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Greidanus MA, van Ommen F, de Boer AGEM, Coenen P, Duijts SFA. Experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment: a focus group study. J Cancer Surviv 2024:10.1007/s11764-024-01657-5. [PMID: 39138713 DOI: 10.1007/s11764-024-01657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE To explore experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment. METHODS Four digital focus group interviews were conducted with 16 cancer survivors (< 10 years post-diagnosis) who have pursued to return to work within the last 2 years. Interview topics included motivations, facilitators of and barriers to job seeking, and returning to and maintaining paid employment. Interview audio recordings were transcribed verbatim and analyzed using conventional content analyses. RESULTS Participants were mostly female (94%), and the majority had successfully returned to paid employment (56%). Both intrinsic factors (e.g., sense of purpose, social interactions) and extrinsic factors (e.g., financial necessity) motivated their return to paid employment. During job seeking, participants experienced facilitators including support, personal qualities (e.g., life experience), and trial workplaces. Barriers included inadequate support, perceived employer discrimination, and work ability uncertainty. Returning to and maintaining employment was facilitated by flexible work, supportive colleagues, and intrinsic drive, while barriers included side effects (e.g., fatigue) and overly demanding work. CONCLUSIONS Unemployed and/or work-disabled cancer survivors are generally motivated to return to paid employment by both intrinsic and extrinsic factors, but uncertainty about their ability and inadequate support may hinder this. These findings highlight the need for trial workplaces, support during every phase of return to paid employment, and a flexible, supportive workplace. IMPLICATIONS FOR CANCER SURVIVORS Tailored interventions addressing the needs identified in this study are urgently needed. The recommendations provided offer strategies for various stakeholders to enhance support for unemployed and work-disabled cancer survivors.
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Affiliation(s)
- M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands.
| | - F van Ommen
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - P Coenen
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Movement Sciences Research Institute, Musculoskeletal Health, Amsterdam, The Netherlands
| | - S F A Duijts
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Rijnkade 5, Utrecht, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
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Fiabane E, Dordoni P, Perrone C, Bernardo A, Corsi F, Gabanelli P. What really matters for returning to work after breast cancer? A 6-month exploratory study. Women Health 2024; 64:298-307. [PMID: 38499393 DOI: 10.1080/03630242.2024.2324312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
Return to work (RTW) after breast cancer (BC) may significantly impact on women recovery and quality of life. Literature hightlighed several factors associated to RTW after BC but there is still some concern about prognostic factors influencing work resumption after BC treatments. The present study aims to explore which baseline factors are associated with RTW at 6-month after BC surgery. The participants in this 6-month prospective study were 149 patients who underwent breast cancer-related surgery and accessed an Oncology Clinic for cancer therapy from March 2017 to December 2019 in Northern Italy. Participants filled in a battery of questionnaires at baseline, and they were asked whether they had returned to work at 6-month follow-up. Psychological measurements included job stress (Job Content Questionnaire), work engagement (Utrecht Work Engagement Scale), quality of life (World Health Organization Quality of Life- BREF), anxiety and depression (Hospital Anxiety and Depression Scale), resilience (Connor - Davidson Resilience Scale - 10 item) and personal expectations about RTW (ad-hoc single item). Moreover, sociodemographic, clinical, and work-related data were collected. Independent t-test and Chi-square test were used for comparisons among variables; logistic regression model was used to explore predictors of RTW. A total of 73.9 percent returned to work at6-month after surgery. In the multivariate model, chemiotherapy (B = -1.428; SE = 0.520) and baseline women's expectations about their RTW (B = -0.340; DS = 0.156) were significant predictors of RTW. These results suggest that careful individual clinical and psychological screening of risk factors at baseline can prevent from occupational disability and long sickness absence.
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Affiliation(s)
- Elena Fiabane
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Paola Dordoni
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Cecilia Perrone
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonio Bernardo
- Operative Unit of Medical Oncology of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Fabio Corsi
- Breast Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Paola Gabanelli
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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de Boer AG, Tamminga SJ, Boschman JS, Hoving JL. Non-medical interventions to enhance return to work for people with cancer. Cochrane Database Syst Rev 2024; 3:CD007569. [PMID: 38441440 PMCID: PMC10913845 DOI: 10.1002/14651858.cd007569.