Evidence map›Paper›PMID 34395255›Full record

ArticleFrontiers in oncology2021

Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption.

Caitlin B Biddell, Stephanie B Wheeler, Rebekah S M Angove, Kathleen D Gallagher, Eric Anderson, Erin E Kent, Lisa P Spees

Open access · goldAbstract read
In one paragraph

Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
5.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Prognostic factors for return to work in breast cancer survivors.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Article
  3. Financial toxicity among breast cancer survivors receiving care during the pandemic.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  4. Article
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  6. Hispanic/Latino Ethnicity Is an Independent Predictor of Worse Survival for Gastric Cancer in a Multicenter Safety-Net Patient Population.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
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  16. Characterizing Cancer and Work Disparities Using Electronic Health Records.International journal of environmental research and public health · 2022
    Article
  17. Determinants of telemedicine adoption among financially distressed patients with cancer during the COVID-19 pandemic: insights from a nationwide study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Article
  18. Review
  19. Racial/Ethnic Disparities in Health and Life Insurance Denial Due to Cancer among Cancer Survivors.International journal of environmental research and public health · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Caitlin B BiddellDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Stephanie B WheelerDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Rebekah S M AngovePatient Advocate Foundation, Hampton, VA, United States.
Kathleen D GallagherPatient Advocate Foundation, Hampton, VA, United States.
Eric AndersonPatient Advocate Foundation, Hampton, VA, United States.
Erin E KentDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Lisa P SpeesDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
University of North Carolina at Chapel Hill · USPatient Advocate Foundation · US

Funding

Examining the Relationship Between Spatial Accessibility to Care, FT, and HRQoL Among Rural Cancer SurvivorsR01CA240092 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ROSENSTEIN, DONALD L, WHEELER, STEPHANIE BROOKE · 2019 to 2022
$2.2M
NCI NIH HHS R01 CA240092
6 · The paper itself

Abstract

introductionCancer-related employment disruption contributes to financial toxicity and associated clinical outcomes through income loss and changes in health insurance and may not be uniformly experienced. We examined racial/ethnic differences in the financial consequences of employment disruption.

methodsWe surveyed a national sample of cancer patients employed at diagnosis who had received assistance from a national nonprofit about the impact of cancer diagnosis and treatment on employment. We used logistic regression models to examine racial/ethnic differences in income loss and changes in health insurance coverage.

resultsOf 619 cancer patients included, 63% identified as Non-Hispanic/Latinx (NH) White, 18% as NH Black, 9% as Hispanic/Latinx, 5% as other racial/ethnic identities, and 5% unreported. Over 83% reported taking a significant amount of time off from work during cancer diagnosis and treatment, leading to substantial income loss for 64% and changes in insurance coverage for 31%. NH Black respondents had a 10.2 percentage point (95% CI: 4.8 - 19.9) higher probability of experiencing substantial income loss compared to NH White respondents, and Hispanic or Latinx respondents had a 12.4 percentage point (95% CI: 0.3 - 24.5) higher probability compared to NH White respondents, controlling for clinical characteristics (i.e., cancer type, stage and age at diagnosis, and time since diagnosis). Similarly, NH Black respondents had a 9.3 percentage point (95% CI: -0.7 - 19.3) higher probability of experiencing changes in health insurance compared to NH White respondents, and Hispanic or Latinx respondents had a 10.0 percentage point (95% CI: -3.0 - 23.0) higher probability compared to NH White respondents. DISCUSSION: Compared with NH White respondents, NH Black and Hispanic/Latinx respondents more commonly reported employment-related income loss and health insurance changes. Given documented racial/ethnic differences in job types, benefit generosity, and employment protections as a result of historic marginalization, policies to reduce employment disruption and its associated financial impact must be developed with a racial equity lens.

Indexed as

canceremploymentfinancial toxicityproductivity losssurvivorship

Identifiers

PMID34395255
PMCPMC8361325
OpenAlexW3190850588

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.