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Low-income women were less likely to have accommodating employers, however.More uniform implementation of accommodations across low and high paying jobs could reduce disparities in employment outcomes among workers with a cancer diagnosis.Nearly 1 in 8 women are diagnosed with breast cancer in the United States, of whom 58 percent are working age (18–64 years).(1, 2) Advances in early detection and management of breast cancer have led to improvements in overall survival; 90 percent of women diagnosed today are expected to be alive in 5 years.(2)Approximately 70–80 percent of breast cancer survivors return to work 3–18 months after diagnosis, and receipt of employer accommodations is among the strongest predictors of work continuation 1–2 years following diagnosis.(3–5) When surveyed 18 months after a breast cancer diagnosis, women who reported having had an accommodating employer had twice the odds of working compared to women who did not have an accommodating employer.(3) The role of employer accommodations in the post-treatment employment outcomes of low-income minority breast cancer survivors remains poorly understood, however.In a longitudinal study of low-income, Medicaid-insured breast cancer survivors in California, all of whom were working prior to diagnosis, only 60 percent were employed 3 years later.(6) Latinas comprised the majority of the sample and took longer to return to work than did non-Latina whites.The category with the lowest job retention after treatment was low-income women (57 percent).Job retention varied widely by race/ethnicity, ranging from 68 percent among Chinese women to 98 percent among non-Latina whites.Potential participants were approached at oncology visits by bilingual or multilingual research staff.

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However, the Americans with Disabilities Act only applies to government employers and private employers with 15 or more employees, excluding workers employed by small businesses.After 5 years of follow-up a concerning trend emerged: 43 percent of those not working 6 months after diagnosis never returned to work.(7)Job loss can have devastating financial consequences, including increased risk of bankruptcy, debt, or both.(8) Workplace accommodations can positively influence work outcomes of patients with a cancer diagnosis.For example, schedule flexibility is associated with a tremendous improvement in job retention.(9) Sick leave also is critical to cancer patients undergoing treatment.The majority of studies of employment outcomes in breast cancer survivors have included primarily US-born, white, middle-income and insured women.Breast cancer’s effects on low-income women and on immigrants and minorities are understudied.Job retention was lowest among low-income women (57 percent), and among Chinese women (68 percent), followed by Koreans (73 percent), Latinas (78 percent), blacks (85 percent), and whites (98 percent).

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