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Public health policy and health economics

2511 - Economic burden of cancer patients and the job assistance from the society


09 Sep 2017


Public health policy and health economics


Cancers in Adolescents and Young Adults (AYA);  Bioethical Principles and GCP


Nobuo Koinuma


Annals of Oncology (2017) 28 (suppl_5): v395-v402. 10.1093/annonc/mdx375


N. Koinuma

Author affiliations

  • Medicine, Tohoku Medical and Pharmaceutical University, 981-8558 - Sendai/JP


Abstract 2511


Cancer patients who face the financial difficulties and are obliged to retire for the treatment are increasing in number. It is urgently important that they keep working to receive the optimal treatment. We investigate the actual situation of the patients who retired for treatment and examine the feasible measures including the desirable balance of work and treatment.


The cancer patients and the attending doctors were surveyed in 40 cancer centers, university hospitals and regional hospitals in Japan.


The number of replies from patients was 3.204. The ratio of patients who were at work before treatment was 50.7%. The ratio of employees was 89.7%. Of these, 31.8% of patients quitted their work for treatment. It was as the highest as 38.7% in lung cancer, and as the lowest as 27.1% in breast cancer. In case of retirees, the ratios of stage I, II, III and IV were 20.6%, 17.9%, 13.9% and 43.7% respectively. The ratio of stage IV was 26.8% in the whole patients, and therefore the retirees tend to be higher in stage. The annual out-of-pocket expense, including direct and indirect expense in the retirees was an average of 6,940 EUR. This was slightly smaller than that of the whole patients. The ratios of patients who felt heavy about the economic burden were 73.7% in retirees and 61.9% in the whole patients. 7.0% of retirees and 5.3% of the whole patients had to change or abandon the most suitable treatment due to the economic reasons. 58.5% of retirees answered that the income was decreased during the cancer treatment and this was significantly higher than that of the whole patients. The percentage of retirees whose tax-included annual income was less than 24,200 EUR was 48. 6%. This was 39.2% in the whole patients. 46.7% of retired employees had no choice but to quite the work, while 42.7% answered that they wanted to continue their work.


One of three patients with cancer is in a working generation, and it is important for patients to balance the treatment with the work. It became clear in the survey that one third of the patient who was working was obliged to retirement. In Japan, the Cancer Control Act was revised in December, 2016 and it became the efforts duty of the company to continue the employment of cancer patients.

Clinical trial identification

Legal entity responsible for the study

Nobuo Koinuma


Ministry of Health, Labor and Welfare


All authors have declared no conflicts of interest.

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