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Original research
Short-term effect of colorectal cancer on income: analysis of an Italian cohort
  1. Elena Farina1,
  2. Marco Rosso2,
  3. Lucia Dansero3,
  4. Roberto Ippoliti4,
  5. Gianmauro Numico5,
  6. Alessandra Macciotta3,
  7. Antonella Bena6,
  8. Fulvio Ricceri3
  1. 1 Department of Epidemiology, ASL TO3, Grugliasco, Piemonte, Italy
  2. 2 Department of Economics, University of Bologna, Bologna, Italy
  3. 3 Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, Università degli Studi di Torino, Orbassano, Piemonte, Italy
  4. 4 Faculty of Business Administration and Economics, University of Bielefeld, Bielefeld, Germany
  5. 5 Department of Medical Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
  6. 6 Documentation Centre for Health Promotion, ASL TO3, Grugliasco, Piemonte, Italy
  1. Correspondence to Lucia Dansero, Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, Università degli Studi di Torino, Orbassano, Piemonte, Italy; lucia.dansero{at}unito.it

Abstract

Introduction The ability to return to work after a cancer diagnosis is a key aspect of cancer survivorship and quality of life. Studies have reported a significant risk of income loss for cancer survivors; however, there is limited evidence of the Italian context.

Methods The Work Histories Italian Panel (WHIP)-Salute database was used to select a cohort of incident cases of colorectal cancer (CRC) among workers in the private sector, based on hospital discharges. A propensity score matching was used to find a balanced control group for several confounders. Ordinary least square and logistic regressions were used to estimate the effect of a CRC diagnosis on annual income and the probability of switching from a full-time contract to a part-time one considering 3 years after the diagnosis.

Results Overall, we identified 925 CRC incident cases from 2006 until 2012. Our results confirm a statistically significant reduction in survivors’ income compared with controls. This reduction was greater in the first year and then tend to decrease, with an average income loss over 3 years of about €12 000. Stratified analyses by sex and position confirmed the overall trend while indicating a strong effect modification. Regarding the switching from full-time to part-time employment, the results were never significant.

Conclusion Income loss does not seem to be related to an increase in part-time contracts, but rather to survivors’ reduced work capacity following the invasive treatments. Further research is needed to investigate the complex dynamics behind this association.

  • employment
  • occupational health
  • longitudinal studies

Data availability statement

Data may be obtained from a third party and are not publicly available. The statistical products available for release are defined within the National Statistics Program. A specific procedure to download an anonymised database with no linkage to individuals is available upon request. For a more detailed description of the WHIP-Salute database, see Servizio di Epidemiologia - Whipsalute.

https://doi.org/10.1136/jech-2022-220088

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. The statistical products available for release are defined within the National Statistics Program. A specific procedure to download an anonymised database with no linkage to individuals is available upon request. For a more detailed description of the WHIP-Salute database, see Servizio di Epidemiologia - Whipsalute.

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    Footnotes

    • EF and MR are joint first authors.

    • Contributors Conceptualisation: EF, MR, RI, GN, FR. Methodology: EF, MR, FR. Formal analysis: EF, MR. Data curation: EF. Software: MR. Writing—original draft preparation: EF, LD. Writing—review and editing: EF, LD, MR, RI, GN, AM, AB, FR. Supervision: AB, FR. Resources: AB. Validation: FR. Guarantor: FR. All authors have read and agreed to the published version of the manuscript.

    • Funding This project was funded by Compagnia di San Paolo, call 'TRAPEZIO - Paving the way to research excellence and talent attraction'.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.