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND People with cancer are 1.4 times more likely to be unemployed than people without a cancer diagnosis. Therefore, it is important to investigate whether programmes to enhance the return-to-work (RTW) process for people who have been diagnosed with cancer are effective. This is an update of a Cochrane review first published in 2011 and updated in 2015. OBJECTIVES To evaluate the effectiveness of non-medical interventions aimed at enhancing return to work (RTW) in people with cancer compared to alternative programmes including usual care or no intervention. SEARCH METHODS We searched CENTRAL (the Cochrane Library), MEDLINE, Embase, CINAHL, PsycINFO and three trial registers up to 18 August 2021. We also examined the reference lists of included studies and selected reviews, and contacted authors of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs on the effectiveness of psycho-educational, vocational, physical or multidisciplinary interventions enhancing RTW in people with cancer. The primary outcome was RTW measured as either RTW rate or sick leave duration measured at 12 months' follow-up. The secondary outcome was quality of life (QoL). DATA COLLECTION AND ANALYSIS Two review authors independently assessed RCTs for inclusion, extracted data and rated certainty of the evidence using GRADE. We pooled study results judged to be clinically homogeneous in different comparisons reporting risk ratios (RRs) with 95% confidence intervals (CIs) for RTW and mean differences (MD) or standardised mean differences (SMD) with 95% CIs for QoL. MAIN RESULTS We included 15 RCTs involving 1477 people with cancer with 19 evaluations because of multiple treatment groups. In this update, we added eight new RCTs and excluded seven RCTs from the previous versions of this review that were aimed at medical interventions. All included RCTs were conducted in high-income countries, and most were aimed at people with breast cancer (nine RCTs) or prostate cancer (two RCTs). Risk of bias We judged nine RCTs at low risk of bias and six at high risk of bias. The most common type of bias was a lack of blinding (9/15 RCTs). Psycho-educational interventions We found four RCTs comparing psycho-educational interventions including patient education and patient counselling versus care as usual. Psycho-educational interventions probably result in little to no difference in RTW compared to care as usual (RR 1.09, 95% CI 0.96 to 1.24; 4 RCTs, 512 participants; moderate-certainty evidence). This means that in the intervention and control groups, approximately 625 per 1000 participants may have returned to work. The psycho-educational interventions may result in little to no difference in QoL compared to care as usual (MD 1.47, 95% CI -2.38 to 5.32; 1 RCT, 124 participants; low-certainty evidence). Vocational interventions We found one RCT comparing vocational intervention versus care as usual. The evidence was very uncertain about the effect of a vocational intervention on RTW compared to care as usual (RR 0.94, 95% CI 0.78 to 1.13; 1 RCT, 34 participants; very low-certainty evidence). The study did not report QoL. Physical interventions Four RCTs compared a physical intervention programme versus care as usual. These physical intervention programmes included walking, yoga or physical exercise. Physical interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.08 to 1.39; 4 RCTs, 434 participants; moderate-certainty evidence). This means that in the intervention group probably 677 to 871 per 1000 participants RTW compared to 627 per 1000 in the control group (thus, 50 to 244 participants more RTW). Physical interventions may result in little to no difference in QoL compared to care as usual (SMD -0.01, 95% CI -0.33 to 0.32; 1 RCT, 173 participants; low-certainty evidence). The SMD translates back to a 1.8-point difference (95% CI -7.54 to 3.97) on the European Organisation for Research and Treatment of Cancer Quality of life Questionnaire Core 30 (EORTC QLQ-C30). Multidisciplinary interventions Six RCTs compared multidisciplinary interventions (vocational counselling, patient education, patient counselling, physical exercises) to care as usual. Multidisciplinary interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.09 to 1.33; 6 RCTs, 497 participants; moderate-certainty evidence). This means that in the intervention group probably 694 to 844 per 1000 participants RTW compared to 625 per 1000 in the control group (thus, 69 to 217 participants more RTW). Multidisciplinary interventions may result in little to no difference in QoL compared to care as usual (SMD 0.07, 95% CI -0.14 to 0.28; 3 RCTs, 378 participants; low-certainty evidence). The SMD translates back to a 1.4-point difference (95% CI -2.58 to 5.36) on the EORTC QLQ-C30. AUTHORS' CONCLUSIONS Physical interventions (four RCTs) and multidisciplinary interventions (six RCTs) likely increase RTW of people with cancer. Psycho-educational interventions (four RCTs) probably result in little to no difference in RTW, while the evidence from vocational interventions (one RCT) is very uncertain. Psycho-educational, physical or multidisciplinary interventions may result in little to no difference in QoL. Future research on enhancing RTW in people with cancer involving multidisciplinary interventions encompassing a physical, psycho-educational and vocational component is needed, and be preferably tailored to the needs of the patient.
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Affiliation(s)
- Angela Gem de Boer
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Sietske J Tamminga
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Julitta S Boschman
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Jan L Hoving
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
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Walker H, Rimmer B, Dutton L, Finch T, Gallagher P, Lewis J, Burns R, Araújo-Soares V, Williams S, Sharp L. Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study. BMJ Open 2023; 13:e074151. [PMID: 37770270 PMCID: PMC10546132 DOI: 10.1136/bmjopen-2023-074151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES This study aimed to explore the work experiences of people living with an oligodendroglioma. DESIGN This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken. SETTING Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks. PARTICIPANTS 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1-18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness. RESULTS Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain. CONCLUSIONS This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired.
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Affiliation(s)
- Hayley Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Yang ZY, Chen WL, Wu WT, Lai CH, Ho CL, Wang CC. Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14418. [PMID: 36361291 PMCID: PMC9655987 DOI: 10.3390/ijerph192114418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.
