How does a cancer diagnosis and treatment impact the financial lives of American workers? In a new survey conducted by University of Michigan researchers, 45 percent of working stage III colorectal cancer patients said they could not retain their jobs during treatment.

"Workers who develop serious illnesses, such as colorectal cancer, can incur economic hardship, regardless of insurance coverage," wrote Dr. Arden M. Morris, chief of the division of colorectal surgery at University of Michigan Health System, and her colleagues in their published report.

Paid sick leave is not a part of health insurance coverage and it is also not mandated under the Affordable Care Act. Only 40 percent of workers in the United States have access to paid time-off when they are sick. Morris and her co-researchers investigated the relationship between access to paid sick leave and job retention among patients with colorectal cancer.

Paid Leave Eases Burden

The research team contacted patients listed as having stage III colorectal cancer in the Georgia and metropolitan Detroit registries between August 2011 and March 2013. Patients were contacted four months postoperatively and could respond up to 12 months postoperatively. In particular, the researchers looked at those employed at diagnosis and their answers to questions about their job and personal finances.

Roughly two-thirds of the targeted patient group responded to the survey. Among the 567 employed respondents, 58 percent were men; 68 percent were white; 28 percent had less than a high school education, and 35 percent reported annual household income of less than $50,000. Importantly, more than half (56 percent) had access to paid sick leave.

Respondents without sick leave, when compared to those paid for sick days, reported significantly higher personal financial burden. Specifically, 28 percent of those without sick leave borrowed money compared to just 18 percent of those with sick leave; 29 percent versus 14 percent had difficulties making credit card payments (respectively), 50 percent versus 35 percent reduced their food and clothing spend, and 57 percent versus 47 percent cut back on recreational activities.

Of all the patients surveyed, a total 55 percent retained their jobs during their illness, while 8 percent became unemployed, 7 percent retired, and 4 percent found new jobs. Slightly more than a quarter (26 percent) became disabled. Those who retained their jobs were significantly more likely to be men, white, married, without comorbid disease, and were more highly educated and were more likely to have a higher annual income, private health insurance, and access to paid sick leave.

Making adjustments, the researchers discovered 59 percent of respondents with paid sick leave retained their jobs while just one-third without paid sick leave did the same. Overall, 45 percent of working people with stage III colorectal cancer did not retain their jobs reportedly due to their cancer diagnosis and treatment, noted the researchers.

Source: Veenstra CM, Regenbogen SE, Hawley ST, et al. Association of Paid Sick Leave With Job Retention and Financial Burden Among Working Patients With Colorectal Cancer. JAMA. 2015.