Methods: Patients (n=283 breast patients and n=207 prostate patients) who were employed full-time (> 35 hours) prior to diagnosis and who remained employed throughout treatment were identified from the Metropolitan Detroit Cancer Surveillance System. We evaluated patient-reported absenteeism as a function of cancer stage and treatment. We controlled for demographic characteristics, employer size, physical activity at work, and the presence of paid sick leave. We estimated absenteeism for the time between diagnosis date and 6 months following diagnosis using ordinary least squares regression. The distribution of days missed from work was skewed to the right, so we transformed days missed to the natural log scale and added 1.

Results: Forty percent of women were from households earning $75,000 or more, approximately 75% had paid sick and were employed by a large employer. Fifty percent worked in jobs requiring physical activity. Nearly all women (94%) reported missing at least 1 day from work, mean days missed 44.5 days (SD=55.2). The median number of days missed was 22 days. Women with local and regional stage disease missed 158% and 300%, respectively, more days than women with in situ cancer. The majority of men (63%) belonged to households earning over $75,000 annually, were employed by large employers and 82% had paid sick leave. Only 43% had jobs with physical demands. Eighty-two percent reported missing 1 or more days, mean days missed from work was 27 (SD=31.9). The median number of days missed was 20. Men who had surgery missed 410% more days than men who did not have surgery. In addition, a college education and being employed by small to medium employers were associated with fewer days missed from work.

Conclusions: Women with later stage disease missed more days from work than women with in situ cancer, lending support to an economic argument for early stage detection. Men with prostate cancer who were treated surgically missed the greatest number of days relative to men who received other types of treatment. Days missed from work may be an important consideration for men and their physicians choosing between nearly clinically equivalent treatment options for prostate cancer.