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Affiliation(s)
- Zhe-Yu Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Science, National Health Research Institutes, Miaoli 350, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Meixner E, Sandrini E, Hoeltgen L, Eichkorn T, Hoegen P, König L, Arians N, Lischalk JW, Wallwiener M, Weis I, Roob D, Debus J, Hörner-Rieber J. Return to Work, Fatigue and Cancer Rehabilitation after Curative Radiotherapy and Radiochemotherapy for Pelvic Gynecologic Cancer. Cancers (Basel) 2022; 14:cancers14092330. [PMID: 35565459 PMCID: PMC9099439 DOI: 10.3390/cancers14092330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
Simple Summary Rehabilitation from cancer treatment and therapy-induced toxicity requires individualized and specialized expertise. Beyond the resolution of treatment-related morbidity, socio-economic and psychological factors must be considered, and lifestyle or household characteristics can have a notable impact on the gradual return to normality and return-to-work rates following cancer therapy. A better identification of patients at a higher risk of prolonged impairment, and a more in-depth understanding of the impacts of treatment is needed to optimize post-therapy recovery. We aim to add to a limited body of literature exploring the posttreatment rehabilitative factors for women following curative radiotherapy for primary gynecologic malignancies. Herein we observed therapy-induced pain and fatigue were significantly more likely to interfere with return-to-work rates. Social support services and post-treatment inpatient cancer rehabilitation programs were helpful in keeping patients connected to their professional lives. Mental issues and the development of depression during follow-up remains an issue particularly for younger patients. Abstract Pain, fatigue, and depression are a common cluster of symptoms among cancer patients that impair quality of life and daily activities. We aimed to evaluate the burden of cancer rehabilitation and return-to-work (RTW) rates. Tumor characteristics, lifestyle and household details, treatment data, the use of in-house social services and post-treatment inpatient rehabilitation, and RTW were assessed for 424 women, diagnosed with cervical, uterine, or vaginal/vulvar cancer, receiving curative radio(chemo)therapy. Progression-free RTW rate at 3 months was 32.3%, and increased to 58.1% and 63.2% at 12 and 18 months, respectively. Patients with advanced FIGO stages and intensified treatments significantly suffered more from acute pain and fatigue. A higher Charlson-Comorbidity-Index reliably predicted patients associated with a higher risk of acute fatigue during RT. Aside from the presence of children, no other household or lifestyle factor was correlated with increased fatigue rates. Women aged ≤ 45 years had a significantly higher risk of developing depression requiring treatment during follow-up. Post-treatment inpatient cancer rehabilitation, including exercise and nutrition counseling, significantly relieved fatigue symptoms. The burdens for recovery from cancer therapy remain multi-factorial. Special focus needs to be placed on identifying high-risk groups experiencing fatigue or pain. Specialized post-treatment inpatient cancer rehabilitation can improve RTW rates.
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Affiliation(s)
- Eva Meixner
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Correspondence:
| | - Elisabetta Sandrini
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Line Hoeltgen
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Tanja Eichkorn
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Philipp Hoegen
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Nathalie Arians
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
| | - Jonathan W. Lischalk
- Department of Radiation Oncology, Perlmutter Cancer Center, New York University Langone Health, New York, NY 10023, USA;
| | - Markus Wallwiener
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Ilse Weis
- Social Service Counselling, University Hospital Heidelberg, 69120 Heidelberg, Germany; (I.W.); (D.R.)
| | - Daniela Roob
- Social Service Counselling, University Hospital Heidelberg, 69120 Heidelberg, Germany; (I.W.); (D.R.)
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Heidelberg Ion Therapy Center (HIT), 69120 Heidelberg, Germany
- German Cancer Research Center (DKFZ), Clinical Cooperation Unit Radiation Oncology, 69120 Heidelberg, Germany
| | - Juliane Hörner-Rieber
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (E.S.); (L.H.); (T.E.); (P.H.); (L.K.); (N.A.); (J.D.); (J.H.-R.)
- Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Research Center (DKFZ), Clinical Cooperation Unit Radiation Oncology, 69120 Heidelberg, Germany
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7
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The Challenge of Return to Work after Breast Cancer: The Role of Family Situation, CANTO Cohort. ACTA ACUST UNITED AC 2021; 28:3866-3875. [PMID: 34677248 PMCID: PMC8534983 DOI: 10.3390/curroncol28050330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/24/2022]
Abstract
Return to work (RTW) after breast cancer is associated with improved quality of life. The link between household characteristics and RTW remains largely unknown. The aim of this study was to examine the effect of the family situation on women’s RTW two years after breast cancer. We used data of a French prospective cohort of women diagnosed with stage I-III, primary breast cancer (CANTO, NCT01993498). Among women employed at diagnosis and under 57 years old, we assessed the association between household characteristics (living with a partner, marital status, number and age of economically dependent children, support by the partner) and RTW. Logistic regression models were adjusted for age, household income, stage, comorbidities, treatments and their side effects. Analyzes stratified by age and household income were performed to assess the association between household characteristics and RTW in specific subgroups. Among the 3004 patients included, women living with a partner returned less to work (OR = 0.63 [0.47–0.86]) and decreased their working time after RTW. Among the 2305 women living with a partner, being married was associated with decreased RTW among women aged over 50 (OR = 0.57 [0.34–0.95]). Having three or more children (vs. none) was associated with lower RTW among women with low household income (OR = 0.28 [0.10–0.80]). Household characteristics should be considered in addition to clinical information to identify vulnerable women, reduce the social consequence of cancer and improve their quality of life.
