Cancer's unequal impact on incomes in Norway

Figures & data

Table I. Descriptive statistics of the cohorts included and not included in this study and persons' current and prior income status^a.

	Women 2008^b				Men 2008
	Income ≠ 0^c Included in study		Income = 0^d Excluded		Income ≠ 0^c Included in study		Income = 0^d Excluded
	N	%	N	%	N	%	N	%
Cancer status
Without cancer	491 418	90.3%	52 730	9.7%	530 475	93.0%	39 752	7.0%
With cancer^e	11 042	86.5%	1721	13.5%	6172	89.7%	712	10.3%
Total	502 460	90.2%	54 451	9.8%	536 647	93.0%	40 464	7.0%
	1999^f				1999
	Income ≠ 0^c		Income = 0^d		Income ≠ 0^c		Income = 0^d
Without cancer	482 977	88.8%	61 171	11.2%	536 790	94.1%	33 437	5.9%
With cancer^e	11 296	88.5%	1467	11.5%	6457	93.8%	427	6.2%
Total	494 273	88.8%	62 638	11.2%	543 247	94.1%	33 864	5.9%

^aWomen and men's income status (gross labor earnings and compensatory public welfare measures, capital gains exempted) at the end and beginning of follow-up. ^bIncomes per December 31 2008. ^cEmployed or on public welfare benefits. ^dNot employed and not on public welfare benefits (includes students, home makers and others not qualified for benefits). ^eDiagnosed with cancer 2000–2007. Persons diagnosed prior to 2000 or in 2008 have been excluded from this study. ^fIncomes per December 31 1999.

Table II. A fully adjusted model of the percent wise effects of any cancer diagnosed between 2000 and 2007 on incomes in 2008^a.

	Women				Men
	N^b	%	% change^c	95 % CI^d	N	%	% change	95 % CI
Cancer status^e
No cancer	491 418	97.8	ref	ref	530 475	98.8	ref	ref
Dx 1–8 years prior	11 042	2.2	−6.6	−7.6, −5.6	6172	1.2	−6.6	−7.9, −5.3
Dx 1–2 years prior	3691	0.7	−4.9	−6.6, −3.1	2403	0.4	−6.2	−8.3, −4.1
Dx 3–4 years prior	3082	0.6	−5.7	−7.6, −3.9	1609	0.3	−8.2	−10.7, −5.6
Dx 5–6 years prior	2401	0.5	−8.5	−10.5, −6.4	1181	0.2	−6.1	−9.1, −3.1
Dx 7–8 years prior	1868	0.4	−9.1	−11.4, −6.8	979	0.2	−5.4	−8.7, −2.0
Age^e
40–44 years	141 321	28.1	< 0.1	N/A	149 300	27.8	4.2	3.7, 4.6
45–49 years	129 306	25.7	ref	ref	135 631	25.3	ref	ref
50–54 years	123 870	24.7	−8.4	−8.8, −8.0	131 189	24.4	−6.8	−7.2, −6.4
55–59 years	107 963	21.5	−18.4	−18.7, −18.0	120 529	22.5	−15.2	−15.6, −14.8
Education^e
Elementary or missing	96 781	19.3	−19.0	−19.4, −18.6	106 157	19.8	−14.7	−15.0, −14.3
High school	90 647	18.0	−8.7	−9.1, −8.2	78 658	14.7	−6.6	−7.1, −6.1
< 3 years of college	140 269	27.9	ref	ref	167 626	31.2	ref	ref
3–4 years of college	146 313	29.1	12.7	12.2, 13.1	133 379	24.9	10.6	10.2, 11.1
> 4 years of college	28 450	5.7	31.8	30.8, 32.8	50 827	9.5	26.0	25.5, 26.7
Earnings in 1999
$0 or missing	31 429	6.6	−12.0	−12.7, −11.2	13 835	2.6	13.8	12.3, 15.3
$1–$9999	33 390	10.9	ref	ref	14 279	2.7	ref	ref
$10 000–$19 999	54 700	10.9	30.8	29.8, 31.8	15 293	2.8	63.1	61.1, 65.2
$20 000–$29 999	98 387	19.6	56.4	55.3, 57.5	24 787	4.6	88.8	86.6, 90.6
$30 000–$39 999	139 227	27.7	87.3	86.1, 88.6	82 939	15.5	127.7	125.5, 130.1
$40 000–$49 999	91 742	18.3	121.8	120.2, 123.4	140 279	26.1	167.4	164.9. 170.1
$50 000–$59 999	29 951	6.0	157.9	155.7, 160.2	96 307	17.9	209.8	206.7, 212.9
$60 000–$79 999	16 388	3.3	207.6	204.4, 210.9	86 276	16.1	270.3	266.6, 274.1
>= $80 000	7246	1.4	296.5	290.8, 302.3	62 652	11.7	410.4	405.2, 415.8
Marital status^e
Married	304 354	60.6	<-0.1	N/A	316 631	59.0	8.0	7.7, 8.4
Not married	198 106	39.4	ref	ref	220 016	41.0	ref	ref
Children^e
Yes	452 931	90.1	14.8	14.2, 15.4	449 674	83.8	15.1	14.6, 15.6
No	49 529	9.9	ref	ref	86 973	16.2	ref	ref

