Improvements in cancer detection and treatment have led to an increase in the number of Americans surviving and living with cancer. Approximately 50 % of cancer survivors are under 65 years, with a large number working during therapy or returning to work after treatment. While numerous studies have examined cancer risk and health behaviors associated with developing cancer, very few have focused on these behaviors among persons who have been living with cancer. Using the 1997-2010 National Health Interview Survey (NHIS) database, as well as the 2000, 2005 and 2010 NHIS Cancer Supplement data, to evaluate a nationally representative sample of working age Americans living with cancer, I propose to: 1) Examine the health disparities, functional limitations, and morbidity status of this subset of the US population stratified by age, gender, race/ethnic status, education, health insurance, cancer type, and employment status and occupational/industry categories;2) Examine the relationship between sociodemographic indicators, cancer risk factors, cancer screening behaviors, and employment status among persons with cancer using structural equation modeling (SEM);3) Document and compare prevalence rates and trends between occupational groups over this time period among working adults who have been diagnosed with cancer. The identification of disparities may shed some light on the differences in self-health perception and adherence to treatment and future health behavior by age, gender, race, and socioeconomic status among persons diagnosed and working with cancer. In addition, the identification of cancer-related disparities within the population and its association with employment could be an important driver in examining changes in policies affecting employment-related health insurance and insurance coverage for cancer screening and treatment (as well as other workplace accommodations) for the increasing numbers of Americans working with cancer.
This proposed research is responsive to several Research Priorities of the National Cancer Institute (NCI) including identification of health disparities, evaluating cancer trends, and planning future interventions to decrease these disparities. Using the NHIS database we will examine health disparities among persons who continue to work after cancer diagnosis.
