Abstract / Summary
Background: Compared to salaried people, self-employed people have received considerably less research attention regarding health, working conditions, and rehabilitation. Objective: To examine the long-term effects (up to five years) of cancer on employment among self-employed cancer survivors (CSs). Employment outcomes were compared with those of self-employed cancer-free controls, salaried CSs, and salaried cancer-free controls. Additionally, the relationship between sociodemographic variables and employment was explored. Methods: Data from the Cancer Registry of Norway and Statistics Norway were obtained for information on cancer diagnoses, employment status, and sociodemographic characteristics for 725 self-employed CSs, 725 matched self-employed controls, and 10,463 salaried CSs and 10,463 salaried matched controls. All participants were aged 30–55, employed at the time of diagnosis (T0) (2004–2008), and alive five years later (T5) (2009–2014). Logistic regression analyses were performed. Results: At T5, 83% of male and 85% of female self-employed CSs were employed. Among salaried CSs, the likelihood of being employed at T5 was significantly lower than among salaried controls [adjusted odds ratio (ORadj) = 0.53 (95% confidence interval (CI) = 0.49–0.58)], whereas no significant difference was observed between self-employed CSs and their controls [ORadj = 0.86 (95% CI = 0.64–1.16)]. Compared to salaried controls, both self-employed CSs and controls were less likely to be employed. Income level was the most important sociodemographic factor predicting employment at T5 for all groups. This was particularly evident for the self-employed CSs [ORadj = 6.91 (95% CI = 3.48–13.67)]. Conclusions: Cancer showed a significant association with T5 employment among salaried workers, but not among the self-employed. Low income was particularly important for not being employed at T5 among self-employed CSs.