^aEffects on cancer on incomes, i.e. labor earnings and any compensatory welfare benefits, are modeled. The analyses are limited to only those alive and with a registered income per December 31, 2008. The modeled income for the reference categories are $36 100 for women and $39 200 for men, respectively. ^bNumber of persons. ^cPercent wise deviation from reference category. ^dConfidence interval. ^ePer December 31, 2008.

Table III. Estimates of the effect of cancer site and stage at diagnosis on incomes in 2008^a.

		Women				Men
	ICD-10	N^b	%^c	% change^d	95 % CI^e	N	%	% change	95 % CI
Cancer status
No cancer	N/A	491 418	N/A	ref	ref	530 475	N/A	ref	ref
Skin cancer	C43-C44	1310	11.9	0.6	−2.4, 3.7	970	15.7	−2.7	−6.1, 0.8
Colorectal cancer	C17-C21	782	7.1	−6.1	−9.7, −2.3	873	14.1	−7.2	−10.6, −3.6
CNS tumors	C69-C72, D32-D33	632	5.7	−17.6	−21.2, −14.0	468	7.6	−17.1	−21.7, −12.8
Renal/bladder cancer	C64-C68	209	1.9	−11.2	−17.7, −4.2	627	10.2	−5.4	−9.5, −1.1
Non-Hodgkin disease	C82-C85, C95	281	2.5	−17.0	−22.2, −11.4	439	7.1	−12.0	−16.5, −7.2
Leukemia	C90-C95	218	2.0	−18.6	−24.4, −12.3	326	5.3	−12.9	−18.0, −7.4
Endocrine cancer	C73-C75	312	2.8	−1.8	−7.5, 3.9	119	1.9	0.6	−9.1, 11.2
Head-and-neck cancer	C00-C14, C30-C32	109	1.0	−8.0	−17.1, 2.2	285	4.6	−5.1	−11.0, 1.3
Lung cancer	C34	135	1.2	−20.1	−27.3, −12.2	150	2.4	−21.1	−27.8, −13.7
Hodgkin disease	C81	62	0.6	−11.2	−22.8, 2.0	108	1.7	−12.2	−21.0, −2.4
Soft tissue cancer	C45-C49	36	0.3	8.4	−9.6, 30.1	46	0.7	−7.3	−21.1, 9.0
Bone cancer	C40-C41	19	0.2	−33.4	−48.2, −14.4	25	0.4	−20.6	−36.3, −1.1
Prostate cancer	C61	N/A	N/A	N/A	N/A	928	15.0	−2.6	−6.1, 1.0
Testicular cancer	C62-C63	N/A	N/A	N/A	N/A	731	11.8	−0.2	−4.2, 3.9
Breast cancer	C50	4808	43.5	−5.7	−7.2, −4.2	N/A	N/A	N/A	N/A
Cervical/uterine cancer	C53-C55	1318	11.9	−3.8	−6.7, −0.9	N/A	N/A	N/A	N/A
Ovarian cancer	C56	759	6.9	−9.4	−13.0, −5.8	N/A	N/A	N/A	N/A
Other or unknown	C76-C80, C88, nos^f	52	0.5	−11.7	−24.1, 2.7	77	1.2	−8.2	−19.0, 4.1
Stage at diagnosis
No cancer	N/A	491 418	N/A	ref	ref	530 475	N/A	ref	ref
Local cancer	N/A	6305	57.1	−5.3	−6.6, −4.0	2952	47.8	−4.8	−6.7, −2.8
Regional cancer	N/A	2753	24.9	−7.0	−8.9, −5.1	1166	18.9	−9.2	−12.1, −6.2
Metastatic cancer	N/A	604	5.5	−19.3	−22.8, −15.6	405	6.6	−18.0	−22.3, −13.4
Unknown^g	N/A	1380	12.5	−6.0	−8.7, −3.2	1649	26.7	−5.0	−7.5, −2.4

