{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:57:15Z","timestamp":1790614635317,"version":"4.1.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Diagnosis of breast and gynecologic cancers may hamper employment; little is known about who is at greater risk of resignation.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine whether a breast or gynecologic cancer diagnosis is associated with resignation in working women and to identify high-risk subpopulations.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This matched cohort study included women aged 15 to 58 years insured by the Japan Health Insurance Association. From April 2017 to March 2023, women newly diagnosed with breast, cervical, uterine, or ovarian cancer were identified and matched in a 1:10 ratio to working women without these cancers.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Cancer diagnosis was based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)<\/jats:italic>.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was all-cause resignation, and the secondary outcome was a composite of resignation and death, both assessed during a 2-year follow-up. Stratified Cox proportional-hazards models were applied, with multiple imputation and covariate adjustments. Subgroup analyses by prespecified covariates assessed effect size moderation and interactions between exposure and these covariates.<\/jats:p><\/jats:sec>Results<\/jats:title>The study included 99\u202f964 women with cancer, including 59\u202f452 women with breast cancer (median [IQR] age, 48 [44-53] years), 14\u202f713 women with cervical cancer (median [IQR] age, 46 [39-51] years), 16\u202f933 women with uterine cancer (median [IQR] age, 49 [44-53 years]), and 8866 women with ovarian cancer (median age [IQR] age, 47 [40-52] years), as well as 999\u202f640 matched controls (594\u202f520 for the breast cancer cohort, 147\u202f130 for the cervical cancer cohort, 169\u202f330 for the uterine cancer cohort, and 88\u202f660 for the ovarian cancer cohort). Most women with cancer were working in the medical, health care, or welfare sector (32\u202f123 women [32.1%]). During follow-up, resignation rates were significantly higher for women with cancer vs controls (breast cancer: 10\u202f820 women [18.2%] vs 97\u202f892 women [16.5%]; hazard ratio [HR], 1.18; 95% CI, 1.16-1.20; cervical cancer: 3296 women [22.4%] vs 27\u202f476 women [18.7%]; HR, 1.31; 95% CI, 1.26-1.36; uterine cancer: 3161 women [18.7%] vs 27\u202f786 women [16.4%]; HR, 1.24; 95% CI, 1.19-1.29; ovarian cancer: 2004 women [22.6%] vs 15\u202f847 women [17.9%]; HR, 1.44; 95% CI, 1.37-1.51). Regarding the composite outcome of resignation and death, there was an increased risk for all cohorts, ranging from an HR of 1.25 (95% CI, 1.22-1.27) for breast cancer to 1.81 (95% CI, 1.73-1.89) for ovarian cancer. Among all 4 cancer cohorts, resignation risk was higher among women with older age, lower income, and a history of depression.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study using a nationwide health claims database in Japan, breast and gynecologic cancers were associated with a higher resignation risk, especially among those with older age, lower income, and depression history. These findings suggest that developing targeted support interventions may benefit women at high resignation risk after a cancer diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.28844","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T15:31:08Z","timestamp":1756135868000},"page":"e2528844","source":"Crossref","is-referenced-by-count":1,"title":["Resignation in Working Women With Breast and Gynecologic Cancers"],"prefix":"10.1001","volume":"8","author":[{"given":"Masahiro","family":"Iwakura","sequence":"first","affiliation":[{"name":"Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Clinical and Translational Research Centre, Keio University Hospital, Tokyo, 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