Work and income changes after cancer in rural China: A cross-sectional survey

Background: The present study aimed to first describe the work-related outcomes of cancer survivors and to then identify those characteristics that influenced the decision to stop working in rural China. Methods: We assessed 752 cancer survivors (residents of rural areas, working at the time of diagnosis, >1 year since completing treatment) from the cross-sectional study “China Survey of Experiences with Cancer”. Participants reported changes in employment status, income, and the ability to perform physical jobs due to cancer, as well as the work-related outcomes of their informal caregivers. Logistic regression analyses were used to examine the association between sociodemographic characteristics, cancer characteristics, and changes in work (ie, continue to work vs not working). Results: The participants were largely farmers (96%), women (56%), younger than 65 years old (69%), and diagnosed with colorectal (31%) and breast cancer (31%). Thirty-nine percent reported reducing working hours, and 40% reported stopping work altogether. Approximately 7% of informal caregivers also stopped working in order to take care of those diagnosed with cancer. Thirty-three percent of cancer survivors and 5% of their informal caregivers had no source of income following treatment. Controlling for other variables, lower educational attainment, physical limitations in work, and different cancer sites were significantly associated with ending employment in both men and women, while among men specifically, we observed that older age, being unmarried, and being diagnosed at later stages were significantly associated with an end to working. Conclusion: Rural cancer survivors are at a high risk for stopping work after completing treatment, and many survivors and their caregivers experience poor work-related outcomes and economic hardship. These results highlight the importance of paying attention to the work experiences of cancer survivors in rural China.