In a Japanese cohort study, working women diagnosed with ovarian cancer were found to have the highest rate of resignation, with a nearly twofold increase in patients with cancer who had a history of depression. The researchers also looked the rates of resignation among women who were diagnosed with breast, cervical, or uterine cancers and found that all were significantly higher than the rates of their cancer-free peers. Adjusted hazard ratios (HRs) for resignation ranged from 1.18 for breast cancer to 1.44 for ovarian cancer, and when considering the composite of resignation or death, HRs increased further from 1.25 to 1.81.
The researchers followed resignation incidence over 2 years and matched each cohort 1:10 to women without cancer. In the ovarian cancer cohort, 23% of women resigned, compared with 18% in the matched control group. In the breast cancer cohort, 18% resigned vs 17%; 22% of the cervical cancer cohort resigned vs 19%; and 19% of the uterine cancer cohort resigned vs 16%. Depression history was more common in women with cancer than those without. Specicially, prevalence of depression was 8 to 10 times higher in women with cancer compared with matched controls.
The study authors theorized the reason for the higher rate of resignation in patients with ovarian cancer may be due more frequent diagnoses at later stages than other cancers. Additionally, Japan's retirement allowance system differs from that of many western countries, increasing with tenure and frequently being given for voluntary resignations, which may influence a patient's decision to resign. Higher age, longer tenure, and lower income were also found to be connected to higher likelihood of resignation.
The analysis was conducted using data from the Japan Health Insurance Association database, which included 99,964 women aged 15 to 58 who were diagnosed with cancer between 2017 and 2023. The study authors used qualification loss date and reasons to determine all-cause resignation. Limitations included a lack of data on cancer severity, household status, and the types and intensity of cancer treatments. The database also excluded non–employer-insured workers and self-employed individuals, potentially limiting generalizability.
“These findings highlight the need for targeted workplace support to help retain women with cancer in the workforce,” wrote author Masahiro Iwakura, PhD, of Akita University Graduate School of Medicine in Akita, Japan. The study authors encouraged not only cancer screening, but also mental health screening for early detection and intervention. They also noted that financial counseling appeared beneficial in promoting work continuity.
Conflicts of interest can be found in the original study.
Source: JAMA Network Open
