Impact of head and neck cancer on the income of Italian employees

Purpose: In recent decades, survival rates for head-and-neck (H&N) cancers have risen, drawing attention to survivors’ working reintegration after treatments. This cohort study aims to evaluate the effect of H&N tumours on the income of employees in the private sector in Italy. Methods: Data were extrapolated from the WHIP-Salute archive, which contains work and health information of workers of the private sector in Italy. Incident cases of H&N cancer (between 2004 and 2013) were matched with cancer-free workers using an Optimal Variable Ratio Matching. Linear regression models were used to estimate the effect of H&N tumours on weekly income in the year of diagnosis and in the subsequent two years, overall and stratifying according to sex, job position, and cancer stage. Results: 592 H&N cancer cases were identified, predominantly male (86%), blue-collar workers (72%), and with localized disease (60%). A significant decline in the average weekly income for workers with cancer compared to their cancer-free counterparts was evident, both in the year of diagnosis (β=-38.59, p < 0.001) and in the next two years (β=-35.60, p < 0.001, and β=-29.95, p < 0.001, respectively). Similar trends were observed in stratified analyses. Conclusions: This study suggests a short-term disparity in weekly income between workers with H&N cancer and their cancer-free counterparts. Reasons may lie in reduced working capacity of patients following cancer treatments. Implications for cancer survivors: Employer awareness about survivors’ conditions can enhance workplace inclusivity. Furthermore, the implementation of ad-hoc policies may lead to a successful reintegration of H&N cancer survivors into the workforce.