{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:55:37Z","timestamp":1792108537550,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T00:00:00Z","timestamp":1518480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["U19 OH008868"],"award-info":[{"award-number":["U19 OH008868"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Although cancer survivors are more likely to be unemployed than individuals without a cancer history, employment participation after treatment of early\u2010stage breast cancer has not been widely studied to date. The objectives of the current study were to evaluate employment trajectories in a cohort of patients with early\u2010stage breast cancer and age\u2010matched controls from the time of diagnosis to the 2\u2010year follow\u2010up, and identify factors associated with diminished and emerging employment participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>As part of a larger cohort study of 1096 patients with early\u2010stage breast cancer and same\u2010aged women without breast cancer, data from 723 working\u2010age (aged 40\u201064 years) women (347 patients and 376 controls) were analyzed to evaluate 4 employment trajectories (sustained unemployment, diminished employment, emerging employment, and sustained employment). Multivariable logistic regression models were used to identify factors associated with diminished employment versus sustained employment, and emerging employment versus sustained unemployment.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Lower percentages of patients (71%) compared with controls (79%) reported full\u2010time or part\u2010time employment at enrollment (<jats:italic>P<\/jats:italic>&lt;.01). Fatigue was a significant predictor of diminished employment for both patients (odds ratio [OR], 5.71; 95% confidence interval [95% CI], 2.48\u201013.15) and controls (OR, 2.38; 95% CI, 1.21\u20104.68). Among patients, African American race (OR, 4.02; 95% CI, 1.57\u201010.28) and public\/uninsured insurance status (OR, 4.76; 95% CI, 1.34\u201012.38) were found to be associated with diminished employment. Among controls, high social support was associated with emerging employment (OR, 3.12; 95% CI, 1.25\u20107.79).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Fatigued patients, African American patients, and publicly insured\/uninsured patients with cancer were more likely to experience diminished employment after 2 years of follow\u2010up. Further investigation with longer follow\u2010up is warranted to identify factors associated with these disparities in employment participation after treatment of early\u2010stage breast cancer. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:2026\u201035<\/jats:bold>. \u00a9 <jats:italic>2018 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31270","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T10:22:43Z","timestamp":1518517363000},"page":"2026-2035","source":"Crossref","is-referenced-by-count":51,"title":["Early\u2010stage breast cancer and employment participation after 2 years of follow\u2010up: A comparison with age\u2010matched controls"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6209-4888","authenticated-orcid":false,"given":"Christine C.","family":"Ekenga","sequence":"first","affiliation":[{"name":"Brown School Washington University in St. Louis St. Louis 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