Objectives To assess whether the twenty-year cost and absence trends of employees whose spouses have various cancers had similar slopes.

Methods Retrospective analysis of Workpartners Research Reference Database (RRDb, 2001—2020). For each year, employee-caregivers whose spouses had ICD-9/-10 codes within the 37 Agency for Healthcare Research and Quality’s (AHRQ) cancer categories were identified. Non-specific cancer categories (CC) were excluded, remaining categories assigned to: Breast (male+female), Female (cervix+uteris), GI, Male (prostate+testes), Skin, or “Other”. Employee-caregivers had continuous eligibility for the calendar year they were identified. Analysis focused on “all cancer” (ALL) and each CC’s prevalence, employee/patient medical/prescription costs and Charlson Comorbidity Indexes (CCI). For the employees only: absence (percent utilizing, days, and cost [average and median percent of salary]) due to all-cause leaves for: sick leave (SL), short-/long-term disability (STD/LTD), and workers’ compensation (WC). Outcomes counted in claim start year. For each metric, trend lines were plotted and 95% confidence intervals of the slopes were compared to determine slopes that differed from zero and differences in slopes between CCs.

Results The twenty-year study period averaged 5458 spouses/year with any cancer (Breast=18.8%, Female=33.0%, GI=7.1%, Male=5.9%, Skin=23.5%, “Other”=20.4%). Spouse-patients’ prevalence-slope increased (except Female decreased), with ALL’s slope>Breast, GI, and Male. Spouse-patients’ medical and prescription cost slopes were all >0, with Skin<Other. Employee-caregivers’ costs (medical, prescription, and average-SL) and SL-days had similar slopes to ALL and were increasing over time. Employee-caregivers’ WC-utilization-slopes<0 for ALL, Breast, and Other. Employee-caregivers’ STD-utilization-slope<0 for GI. Employee-caregivers’ STD-Days-slopes>0 for ALL, Breast, Female, and Skin. All employee-caregiver slopes for median-STD-payments as a percent of salary were <0 except Female and Breast. Other had the only LTD-median-payment slope>0.

Conclusions This research found that while the rates of increase for costs were similar for all groups studied, prevalence and other metrics varied by cancer type.