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]

Also see:6 tips for managing the cost of cancer care.”

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]

Also see:Supporting workers with cancer.”

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.

Also see:Cancer screenings moving up on employees’ wellness wish list.”

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.

Also see:Broker’s specialization tied to cancer diagnosis.”

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.
Also see:Critical illness coverage reaches tipping point.”

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.
Also see:Cancer screening participation lags.”

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.

Also see:How EY improved EAP effectiveness, utilization.”

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.

Robert W. Jacob is director, health & productivity, with Unum U.S.’s national client group. Michelle Martin is vice president, human resources at CBS Corporation.


[1] Unum internal data,  2014

[2] American Cancer Society, http://www.cancer.org/cancer/cancerbasics/questions-people-ask-about-cancer, 2015 (accessed Aug. 4, 2015)

[3] American Cancer Society, Cancer Treatment & Survivorship Facts & Figures, 2014-2015

[4] Workforce magazine, “ How companies can support cancer survivors in the workplace –and manage costs”, Feb. 27, 2013 (accessed Sept. 28, 2015)

[5] Wells Fargo, Wells Fargo Survey Finds Saving for Retirement Not Happening for a Third of Middle Class (2014) https://www.wellsfargo.com/about/press/2014/middle-class-retirement-saving_1022/

[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).  

[7] Workforce magazine, “ How companies can support cancer survivors in the workplace –and manage costs”, Feb. 27, 2013 (accessed Sept. 28, 2015)

[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).

[9] , 10 Unum Short Term Disability data: 2011-2013.

11 The Cochrane Collaboration, “Interventions to enhance return-to-work for cancer patients”, 2013

12 National Alliance for Caregiving and AARP, Caregiving in the U.S. 2015  http://www.caregiving.org/caregiving2015/

13 National Business Group on Health andNational Comprehensive Cancer Network, “An Employer’s Guide to Cancer Treatment and Cancer Prevention”, 2013, An Employer’s Guide to Cancer Treatment & Prevention

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