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8
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Kvillemo PK, Chen L, Bottai M, Frumento P, Almondo G, Mittendorfer-Rutz E, Friberg E, Alexanderson KAE. Sickness absence and disability pension among women with breast cancer: a population-based cohort study from Sweden. BMC Public Health 2021; 21:697. [PMID: 33836707 PMCID: PMC8033713 DOI: 10.1186/s12889-021-10703-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/24/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Women's return to work after diagnosis of breast cancer (BC) is becoming more prevalent. However, register-based national investigation on sickness absence (SA) and disability pension (DP) in BC women is lacking. The aim of the study was to explore SA and DP before and after a first BC diagnosis and the possibility to predict new cancer-related SA by using disease-related and sociodemographic factors. METHODS A longitudinal register study of the 3536 women in Sweden aged 19-64 with a first BC diagnosis in 2010 was conducted by linkage of five nationwide registers. Particularly, detailed information on SA and DP was obtained from the National Social Insurance Agency. Descriptive statistics on SA and DP 2 years before through 3 years after the BC diagnosis were performed. The risk of having a new SA spell due to BC or BC-related diagnoses was modeled using logistic regression. RESULTS The proportion of women with SA increased during the year following the BC diagnosis date and declined over the next 2 years to proportions before diagnosis. At the time of BC diagnosis, half of the women began a new SA spell > 14 days with cancer, cancer-related, or mental diagnosis. Disease-related and sociodemographic factors including occupational sector, living area, age, cancer stage, educational level, and number of previous SA days showed statistical significance (p < 0.05) in predicting a new SA around BC diagnosis. By using these factors, it was possible to correctly predict 67% of the new SA spell. CONCLUSIONS SA among women with BC was elevated mainly in the first year after diagnosis. New SA following BC diagnosis can accurately be predicted.
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Affiliation(s)
- Pia K Kvillemo
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Frumento
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Gino Almondo
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Kristina A E Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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9
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Gernaat SAM, Johnsson A, Altena R, Wilking U, Hedayati E. Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity. Eur J Cancer Care (Engl) 2021; 30:e13353. [PMID: 33151558 PMCID: PMC7900972 DOI: 10.1111/ecc.13353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/18/2020] [Accepted: 10/13/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We aimed to determine the longitudinal prevalence and the predictors of sickness absence (SA) and disability pension (DP) in breast cancer (BC) women who eventually developed relapse. METHODS A total of 1293 BC women, who were ages 20-63 years, diagnosed between 1996 and 2011 and by 2016 had all developed relapse, were identified in Swedish registers and were followed from two years before to five years after their primary diagnosis, while they were relapse-free. Annual prevalence of SA and DP was calculated. Logistic regression was used to estimate adjusted odds ratios (AOR) for long-term SA (>30 days) at one (y1) and three (y3) years post-diagnosis. RESULTS Prevalence of long-term SA was 68.1% in y1 and 16.3% in y5. Prevalence of DP progressively increased from 16.3% in y1 to 29.0% in y5. Predictors of long-term SA included age <50 years (y1:AOR = 1.79 [1.39-2.29]), TNM stage III (y1:AOR = 1.54 [1.03-2.31]; y3:AOR = 2.21 [1.32-3.72]), metastasis (y1:AOR = 1.64 [1.26-2.12]; y3:AOR = 1.51 [1.05-2.18]), comorbidity (y1:AOR = 2.41 [1.55-3.76]; y3 AOR = 4.62 [2.49-8.57]) and any combination of radiotherapy, chemotherapy and hormonal therapy (y1:AOR = 2.05-5.71). CONCLUSION Among BC women who later developed relapse, those who had higher stages of BC, had comorbidity and received neoadjuvant and/or adjuvant therapy were at significantly higher risk of needing long-term SA after their diagnosis.
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Affiliation(s)
- Sofie A. M. Gernaat
- Department of MedicineClinical Epidemiology DivisionKarolinska InstituteStockholmSweden
| | - Aina Johnsson
- Department of Oncology‐PathologyKarolinska InstituteStockholmSweden
- Neurobiology, Care Science and SocietyDivision of Family MedicineKarolinska InstitutetHuddingeSweden
| | - Renske Altena
- Department of Oncology‐PathologyKarolinska InstituteStockholmSweden
- Medical Unit of Breast CancerSarcoma and Endocrine TumorsTheme CancerKarolinska University HospitalStockholmSweden
| | - Ulla Wilking
- Department of Oncology‐PathologyKarolinska InstituteStockholmSweden
| | - Elham Hedayati
- Department of Oncology‐PathologyKarolinska InstituteStockholmSweden
- Medical Unit of Breast CancerSarcoma and Endocrine TumorsTheme CancerKarolinska University HospitalStockholmSweden
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10
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Shaw S, Atkinson K, Jones LM. Cancer survivors' experiences of an exercise program during treatment and while employed: A qualitative pilot study. Health Promot J Austr 2020; 32 Suppl 2:378-383. [PMID: 33305519 DOI: 10.1002/hpja.447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/07/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED This study examined breast cancer survivors' (BCS) views on the role of exercise therapy while they were working in employment during cancer treatment. METHODS Research was undertaken with five participants who undertook an exercise programme as adjuvant care during treatment for breast cancer. Four female and one male client, the only clients who met the criteria for study in the clinic, were interviewed twice each during a two-month period. Participants wrote diaries to supplement the interview data and provide prompts for the second interview. An interpretive paradigm was used to identify themes for analysis. A multiple coding approach was used to interpret the data. The study was conducted at a small breast cancer recovery clinic, situated at a university in the South Island of New Zealand. RESULTS Participants reported that exercise was essential to their ability to work through the active treatment phase and provided positive effects on social, mental and emotional well-being. CONCLUSIONS Exercise therapy is an important element of enabling to work during treatment, for physical, mental and social well-being. SO WHAT?: Future research is required on support for employers to enable exercise therapy for employees; the needs of self-employed patients; tailoring exercise therapy for patients for whom social support is not a primary motivation; and the place of a clinic as a 'middle-ground' between social and emotional support and an exercise clinic.
