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Breast Cancer: Economic Impact and Labour Force Re-Entry
Report comissioned by the Canadian Breast Cancer Network ,
 We may think of breast cancer as a health condition, but it is also an economic condition. A diagnosis of breast cancer can have an enormous cost for women and men living with the disease and for their families. Persons living with breast cancer usually have to take time off work for treatment and recovery. Their re-entry into the work force after treatment can be difficult.
A recently released report presents the results of research conducted for the Canadian Breast Cancer Network (CBCN) on the economic impact of breast cancer and the challenges of returning to work.
The research was conducted during the first six months of 2009 and consisted of an online survey in which 446 people participated, 98% were women and 97% were of usual working age (18-64) at the time of diagnosis. A qualitative follow-up survey and a general public opinion survey were also completed.
The economic impact was felt to be significant with 80% of respondents stating they experienced a financial impact from the disease. Many respondents were unaware of the high cost of the disease until they began treatment. Like many Canadians, they had assumed that public health care would cover most of their costs. The economic reality came as a shock.
Respondents felt the Federal Government should improve Employment Insurance benefits and provide more generous tax breaks. It was noted that the average duration of treatment was 38 weeks and 2/3 of patients took 16 or more weeks off work. As Employment Insurance (EI) benefits last for a maximum of 15 weeks there is an average gap of 23 weeks without this coverage. As well, it was noted that the benefit was at 55% of salary level and judged by many to be woefully inadequate. In addition, the federal Employment Insurance program's eligibility excludes those without enough accumulated work hours, the self-employed and homemakers. The general population survey revealed 75% of Canadians support an increase in the duration of EI sickness benefits for persons living with breast and other cancers.
Respondents had mixed experiences of returning to work. 20% returned to work before they were ready because of financial pressure. Those who were able to make a gradual return to work were more likely to report a positive experience. Some had rehabilitation and ergonomic adjustments to their workplace to accommodate their new situation.
Attitudes of employers and co-workers had a major effect on ease of re-entry, with gradually increasing workload being the more important factor in accommodating post-treatment needs.
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Almost half the respondents report a reduced physical ability to work after treatment and 1/5 were forced to quit due to work-relate restrictions, side effects from treatments, fatigue and pain.
The health and psychosocial impact of financial burden was significant, with the most common experiences being stress and sleeplessness. Chemotherapy has an economic impact. Those who received chemo had the greatest drop in family income, took more time off work and were more likely to quit their jobs. Chemo Brain was identified as a challenge in returning to work.
It is clear from the research breast cancer is an economic, as well as a health, condition. Survey respondents told us they often found the financial burden to be as stressful as the disease and the financial impact sometimes lasts longer than the disease itself.
People can survive breast cancer, but they may live with the economic impact for the rest of their lives. Loss of work or return to work at a lower salary can have long-term effects. The information makes it clear that breast cancer has a strong economic impact and creates challenges for those re-entering the workforce. This is a concern for all Canadians. The general population survey indicates that Canadians would be receptive to measures which ease the financial burden of the disease.
The complete CBCN commissioned report Breast Cancer: Economic Impact and Labour Force Re-Entry is available online at www.cbcn.ca or to order the print version call 1.800.685.8820. Available in French and English.
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