Women diagnosed with breast cancer are no more likely than women in the
general population to experience discrimination at work, according to a
new study in the December 15 issue of the Journal of the National Cancer Institute.
Despite legislation in Canada and other countries to protect workers
from discrimination based on disability or health state, some cancer
survivors have reported problems in the workplace after cancer. These
problems have included job loss, demotion, decreased wages, difficulty
in obtaining a new job, and problems with supervisors and colleagues.
However, few quantitative studies have addressed the work experiences
of cancer survivors.
To assess breast cancer survivors' work experience, Elizabeth
Maunsell, of the Université Laval in Quebec City, and colleagues
conducted a population-based retrospective cohort study in Quebec,
Canada, of a series of breast cancer patients who were age 60 and
younger at diagnosis. The work experiences of 646 of these women over
the 3 years after their diagnosis were compared with the experiences
during the same time period of a group comprised of 890 women who were
similar to the survivors except that they had never been diagnosed with
cancer.
Slightly more breast cancer survivors than women in the
comparison group (21% versus 15%) were unemployed at the end of the
3-year period. However, 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 3 years later, no deterioration in working
conditions was observed in either group. In addition, negative events,
such as firings, were rare in both groups.
"[W]e recognize that individual women may find the return to
work after breast cancer difficult and may attribute work problems or
the personal decision to reduce work effort to the fact of having had
breast cancer," the authors write. "On a population basis, however, we
found little evidence to support the idea of involuntary changes in
work situation because of breast cancer in Quebec. Thus, we believe
that these results should provide some reassurance for working women
who have just been diagnosed with breast cancer, especially women who
are part of health and social systems similar to those in Canada."
In an editorial, Leslie R. Schover, Ph.D., of the University of
Texas M. D. Anderson Cancer Center in Houston, discusses how most
stereotypes of breast cancer survivorship have proven to be untrue. For
example, breast cancer does not lead to higher divorce rates, and the
type of breast surgery plays little role in a woman's sexual function
or satisfaction. "We should, however, not grow complacent about, nor
should we trivialize, the emotional and physical pain of acute cancer
treatment," she writes. "However, future research on breast cancer
survivorship should focus on those women who may be at increased risk
for poor psychosocial outcomes: those who belong to underserved
minority groups, are less well educated, are younger at diagnosis, have
conflicted relationships, and are made prematurely menopausal by
adjuvant chemotherapy."
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