The aim of this program is to insure that adults who have had cancer in childhood secure employment commensurate with their training and abilities; and adequate life and health insurance for themselves and their families. Prior studies suggest that there is widespread discrimination in these areas. It is contended that in respect to employment and health insurance, this is frequently based on attitudes which have little scientific basis; and in respect to life insurance, on outdated or irrelevant data. The facilities of two pediatric centers with large oncology services, and excellent long-term patient follow-up will be employed. Beginning with a questionnaire-interview survey of 786 patients (and 546 controls) who are 16 years of age or more (200 greater than 30 years; 80 greater than 35 years), the initial phase of the study will include the development of a psychosocial profile with emphasis on the experience of survivors in these areas. Hypotheses that greater difficulty in securing adequate health and life insurance and appropriate employment exist among post- cancer patients will be tested. In the second phase of the study approximately 500 patients, ages of 15 and 30 years, will be randomly assigned to Intervention or Non-intervention categories. Each category will be increased by approximately 125 new patients study year. Intervention will consist of a series of direct contacts with volunteer employer groups (personnel directors, hiring agents, employers) and insurance groups (medical directors, underwriter, actuaries) both individually and collectively. Volunteers are affiliated with support groups of the applicant institutions and/or the American Cancer Society. Assessments in three areas, (a) employment, (b) health insurance and (c) life insurance will be made at the onset of the study and annually thereafter in all groups. After 21/2 years, individuals in the Non-intervention category will """"""""crossover"""""""" into the Intervention group for two years and subsequent analysis. If this approach to the problems of the survivor of childhood cancer is effective in these two institutions it can be duplicated in other major cities in the U.S. Its application to adults with a history of other (not cancer related) devastating diseases of childhood is suggested.
| Hays, D M (1993) Adult survivors of childhood cancer. Employment and insurance issues in different age groups. Cancer 71:3306-9 |
| Hays, D M; Landsverk, J; Sallan, S E et al. (1992) Educational, occupational, and insurance status of childhood cancer survivors in their fourth and fifth decades of life. J Clin Oncol 10:1397-406 |
