Today, cancer is one of the most prevalent health conditions in the U.S. and a leading cause of disability in the workplace.
[1] Over the course of their lives, about half of all men and one-third of all women develop cancer.
[2]
Improved
cancer treatment protocols are resulting in an ever-growing number of
survivors. Currently there are close to 14.5 million cancer survivors in
the U.S. and that number is expected to rise to almost 19 million by
2024.
[3]
The impact on the workplace will be significant, because statistics
show that 80% of working-age cancer patients return to their jobs.
[4]
Additionally,
the risk of the most common cancers, including breast, prostate and
lung, increases with age, impacting the aging workforce significantly.
And with a third of middle-class working Americans planning to work
until they are 80 years old, employers will likely see an increase in
the aging workforce, as they continue working longer to support
retirement.
[5]
The cost of cancer
Given
these statistics, employers are turning their focus on cancer care as
they look for ways to better manage health care costs. According to
research by the
Integrated Benefits Institute
in 2014, it’s estimated that cancer costs employers an estimated
$19,000 a year in lost work time and medical treatments per 100
employees. Cancer survivors generally have twice the annual medical
costs than patients without cancer because of ongoing monitoring as well
as the side effects of treatment or long-term effects of the disease.
[6]
Employers
in certain industries with older workforces are already experiencing
higher absence rates and correspondingly higher medical and prescription
drug costs. “While cancer patients represent just 1.6% of the privately
insured population, they account for 10% of employers’ medical claim
costs and a large share of long-term and short-term disability claims”.
[7]
The
cost of cancer care will continue to rise along with the number of
survivors. According to one report, it’s estimated that U.S. population
growth alone will increase the cost of cancer care by 27% from 2010 to
2020.
[8]
For employers, the challenge will be helping their employees touched by
cancer return to productivity and lead healthy lives in the future.
What employers can do
Developing
strategies to help employees in the workplace with cancer is complex
and multi-dimensional. A one-size-fits-all approach won’t work, because
every employer must base strategies on the company’s culture, workforce
demographics and specific cancer incidence.
For example, certain
industries such as construction and transportation have a younger
average employee population and frequently a higher percentage of male
workers. According to Unum short-term disability data from 2011-2013,
employees in the construction industry have a high prevalence of lung,
stomach, skin and prostate cancer, while employers in the health care
industry more typically see a very high incidence of breast and ovarian
cancer. The challenge for employers is the ability to recognize patterns
in absence and productivity along with medical spending trends for
their industry. Employers can then use that data to align health,
wellness, prevention and return-to-work programs.
In
addition, the average age of disability shows little variation across
industries despite very different workforce demographics.
[9]
Yet by types of cancer, the average age is considerably different
regardless of industry, with prostate the oldest at 58 years and thyroid
at just younger than 50.
[10]
That means employers need to research and understand their own
company’s particular absence and disability patterns to help identify
the benefits and programs that can most effectively support employees
diagnosed with or impacted by cancer.
Helping employees return to productivity
The
greatest challenge in supporting recovering cancer patients in the
workplace is accommodating them through their treatment. Treatment can
take anywhere from six to 12 months, and response to treatment varies.
Patients often experience fatigue, emotional and coping challenges and
“chemo brain,” or the impact of treatment on one’s memory and attention.
A
graduated RTW plan will often be the most successful approach to
helping a cancer survivor transition back to work. One review has shown
that a multidisciplinary intervention, including physical, psychological
and vocational components, can lead to higher rates of return to work.
[11]
Resources needed to most effectively develop a graduated plan include
trained professionals in the area of oncology: physicians, claims
specialists, clinicians and vocational consultants.
Providing
cancer patients with transitional resources and RTW options is crucial
to helping an employee resume job duties. Accommodations such as reduced
workplace stress or elimination of physical exertion can help with
fatigue, as can alternative work schedules or work space to minimize
visual or auditory distractions. Other accommodations may include
ergonomic workstation design, automatic door openers, allowing an
employee to work from home and temporary assignment to a less strenuous
area. The key for employers is being flexible and working with the
employee to develop the most effective strategy for each situation.
A cancer support program
Employers
should realize that in building an effective cancer workplace strategy,
the best programs will be proactive, including a range of programs,
services and resources to help employees touched by cancer. Employers
may want to focus on three key areas when developing their program:
1. Financial and benefit plan design. Plans and policies should provide:
- Seamless integration of short-term disability and long-term disability plans;
- Consistent, compliant FMLA policies and processes, including intermittent leave and tracking capabilities;
- Paid time-off or vacation donation.
In
addition, disability plan features should ensure that there are no gaps
between the elimination period and sick days or paid time-off; a
minimum recurrent provision (30 days for STD and six months for LTD);
and a definition of disability that includes partial or residual. More
commonly, employers are offering voluntary worksite benefits such as
critical illness/cancer coverage as a way to help their employees
protect against a major health event.
2. Absence management. Establishing
a culture of RTW and prioritizing work-life balance is key to a
successful strategy. Protecting productivity should be a key objective
of any cancer program, and establishing a formal RTW policy is
paramount. A transitional RTW program and policy benefits both the
employee and the employer because they can help:
- Increase productivity in the workplace;
- Remove barriers to return to work and reduce absence;
- Prevent financial and employment hardship;
- Ensure equality, protecting the employer against risk
A
comprehensive absence management program includes communication at the
time of diagnosis and during treatment, along with interactive
engagement and coaching. This will help reduce uncertainty, create trust
and ensure a successful return-to-work experience.
3.
Emotional and caregiver support. Employees
going through a cancer experience almost always seek a quick return to
their “normal” lifestyle. The physical, emotional and financial
challenges they face require extensive support to help them transition
to a “new normal.” One often-overlooked resource available through the
worksite is an employer’s employee assistance program.
A
comprehensive and well-funded EAP can provide services to address a
variety of issues, including managing depression, the stress of
treatment and, frequently, the demands of caregiving. Cancer caregivers
often face career and personal challenges, including economic
constraints or the need to cut working hours. Six in 10 caregivers
report being employed at some point in the past year while caregiving.
Among them, 56% worked full time, and on average, they worked 34.7 hours
a week.
[12]
Promoting
EAP resources and offering support before it may even be needed can
help minimize the impact on productivity and help individuals get the
emotional care they need.
The
aging of America will accelerate in the coming decades, as will the
impact of cancer in the workplace. Creating a comprehensive, targeted
program that supports employees affected by cancer can seem
overwhelming, but it can also be extremely rewarding. A great resource
to assist employers is “
An Employer’s Guide to Cancer Treatment & Prevention”, which provides an online and interactive toolkit to help address the growing impact of cancer in the workplace.
[13]
Employers should focus on implementing a strategy that will align with
their demographics and unique workplace culture, and that compliments
its broader health and wellness strategies and employee benefits.
********
[1 ] Unum internal data, 2014
[3] American Cancer Society, Cancer Treatment & Survivorship Facts & Figures, 2014-2015
[6]
The American Association for Cancer Research (AACR) “Cancer survivors
in the United States: Prevalence across the Survivorship Trajectory and
Implications for Care” Cancer Epidemiology, Biomarkers & Prevention
(2013).
[8]
Angela B. Mariotto, K. Robin Yarbroff , Yongwu Shao, Eric J. Feuer, and
Martin L. Brown, “Projections of the Cost of Cancer Care in the United
States: 2010–2020” Journal of the National Cancer Institute (2011).
