0.72, P Download : Download high-res image (146KB) Download : Download full-size image Conclusions: Gynecologic cancer patients experienced higher rates of unemployment, and loss of productivity compared to the overall US population. Disrupted employment was associated with at least one month of no health insurance coverage, and lack of a high school degree and increased healthcare utilization were independently associated with unemployment. While there was no association between the 2008 financial crisis era and unemployment, these data may help identify patients vulnerable to employment loss and health insurance loss during the current recession.
R. Nitecki, B. Albright, H. Moss