Cancer occurrence: short- and medium-term effects on employment, unemployment, and sick leave.

Summary The reduction of inequalities in the face of disease is one of the major expectations of the third Cancer Plan 2014-2019, which recommends "reducing the impact of cancer on personal life" in order to avoid the "double penalty" (disease and exclusion from the labor market). In this context, we evaluate the impact of one to five years of a first registration as a long-term disease (ALD) characterizing cancer on the employment status and duration spent in employment, illness and unemployment of private sector employees. We use the Hygie administrative database, which records the professional career and illness episodes of a sample of employees affiliated to the General Social Security System. The evaluation of the impact of the occurrence of cancer is based on a double difference method with exact matching to compare sick employees to employees without any ALD. The first year after diagnosis corresponds to the time of treatment characterized by an increase in the number of quarters of sick leave of 1.7 for women and 1.2 for men. Age also plays a role in illness-related absences. In addition, the employability of workers with cancer decreases over time. The proportion of women and men employed for at least one quarter drops by 8 and 7 percentage points respectively in the year following the onset of cancer and up to 13 percentage points five years later. This distance to employment increases when the sick employees are older. The effect of the disease at five years is 15 and 19 percentage points respectively for men over 51 and for women over 48. These gender and age differences may reflect differences in the location and severity of the cancers, on the one hand, and in the after-effects of the cancers and the difficulties of re-entering the labour market, which are greater with advancing age, on the other.