Perceived discrimination at work: examining social, health and work-related factors as determinants among breast cancer survivors – evidence from the prospective CANTO cohort

Background

We assessed the prevalence of self-reported perceived discrimination in the workplace after the end of treatment among breast cancer (BC) survivors and studied its association with social, health-related and work-related factors.

Methods

We used data from a French prospective cohort (CANcer TOxicities) including women diagnosed with stage I–III BC. Our analysis included 2130 women who were employed, <57 years old at BC diagnosis and were working 2 years afterwards. We assessed the association between social, health-related and work-related factors and perceived discrimination in the workplace using logistic regression models.

Results

Overall, 26% of women reported perceived discrimination in the workplace after the end of treatment. Women working for a small company, in the public sector or with better overall health status were less likely to report perceived discrimination. Women who benefited from easing dispositions at their workplace, who did not feel supported by their colleagues and those who returned to work because of fear of job loss were more likely to report perceived discrimination.

Conclusions

One in four BC survivors perceives discrimination in the workplace. Health and work-related factors are associated with increased likelihood of reporting perceived discrimination.

Trial registration number

NCT01993498.

[Compensation of damage in cancerology]

In a few situations, the consequences secondary to a carcinological pathology require an assessment of damages for compensatory purposes. This is particularly the case when liable parties have been found to be at cause of the disease: occupational pathologies in the case of inexcusable employer's fault, exposure to a radioactive risk, for example in the context of full compensation for damages suffered by the victims of nuclear experiments performed by France, or lastly, in the after-effects of late diagnosis. This article does not discuss the imputability of cancer pathologies to an event, but it proposes an adaptation of methods for assessing damages, in an attempt to provide full compensation for damages.

Cancer survivors' efforts to facilitate return to work

This study assesses individual factors that influence return to work (RTW) and in particular on the cancer survivors' ability to prepare his/her job resumption. A self-administered questionnaire was completed by 105 cancer survivors after at least 4 weeks after the time of their RTW. Various methods of returning to work were compared between occupational and medical characteristics with multivariate statistical tests. Regular contact by a cancer survivor with the company during sick leave is associated with RTW within 1 year of diagnosis (ORaj = 5.78). Optional pre-reinstatement visit with the occupational physician is associated with the absence of employee activity's change (ORaj = 2.30). The cancer survivors who during treatment period ask for an adaption of treatment are more likely to have a change in working conditions (ORaj = 14.5). The adaptation to recovery conditions appears to be associated with survivors' effort to RTW. It should be confirmed with new studies.

The positive effect of workplace accommodations on the continued employment of cancer survivors five years after diagnosis

PURPOSE

To address the gap highlighted in the literature on the effect of professional interventions to facilitate continued employment, this study aims to evaluate the effect of workplace accommodations on the continued employment 5 years after a cancer diagnosis.

METHODS

This study is based on VICAN5, a French survey conducted in 2015-2016 to examine the living conditions of cancer survivors 5 years after diagnosis. Two subsamples, one with and one without workplace accommodations, were matched using a propensity score to control for the individual, professional, and medical characteristics potentially associated with receipt of workplace accommodations.

RESULTS

The study sample was composed of 1514 cancer survivors aged 18-54 and employed as salaried at diagnosis. Among them, 61.2% received workplace accommodations within 5 years after diagnosis: 35.5% received a modified workstation, 41.5% received a modified schedule, and 49.2% received reduced hours. After matching, receipt of workplace accommodations appeared to improve the continued employment rate 5 years after cancer diagnosis from 77.8% to 95.0%.

CONCLUSIONS

Receipt of workplace accommodations strongly increases the continued employment of cancer survivors 5 years after diagnosis. More research is needed to better understand the differences in receipt of workplace accommodations along with the related selection effect.

Relations causales entre santé et travail

Les économistes s’intéressent aux liens entre santé et travail en examinant en particulier trois relations : l’effet négatif de la santé dégradée sur la position sur le marché du travail, l’influence positive du travail sur la santé mais aussi le rôle délétère de certaines conditions de travail et d’emploi sur l’état de santé. Si la littérature internationale est abondante sur la question, la littérature française est plus récente. En France, les effets d’événements de santé sont plus pénalisants sur la trajectoire professionnelle lorsqu’ils surviennent en seconde partie de carrière invitant à la mise en place d’une prévention précoce en entreprise. Les études soulignent aussi des populations fragiles face aux ruptures de trajectoires professionnelles ou de santé telles que les hommes anxieux.