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Affiliation(s)
- Sally Shaw
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Katy Atkinson
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
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11
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Retour à l’emploi après cancer du sein : apports de la recherche collaborative en santé au travail et d’une charte de partenariat entre acteurs concernés. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Plym A, Johansson ALV, Bower H, Wennstig AK, Fredriksson I, Ahlgren J, Lambe M. Impact of chemotherapy, radiotherapy, and endocrine therapy on sick leave in women with early-stage breast cancer during a 5-year period: a population-based cohort study. Breast Cancer Res Treat 2020; 182:699-707. [PMID: 32506337 PMCID: PMC7320921 DOI: 10.1007/s10549-020-05720-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/02/2020] [Indexed: 12/23/2022]
Abstract
Purpose To examine the influence of type of oncological treatment on sick leave in women of working age with early-stage breast cancer. Methods We identified 8870 women aged 30–64 diagnosed with stage I–II breast cancer between 2005 and 2012 in the Breast Cancer Data Base Sweden. Associations between type of oncological treatment (radiotherapy, endocrine therapy, and chemotherapy) and sick leave were estimated by hazard ratios, probabilities, and length of sick leave using multi-state survival analysis. Results During the first 5 years after diagnosis, women aged 50–54 years at diagnosis receiving chemotherapy spent on average 182 (95% CI 151–218) additional days on sick leave compared with women not receiving chemotherapy, but with otherwise similar characteristics. Correspondingly, women initiating endocrine therapy spent 30 (95% CI 18–44) additional days on sick leave and women receiving post-mastectomy radiotherapy 53 (95% CI 37–69) additional days. At year five, the rate of sick leave was increased in women who had received chemotherapy (HR 1.19, 95% CI 1.11–1.28) or endocrine therapy (HR 1.15, 95% CI 1.05–1.26). Chemotherapy and endocrine therapy were associated with increased rates of sick leave due to depression or anxiety. Conclusion Our findings of increased long-term risks of sick leave after oncological treatment for breast cancer warrant attention from caregivers taking part in cancer rehabilitation. In light of the ongoing debate about overtreatment of early-stage breast cancer, our findings point to the importance of properly selecting patients for chemotherapy not only for the medical toxicity but also the possible impact on their livelihood. Electronic supplementary material The online version of this article (10.1007/s10549-020-05720-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Plym
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden.
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden.,Cancer Registry of Norway, Oslo, Norway
| | - Hannah Bower
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
| | - Anna-Karin Wennstig
- Department of Surgical and Perioperative Science, Umeå University, Umeå, Sweden.,Department of Oncology, Sundsvall Hospital, Sundsvall, Sweden
| | - Irma Fredriksson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Breast and Endocrine Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Ahlgren
- Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden.,Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden.,Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden
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13
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Naughton MJ, Beverly Hery CM, Janse SA, Naftalis EZ, Paskett ED, Van Zee KJ. Prevalence and correlates of job and insurance problems among young breast cancer survivors within 18 months of diagnosis. BMC Cancer 2020; 20:432. [PMID: 32423486 PMCID: PMC7236509 DOI: 10.1186/s12885-020-06846-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
Background The prevalence and correlates of job and insurance problems were examined among a cohort of young U.S. breast cancer survivors during the first 18-months following diagnosis. Methods Participants were 708 women diagnosed at ≤45 years with stage I-III breast cancer. 90% were non-Hispanic white, 76% were married/partnered and 67% had ≥4-year college degree. Univariable and multivariable logistic regression examined the associations between demographic, lifestyle and clinical factors with job and insurance problems. Results 18-months after diagnosis, 56% of participants worked full-time, 16% part-time, 18% were homemakers and/or students, 4.5% were unemployed, and 2.4% were disabled. The majority (86%) had private insurance. Job-related problems were reported by 40% of women, and included believing they could not change jobs for fear of losing health insurance (35.0%), being fired (2.3%), and being demoted, denied promotion or denied wage increases (7.8%). Greater job-related problems were associated with being overweight vs. under/normal weight (p = 0.006), income <$50,000/per year (p = 0.01), and working full-time vs. part-time (p = 0.003). Insurance problems were reported by 27% of women, and included being denied health insurance (2.6%), health insurance increases (4.3%), being denied health benefit payments (14.8%) or denied life insurance (11.4%). Insurance problems were associated with being under/normal weight vs. obese (p = 0.01), not being on hormone therapy (p < 0.001), and a tumor size > 5 cm vs. < 2 cm (p = 0.01). Conclusions Young survivors experienced significant job- and insurance-related issues following diagnosis. To the extent possible, work and insurance concerns should be addressed prior to treatment to inform work expectations and avoid unnecessary insurance difficulties.
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Affiliation(s)
- Michelle J Naughton
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
| | - Chloe M Beverly Hery
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Sarah A Janse
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, 43210, USA
| | - Elizabeth Z Naftalis
- Health Texas Community Health Services Corporate Director of Breast Services, Dallas, TX, 75001, USA
| | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Kimberly J Van Zee
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
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14
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de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, Bardi E, Bultmann U, Sharp L. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv 2020; 14:135-150. [PMID: 32162193 PMCID: PMC7182621 DOI: 10.1007/s11764-020-00862-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. METHODS We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. RESULTS Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both cross-sectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. CONCLUSION Almost three-quarters of long-term cancer survivors working at diagnosis retain work. IMPLICATIONS FOR CANCER SURVIVORS These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.
