OBJECTIVES: To quantify loss of employment duration and loss of productivity for patients with different subtypes and stages of lung cancer.

METHODS: We identified nationwide lung cancer patients diagnosed at ages of 50-64 between 2011 and 2017. Monthly survival probabilities were weighted by monthly employment-to-population ratios (EMRTIOs) and working salaries for lifetime employment duration and productivity. We compared the lifetime employment duration and productivity with those of age-, sex-, calendar year-matched general population for loss of employment duration and productivity. Subgroup analysis of patients who were smokers was performed, which were multiplied by the pathology and stage shift in the National Lung Screening Trial (NLST) for savings of employment duration and productivity.

RESULTS: Compared with matched referents, lung cancer patients had not only an inferior survival but also lower EMRATIOs. The mean loss of employment duration and loss of productivity for patients with stage IV non-squamous cell carcinoma were 2.6 years and US$42,006, respectively. If the patients could be diagnosed earlier at stage I, the loss of employment duration would become 0.3 years, and loss of productivity would be US$-7729. Simulating 10,000 participants with the same pathology and stage shift in the NLST, the savings of employment duration and productivity were 149.7 (95% prediction interval: 131.6 to 170.7) years and US$2564K (95% prediction interval: US$2243K to US$2819K), respectively.

CONCLUSIONS: Patients with advanced-stage lung cancer suffered from greater losses of employment duration and productivity than early-stage patients. The results could be applied to evaluate the benefit of lung cancer screening.