Consequences of the occurrence of cancer on career paths: an analysis of medico-administrative data.

Summary This report studies the short- and medium-term effects of the occurrence of cancer on employment and activity. It uses the Hygie database, produced by Irdes from administrative data of the National Health Insurance Fund and the National Old Age Insurance Fund. Hygie makes it possible to reconstruct the individual's career and health events. A first part exploits the retrospective dimension linked to the career and confirms the penalizing effect of cancer on activity and the increase in sick leave. The results of a double-difference model with exact matching show the persistence of the effects of the disease on the distance from the labour market, with the probability of being employed at least one quarter in the year decreasing up to a five-year horizon. We also measure the effect of the twelve most prevalent cancers in the Hygie database and of chronic diseases with a potential impact on the labour market. The largest effects are for lung and bronchial cancer, schizophrenia and HIV. Chronic diseases other than cancer have much smaller effects, probably because their long-term treatment improves quality of life. A second part exploits the panel dimension of the sample to study occupational transitions following a cancer diagnosis. It shows that the affected population encounters great difficulties in remaining in employment, or returning to it. These difficulties are accentuated for employees who are new to the job market or who have had an unstable career, or one marked by significant sick leave. In addition, the after-effects of care lead to a more frequent transition to unemployment and inactivity to the detriment of employment. Developing professional support methods for people whose careers have been more uneven, and whose socio-professional status is less protective, would therefore be one way of improving their living conditions.