Frequency of and factors associated with social problems among working-age patients with cancer in Japan

Abstract Background: Cancer substantially affects working-age patients in Japan, and 26.8% of newly diagnosed cases occur in people aged 20–64 years. These patients face social challenges such as employment, financial issues, and family responsibilities. The aim of this study was to determine the frequency and nature of social problems among Japanese working-age patients with cancer and investigate associated factors. Methods: A cross-sectional, internet-based survey was conducted. Participants aged 20–64 years were recruited via an online survey company. An original questionnaire was used to assess social problems in three domains: social life and finances (eg, loneliness and social support), family and intimate relationships (eg, childbearing and romantic partnership), and medical and daily life (eg, treatment-related issues). Psychological distress was measured using the Hospital Anxiety and Depression Scale. Multivariate logistic regression analysis was performed to investigate factors associated with severe social problems. Results: Of 683 respondents aged 20–64 years, 27.5%–50.8% reported at least 1 severe social problem. Younger patients (20–39 years) reported a higher frequency of all types of social problems than older patients and similar levels of psychosocial distress as middle-aged patients (40–49 years). Age was associated with the severity of seven social problems, including those related to social participation and interpersonal relationships. Factors significantly associated with social problem severity included psychological distress (eg, anxiety, depression), clinical factors (eg, treatment status), and sociodemographic factors (eg, marital and work status). Depression was associated with social problems related to lack of confidantes and challenges in romantic partnerships. Anxiety was associated with medical issues and loneliness. Ongoing treatment significantly affected romantic partnerships. Unmarried individuals and those with minor children were more vulnerable to loneliness and family-related and treatment-related problems. Changes in work status intensified family, sexual, and fertility concerns. Conclusions: Our findings highlight the need to integrate social care into cancer care by implementing tailored interventions to address life stage–specific issues. Psychological distress, work changes, being unmarried, and family responsibilities increase the risk of severe social problems. Interventions for high-risk patients that address career stability, fertility concerns, childcare support, and social integration are essential to improving psychosocial well-being among working-age Japanese patients with cancer.