Abstract / Summary
Purpose Employment provides psychological and financial benefits. In this secondary analysis of the Eastern Cooperative Oncology Group- American College of Radiology Imaging Network (ECOG-ACRIN) EAQ162CD study results, we assessed longitudinal changes in employment and work productivity among individuals with stage I–III colorectal cancer and their association with financial hardship.Methods Adults with newly diagnosed stage I–III colorectal cancer treated with curative intent (2018–2020) were surveyed at enrollment, 3, 6, and 12 months. Employment, productivity, and work impairment were measured. Financial hardship was measured using the Comprehensive Score for Financial Toxicity (COST). Longitudinal associations were analyzed using multivariable models.Results Among 280 participants (mean age 55.5; 56.1% [157/280] male) 16.4% (46/280) reported decreased employment at enrollment vs. 4.2% (4/96) at 12 months; employment increases rose from 1.4% (4/280) at enrollment vs. 9.4% (9/96) at 12 months. Higher COST scores (lower hardship) were associated with lower odds of employment change. Among 202 participants employed at enrollment, median work missed declined from 21.9% at enrollment to 0% at follow-up. Physical work ability improved, while mental work ability transiently declined. Employment disruption occurred early, but improved over time.Conclusions These findings highlight the importance of early identification and support for individuals experiencing employment disruption and financial hardship during cancer treatment.