Factors influencing job loss and early retirement in working men with prostate cancerfindings from the population-based Life After Prostate Cancer Diagnosis (LAPCD) study

PurposeTo investigate factors associated with job loss and early retirement in men diagnosed with prostate cancer (PCa) 18-42months previously.MethodsMen 60years at diagnosis who completed the Life After Prostate Cancer Diagnosis (LAPCD) survey were identified. Men who moved from employment at diagnosis to unemployment (EtoU) or retirement (EtoR) at survey (18-42months post-diagnosis) were compared to men remaining in employment (EtoE). Sociodemographic, clinical and patient-reported factors were analysed in univariable and multivariable analysis.ResultsThere were 3218 men (81.4%) in the EtoE, 245 (6.2%) in EtoU and 450 (11.4%) in the EtoR groups. Men with stage IV disease (OR=4.7 95% CI 3.1-7.0, relative to stage I/II) and reporting moderate/big bowel (OR=2.5, 95% CI 1.6-3.9) or urinary problems (OR=2.0, 95% CI 1.4-3.0) had greater odds of becoming unemployed. Other clinical (1 comorbidities, symptomatic at diagnosis) and sociodemographic (higher deprivation, divorced/separated), living in Scotland or Northern Ireland (NI)) factors were predictors of becoming unemployed. Men who were older, from NI, with stage IV disease and with caring responsibilities had greater odds of retiring early. Self-employed and non-white men had lesser odds of retiring early.ConclusionPCa survivors who retire early following diagnosis do not report worse urinary or bowel problems compared to men remaining in employment. However, we identified clinical and sociodemographic factors which increased unemployment risk in PCa survivors.Implications for Cancer SurvivorsTargeted support and engagement with PCa survivors at risk of unemployment, including their families and employers, is needed.