Employment quality as a dynamic exposure: cancer incidence and employment patterns in Denmark between 2008-2021
1
Public Health, Copenhagen Health Complexity Center, Copenhagen, Denmark
2
Department of Occupational and Social Medicine, University Hospital of Holbæk, Holbæk, Denmark
3
Public Health, Section of Environmental Health, Copenhagen, Denmark
4
Global Health, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
5
Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
6
Universitat Pompeu Fabra (UPF), Barcelona, Spain
Popul. Med. 2026;8(Supplement Supplement 1):A3751
ABSTRACT
INTRODUCTION:
Employment quality is a key social determinant of health, yet cancer epidemiology relies on static indicators, limiting evidence on how working-life patterns shape cancer inequalities. This study aims to identify employment quality profiles in the Danish working-age population and examine preliminary patterns in cancer incidence and employment mobility across these profiles.
METHODS:
Nationwide Danish registries were used to follow ~3.7 million individuals aged 18–67 (2008–2021). Employment quality was operationalized using DAN-ROPE, a multidimensional registry-based measure adapted from the Swedish SWE-ROPE, capturing employment insecurity, income inadequacy, and lack of rights and protection. Latent transition analyses assessed employment profiles, mobility and transitions between classes. Incident cancer cases were identified via registry linkage. Annual and cumulative incidence were estimated by employment class and by gender.
RESULTS:
Five classes emerged: Standard secure employment (52%), Marginal/under-employed (1.5%), Temporary/agency employment (8.2%), Stable high-quality employment (31.7%), and Self-employed/multiple job holders (6.7%). Overall, 222,239 incident cancers occurred. Annual incidence was stable (~64–75 per 10,000); cumulative incidence reached ~976 per 10,000 by 2021. Across follow-up, incidence was lowest in Temporary/agency employment (~700–750 per 10,000) and highest in Stable high-quality and Self-employed classes (~1,000–1,100 per 10,000). Women had higher cumulative incidence than men across all classes (~1,000–1,400 vs ~300–900 per 10,000), with stable class ranking over time. Employment quality was dynamic but path-dependent: stability was highest in self-employed/multiple job holders (0.75–0.85), intermediate in standard secure and stable high-quality employment (≈0.53–0.61), and lowest in marginal and temporary/agency employment (≈0.42–0.57).
CONCLUSIONS:
These preliminary findings show that employment quality in Denmark is heterogeneous and dynamic. Cancer appears to reinforce existing employment stratification, conferring retention in protected positions but offering little buffering in insecure employment. Integrating multidimensional employment profiles with cancer incidence is essential for understanding cancer inequalities and survivorship.
Employment quality is a key social determinant of health, yet cancer epidemiology relies on static indicators, limiting evidence on how working-life patterns shape cancer inequalities. This study aims to identify employment quality profiles in the Danish working-age population and examine preliminary patterns in cancer incidence and employment mobility across these profiles.
METHODS:
Nationwide Danish registries were used to follow ~3.7 million individuals aged 18–67 (2008–2021). Employment quality was operationalized using DAN-ROPE, a multidimensional registry-based measure adapted from the Swedish SWE-ROPE, capturing employment insecurity, income inadequacy, and lack of rights and protection. Latent transition analyses assessed employment profiles, mobility and transitions between classes. Incident cancer cases were identified via registry linkage. Annual and cumulative incidence were estimated by employment class and by gender.
RESULTS:
Five classes emerged: Standard secure employment (52%), Marginal/under-employed (1.5%), Temporary/agency employment (8.2%), Stable high-quality employment (31.7%), and Self-employed/multiple job holders (6.7%). Overall, 222,239 incident cancers occurred. Annual incidence was stable (~64–75 per 10,000); cumulative incidence reached ~976 per 10,000 by 2021. Across follow-up, incidence was lowest in Temporary/agency employment (~700–750 per 10,000) and highest in Stable high-quality and Self-employed classes (~1,000–1,100 per 10,000). Women had higher cumulative incidence than men across all classes (~1,000–1,400 vs ~300–900 per 10,000), with stable class ranking over time. Employment quality was dynamic but path-dependent: stability was highest in self-employed/multiple job holders (0.75–0.85), intermediate in standard secure and stable high-quality employment (≈0.53–0.61), and lowest in marginal and temporary/agency employment (≈0.42–0.57).
CONCLUSIONS:
These preliminary findings show that employment quality in Denmark is heterogeneous and dynamic. Cancer appears to reinforce existing employment stratification, conferring retention in protected positions but offering little buffering in insecure employment. Integrating multidimensional employment profiles with cancer incidence is essential for understanding cancer inequalities and survivorship.
| eISSN: | 2654-1459 |
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