^aEffects on cancer on incomes, i.e. labor earnings and any compensatory welfare benefits are modeled. The modeled income for the reference categories are $36 100 for women and $39 200 for men, respectively. ^bNumber of persons. ^cPercentage of cancer cases only. ^dPercent wise deviation from reference category. ^eConfidence interval. ^fNot otherwise specified. ^gIncludes cancers with unknown stage, leukemias and around 25% of the lymphomas for which no stage was recorded.

Table IV. Women's percent wise change in income after cancer by education, prior income, age and parental status^a.

	Education (2008)		Prior income (1999)		Age (2008)		Children (2008)
	Low^b	High^c	Low^d	High^e	40-49 years	50-59 years	No	Yes
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Any cancer 2000-2007	−7.5***	−6.1***	−5.3**	−6.5***	−4.2***	−8.8***	−5.5***	−6.8***
Time since diagnosis
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
1-2 years	−7.2***	−3.5**	−1.5	−4.9***	−3.7*	−6.2***	−6.5*	−4.7***
3-4 years	−4.8**	−6.4***	−6.6*	−5.4***	−4.8**	−7.0***	−2.5	−6.3***
5-6 years	−10.8***	−6.8***	−7.8*	−8.3***	−5.2**	−11.5***	−4.5	−8.9***
7-8 years	−8.0***	−9.8***	−6.8	−9.3***	−2.9	−13.2***	−9.9*	−9.2***
Cancer form
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Skin cancer	−1.1	1.6	2.6	0.3	2.2	−1.1	−0.1	5.5
Colorectal cancer	−8.5 *	−5.3 *	9.6	−8.9 ***	−5.3	−8.2***	−5.0	−6.1**
CNS tumors	−18.2***	−17.9***	−19.7**	−16.5***	−16.7***	−18.5***	−22.5***	−17.2***
Renal/bladder cancer	−22.8***	0.2	−14.1	−13.5***	−12.9*	−12.8**	−6.5	−11.9**
Non-Hodgkin disease	−13.5*	−18.2***	−8.1	−19.9***	−8.3	−21.5***	−14.8	−17.5***
Leukemia	−17.2**	−21.2***	−11.6	−19.7***	−13.4*	−23.0***	13.3	−21.7***
Head-and-neck cancer	−4.6	−11.5*	−9.7	−6.7	−12.3	−7.4	−14.1	−7.6
Lung cancer	−18.6**	−21.6***	−20.2	−20.8***	−7.0	−23.8***	−16.5	−20.7***
Hodgkin disease	−10.6	−7.8	−6.9	−9.8	−6.5	−15.6	−33.5	−6.8
Breast cancer	−5.9***	−5.5***	−6.7*	−5.1***	−2.9*	−7.8***	−8.7**	−5.5***
Cervical/uterine cancer	−4.6	−2.9	−2.9	−2.6	0.1	−7.7***	−4.1	−4.7**
Ovarian cancer	−10.1**	−9.1***	−5.2	−8.4***	−12.0***	−8.0**	−2.0	−10.8***
Stage at diagnosis
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Local cancer	−5.7***	−5.1***	−3.2	−5.6***	−2.8*	−7.7***	−5.9**	−5.3***
Regional cancer	−8.3***	−6.3***	−8.1*	−6.4***	−5.0**	−8.7***	−4.6	−7.5***
Metastatic cancer	−21.4***	−17.4***	−12.4*	−18.0***	−20.1***	−20.0***	−10.3	−20.2***