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Affiliation(s)
- Angela Gem de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Steffen Torp
- Department of Health, Social & Welfare Studies, University College of South-Eastern Norway, Notodden, Norway
| | - Adela Popa
- Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Trine Horsboel
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vesna Zadnik
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Yakir Rottenberg
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edit Bardi
- Kepler Universitäts Klinikum, Linz, Austria
| | - Ute Bultmann
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom.
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15
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Chen L, Alexanderson KAE. Trajectories of sickness absence and disability pension in the 2 years before and 3 years after breast cancer diagnosis: A Swedish longitudinal population-based cohort study. Cancer 2020; 126:2883-2891. [PMID: 32154917 DOI: 10.1002/cncr.32820] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/02/2020] [Accepted: 02/12/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND After breast cancer (BC) diagnosis, work incapacity often occurs among working-age women. We investigated the trajectories of previous and subsequent sickness absence and/or disability pension (SA/DP) days, and risk factors for consistently high levels of future SA/DP among these women. METHODS This longitudinal cohort study included all 3536 women in Sweden aged 19-64 years who received a first BC diagnosis in 2010. Their annual SA/DP net days from 2 years before to 3 years after diagnosis were calculated. SA/DP patterns were depicted by a group-based trajectory model. Logistic regressions were used to calculate odds ratios (ORs) with 95% CIs of >90 or >180 SA/DP days/year. RESULTS Three trajectories of SA/DP days/year were identified: increasing only in year+1 (61% of all), increasing then decreasing in year+3 (30%), and constantly very high (9%). The risk factors associated with annual SA/DP days >90 (long) and >180 days (extreme long) were similar. Factors associated with having >90 SA/DP days for years 1-3 were: stage II (OR, 4.59; 95% CI, 2.98-7.07), stage III+IV (OR, 26.57; 95% CI, 13.52-52.22), prediagnosis SA 1-30 days (OR, 2.73; 95% CI, 1.30-5.70), prediagnosis SA >90 days (OR, 24.52; 95% CI, 12.25-49.08), and prediagnosis DP (OR, 659.97; 95% CI, 292.52->999.99). Conversely, adjusting for prediagnosis SA/DP and stage, sociodemographic factors were not associated with high levels of SA/DP. CONCLUSION After BC diagnosis, SA/DP increased significantly but then decreased. The absolute majority had no SA/DP during year 3. Advanced cancer stage and previous high SA/DP rendered the greatest risk for future high SA/DP. More knowledge is needed for applying the information in rehabilitation and return-to-work planning.
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Affiliation(s)
- Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristina A E Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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16
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Swanberg JE, Vanderpool RC, Tracy JK. Cancer-work management during active treatment: towards a conceptual framework. Cancer Causes Control 2020; 31:463-472. [PMID: 32125547 DOI: 10.1007/s10552-020-01285-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/19/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Forward progress in cancer treatment has resulted in fewer adverse consequences of cancer during and after treatment, offering employed cancer patients the possibility of continuing to work during treatment, returning to work after treatment, or implementing a combination of strategies to manage the cancer-work interface. Yet, much of the research on cancer and employment examines return to work as the primary outcome, neglecting to consider the circumstances of survivors who maintain employment while engaged in active treatment. We introduce the Cancer-Work Management Framework (CWMF), a conceptual framework for understanding the cancer and job demands survivors who continue to work during active treatment experience and how cancer and job resources and strategies could promote cancer-work fit and ultimately optimize employment and health outcomes. METHODS We provide an overview of the research describing the cancer-work management experiences of survivors who maintain employment during active treatment and summarize the theories that informed the CWMF including ecological systems, boundary-spanning, and job demands and resources theories. RESULTS The paper presents a description of the components of the CWMF which include cancer demands, cancer care resources and strategies, work demands, and workplace resources. We also describe a process-cancer-work fit-that reflects the interplay between demands and resources influence employment and health outcomes. CONCLUSIONS Future research directions for developing knowledge about the cancer-work management process are proposed with suggestions for study of how cancer and job demands influence cancer treatment and employment decisions.
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Affiliation(s)
- Jennifer E Swanberg
- Department of Health Policy and Management, School of Professional Studies, Providence College, 1 Cunningham Square, Providence, RI, 02918, USA.
- University of Maryland School of Social Work, Baltimore, MD, USA.
| | - Robin C Vanderpool
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - J Kathleen Tracy
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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17
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Factors associated with return to work in breast cancer survivors treated at the Public Cancer Hospital in Brazil. Support Care Cancer 2020; 28:4445-4458. [PMID: 31925532 DOI: 10.1007/s00520-019-05164-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/30/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the impact of return to work on the quality of life of breast cancer patients and to identify factors related to nonreturn to work. METHODS An observational, cross-sectional study was performed in breast cancer survivors who had worked before their breast cancer diagnosis. We evaluated factors related to return to work (patient perspective, disease, and work), EORTC quality of life questionnaires (general: EORTC QLQ-C30; and breast cancer-specific: EORTC QLQ-BR23), the Shoulder Pain and Disability Index (SPADI), and the Anxiety and Depression Scale (HADS). Half of the patients underwent a physical therapy examination (shoulder goniometry, hand dynamometry, and limb volume). Univariate and multivariate analysis were performed. RESULTS We included 304 patients, 163 of whom underwent physiotherapy evaluation. Approximately 54.0% (164) of the patients returned to work after treatment. The women who returned to work presented lower age, higher education levels, higher incomes, and smaller initial tumor size. The women who returned to work had higher scores related to body image and sexual function, lower scores in relation to disability and pain, and lower scores related to anxiety and depression. In the multivariate model to evaluate nonreturn to work, pretreatment variables were age, education level, and clinical staging. Sequelae related to loss of strength increased the risk of nonreturn to work. CONCLUSION Return to work was influenced by age, education level, previous activity types, axillary treatment, and physical sequelae related to loss of hand strength. Breast cancer treatment decreased the women's work capacity. Return to work improved the patients' quality of life.
