Employment and insurance in survivors of Hodgkin lymphoma and their siblings: a questionnaire study.

Using a questionnaire study, we compared the employment and insurance of Hodgkin lymphoma (HL) survivors versus their siblings. A total of 511 survivors and 224 siblings completed questionnaires. HL survivors were more likely to report job denial, difficulty obtaining insurance due to medical history, and difficulty changing jobs due to fear of losing insurance. On multivariable analysis, male gender, income and scarring of the head and neck were associated with job denial. Male gender and impairment interfering with a job were associated with difficulty obtaining health insurance. Survivors with >4 physician visits in 2 years, <10years from diagnosis, or with permanent hair loss from treatment were more likely to report inability to change jobs due to fear of losing insurance. Compared to their siblings, HL survivors may face greater challenges in obtaining employment and insurance. Late effects from treatment, including permanent cosmetic changes, may contribute to these differences.