^aAll variables from the final model in Table II were included in all models, the respective stratifying variable excempted. ^bLow education includes education at or below high school level and missing. ^cHigh education includes education beyond high school level. ^dLow income refers to labor earnings < $30 000 in 1999. ^eHigh income refers to labor earnings >=$30 000 in 1999. *p-value <0.05. **p-value <0.01. ***p-value <0.001.

Table V. Men's percent wise change in income after cancer by education, prior income, age and parental status^a.

	Education		Prior income (1999)		Age (2008)		Children (2008)
	Low^b	High^c	Low^d	High^e	40-49 years	50-59 years	No	Yes
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Any cancer 2000-2007	−9.6***	−4.8***	−11.5*	−4.7***	−4.9***	−8.7***	−8.9***	−6.1***
Time since diagnosis
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
1-2 years	−9.2***	−4.5***	−16.0	−5.1***	−6.1**	−7.6***	−8.1*	−5.8***
3-4 years	−9.9***	−6.9***	−9.8	−6.0***	−4.5*	−11.3***	−7.1	−8.2***
5-6 years	−10.1***	−4.0*	−19.3*	−2.3	−6.0*	−7.6***	−11.3*	−5.0**
7-8 years	−9.6**	−3.1	−16.0	−4.3*	−2.3	−8.6***	−11.3*	−4.7**
Cancer form
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Skin cancer	−7.4*	0.8	−21.5	1.4	−3.0	−3.6	−9.1	−1.4
Colorectal cancer	−6.3	−8.3***	9.1	−7.0***	−8.0*	−8.7***	−11.2	−6.8***
CNS tumors	−18.5***	−17.4***	−32.4*	−15.1***	−13.7***	−20.9***	−5.4	−19.2***
Renal/bladder cancer	−12.7***	0.5	−14.9	−2.6	−7.8*	−6.2*	−5.6	−5.3*
Non-Hodgkin disease	−12.9**	−10.7***	−27.7	−6.0*	−12.7**	−12.5***	−21.2**	−9.1***
Leukemia	−9.6	−15.0***	4.5	−15.5***	−6.1	−17.1***	−16.8*	−12.7***
Head-and-neck cancer	−5.5	−3.3	5.8	−3.5	0.2	−7.6*	−10.8	−4.9
Lung cancer	−29.9***	−12.4*	−33.3	−22.0***	−15.2	−24.2***	−51.0***	−15.1***
Hodgkin disease	−8.1	−15.0**	−23.6	−8.7	−13.4*	−10.9	−18.8	−9.7
Testicular cancer	−1.0	0.2	−13.1	0.9	1.0	−1.5	−7.5	1.5
Prostate cancer	−6.5*	−0.2	1.9	−1.7	20.1*	−6.0**	9.6	−3.7*
Stage at diagnosis
No cancer	ref	ref	ref	ref	ref	ref	ref	ref
Local cancer	−7.7***	−3.3**	−10.4	−2.5*	−3.4***	−7.0***	−5.2	−4.6***
Regional cancer	−11.3***	−7.6***	−14.2	−6.2***	−9.5***	−10.2***	−15.0**	−8.3***
Metastatic cancer	−23.6***	−13.5***	−19.2	−17.0***	−11.1*	−22.4***	−30.3***	−15.2***

^aAll variables from the final model in Table II were included in all models, the respective stratifying variable excempted. ^bLow education includes education at or below high school level and missing. ^cHigh education includes education beyond high school level. ^dLow income refers to labor earnings < $30 000 in 1999. ^eHigh income refers to labor earnings >=$30 000 in 1999. *p-value <0.05. **p-value <0.01. ***p-value <0.001.