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18
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Dumas A, Vaz Luis I, Bovagnet T, El Mouhebb M, Di Meglio A, Pinto S, Charles C, Dauchy S, Delaloge S, Arveux P, Coutant C, Cottu P, Lesur A, Lerebours F, Tredan O, Vanlemmens L, Levy C, Lemonnier J, Mesleard C, Andre F, Menvielle G. Impact of Breast Cancer Treatment on Employment: Results of a Multicenter Prospective Cohort Study (CANTO). J Clin Oncol 2019; 38:734-743. [PMID: 31834818 PMCID: PMC7048162 DOI: 10.1200/jco.19.01726] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors’ work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
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Affiliation(s)
- Agnes Dumas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France.,Clinical Research Department, Gustave Roussy, Villejuif, France
| | - Ines Vaz Luis
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | - Thomas Bovagnet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Mayssam El Mouhebb
- Clinical Research Department, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | | | - Sandrine Pinto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Cecile Charles
- Department of Supportive Care, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université de Paris, Paris, France
| | - Sarah Dauchy
- Department of Supportive Care, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Suzette Delaloge
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Patrick Arveux
- Clinical Research Department, Centre Georges-François Leclerc, Dijon, France.,INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Charles Coutant
- Clinical Research Department, Centre Georges-François Leclerc, Dijon, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, Paris, France
| | - Anne Lesur
- Institut de Cancérologie de Lorraine Alexis Vautrin, Vandoeuvre les Nancy, France
| | | | | | | | | | | | | | - Fabrice Andre
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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19
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Hamood R, Hamood H, Merhasin I, Keinan-Boker L. Work Transitions in Breast Cancer Survivors and Effects on Quality of Life. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:336-349. [PMID: 29948472 DOI: 10.1007/s10926-018-9789-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose Work transitions among breast cancer survivors remain an underexplored area. We aimed to examine prevalence and determinants of changes in work status, and the effect of these changes on quality of life of breast cancer survivors. Methods A cross-sectional study of 410 female breast cancer survivors randomly drawn from a larger study sample pool (n = 2644), members of "Leumit" healthcare fund, who were diagnosed with primary nonmetastatic invasive breast cancer in the years 2002-2012. The study questionnaire included questions on work characteristics and health-related quality-of-life and was completed by all women contacted. Work transition was defined as a downgrade (from full-time to part-time), termination, or retirement, and was contrasted to no change in work status (retention of full-time or part-time). Work transition was assessed at two intervals: between breast cancer diagnosis and treatment, and between breast cancer diagnosis and time of the survey. Results A total of 206 breast cancer survivors (50%) were employed prior to their diagnosis, of whom 12% stopped working, and 79% downgraded to part-time during treatment. At the time of survey (mean 8 ± 3 years post-diagnosis), 33% of those employed prior to their diagnosis stopped working or retired, 48% downgraded to part-time, and 19% had no change in their work situation. Work transition between diagnosis and time of the survey was significantly associated with poorer quality-of-life. In multivariable analyses, work transition between diagnosis and time of the survey was positively associated with being immigrant compared to native-born Israeli (odds ratio (OR) 4.65; 95% confidence interval (CI) 1.91-11.37; P = .001), and inversely with education level of college or over compared to high school or less (OR 0.27; 95% CI 0.09-0.86; P = .026). Conclusions Breast cancer survivors with characteristics pointing at underprivileged social circumstances more often experienced changes in work status after surviving breast cancer, irrespective of diagnosis, comorbidity or treatment. Breast cancer patients with immigrant status and/or lower educational attainment need more support to be able to keep their job.
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Affiliation(s)
- Rola Hamood
- School of Public Health, University of Haifa, Haifa, Israel
| | - Hatem Hamood
- School of Public Health, University of Haifa, Haifa, Israel.
- Leumit Health Services, Haharoshet 13, Karmiel, Israel.
| | | | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel
- Ministry of Health, Israel Center for Disease Control, Ramat Gan, Israel
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Ota A, Fujisawa A, Kawada K, Yatsuya H. Recent Status and Methodological Quality of Return-to-Work Rates of Cancer Patients Reported in Japan: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081461. [PMID: 31022971 PMCID: PMC6518281 DOI: 10.3390/ijerph16081461] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/11/2019] [Accepted: 04/20/2019] [Indexed: 11/16/2022]
Abstract
Cancer patients’ return-to-work rates in Japan and their methodological quality have been little reported. We conducted a systematic review to explore the recent return-to-work rates and to assess the methodological quality of the existing literature. We selected 13 papers (2 in English and 11 in Japanese) published between 2005 and 2017. The return-to-work rates ranged from 53.8% to 95.2%. Of the selected papers, 12 papers employed a cross-sectional design, possessing high risk of selection bias due to participant selection. A total of 8 papers did not fully report the subjects’ sex, age, employment status at cancer diagnosis, cancer site, stage, and treatment, suggesting high risk of selection bias due to confounding variables. High or unclear risk of attrition bias due to incomplete outcome data was detected in 12 papers in which data on return to work were not collected from all participants. High risk of reporting bias due to selective outcome reporting was pointed out in 6 studies in which the subjects’ employment status at return to work or the duration between cancer diagnosis and assessment of return to work was unclear. Future studies must reduce the risk of selection, attrition, and reporting biases for specifying accurate return-to-work rates.
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Affiliation(s)
- Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Akiko Fujisawa
- Department of Public Health, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Kenji Kawada
- Department of Medical Oncology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
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TAGUCHI R, OKUDE Y, SAITO M. What causes patients with breast cancer to change employment?: evidence from the health insurance data in a medical facility. INDUSTRIAL HEALTH 2019; 57:29-39. [PMID: 30101897 PMCID: PMC6363589 DOI: 10.2486/indhealth.2018-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
Abstract
This study aims to make clear the following aspects of breast cancer patients and their occupation. 1. What percentage of patients have changed their working status around surgery? 2. When did patients change their employment? 3. What is the cause of the employment change? We investigated 269 patients who underwent curative surgery for primary breast cancer at one university hospital in Tokyo. Patients who were under the age of 58 at the time of surgery and had the experience of being a company or government employee during a year prior to the surgery were used as sample for analysis. To determine factors related to the employment change, multiple logistic regression analysis was performed. Nineteen percent patients changed the employment status before and after surgery. Of those, 19% changed the employment by the end of surgery month while 42% did by the fourth month after surgery. Treatment-related factors such as mastectomy and the combination of chemotherapy and hormone therapy affected changes in employment. We believe that the validity of our study can be confirmed by comparing with the previous study results. We show the potential large effects of cancer treatment on patients' daily lives.
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Affiliation(s)
- Ryoko TAGUCHI
- Department of Nutrition and Dietetics, Faculty of Family and
Consumer Sciences, Kamakura Women’s University, Japan
- Department of Breast Oncology, Juntendo University School of
Medicine, Japan
| | - Yukako OKUDE
- Patient Consultation Room, Juntendo University Nerima
Hospital, Japan
| | - Mitsue SAITO
- Department of Breast Oncology, Juntendo University School of
Medicine, Japan
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22
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Kotani H, Kataoka A, Sugino K, Iwase M, Onishi S, Adachi Y, Gondo N, Yoshimura A, Hattori M, Sawaki M, Iwata H. The investigation study using a questionnaire about the employment of Japanese breast cancer patients. Jpn J Clin Oncol 2018; 48:712-717. [PMID: 29939297 DOI: 10.1093/jjco/hyy088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/25/2018] [Indexed: 01/02/2023] Open
Abstract
Background Breast cancer is the most common cancer among women, and its survival rate has improved. As the number of cancer survivors increases, it is important to support their social comeback during and after treatment. Methods Questionnaires were distributed to breast cancer patients treated in Aichi Cancer Center Hospital between June and November 2014. Responders were categorized according to adjuvant therapy (Group A: none, Group B: endocrine therapy, Group C: chemotherapy), or if they had advanced or recurrent breast cancer (Group D). Results A total of 279 patients returned questionnaires (62, 79, 92 and 46 patients in Groups A, B, C and D, respectively). In adjuvant treatment groups, 43 patients (18.5%) quit their job during or after treatment. Most patients had quit their jobs at the time of diagnosis (7.5%), followed by those undergoing chemotherapy (5.6%) and those at the time of operation (4.9%). Quit rate from the workplace in which patients worked at the time of diagnosis was highest in Group C (30%), followed by Group B (20%) and Group A (13%). At the time of operation, 127 patients (57%) were absent from work. In Group D, 16 patients (35%) quit their job during treatment. Rates for patients currently working who had anxiety were 62, 30, 26 and 9% in Groups D, C, B and A, respectively. Conclusions In adjuvant treatment groups, in which quit rate was highest at the time of diagnosis, consultation about working is necessary immediately after diagnosis. Patients treated most heavily had higher quit rates and experienced more anxiety about working.
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Affiliation(s)
- Haruru Kotani
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ayumi Kataoka
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kayoko Sugino
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Madoka Iwase
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Sakura Onishi
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yayoi Adachi
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Naomi Gondo
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masaya Hattori
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Wang L, Hong BY, Kennedy SA, Chang Y, Hong CJ, Craigie S, Kwon HY, Romerosa B, Couban RJ, Reid S, Khan JS, McGillion M, Blinder V, Busse JW. Predictors of Unemployment After Breast Cancer Surgery: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Oncol 2018; 36:1868-1879. [PMID: 29757686 PMCID: PMC6804906 DOI: 10.1200/jco.2017.77.3663] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose Breast cancer surgery is associated with unemployment. Identifying high-risk patients could help inform strategies to promote return to work. We systematically reviewed observational studies to explore factors associated with unemployment after breast cancer surgery. Methods We searched MEDLINE, EMBASE, CINAHL, and PsycINFO to identify studies that explored risk factors for unemployment after breast cancer surgery. When possible, we pooled estimates of association for all independent variables reported by more than one study. Results Twenty-six studies (46,927 patients) reported the association of 127 variables with unemployment after breast cancer surgery. Access to universal health care was associated with higher rates of unemployment (26.6% v 15.4%; test of interaction P = .05). High-quality evidence showed that unemployment after breast cancer surgery was associated with high psychological job demands (odds ratio [OR], 4.26; 95% CI, 2.27 to 7.97), childlessness (OR, 1.30; 95% CI, 1.11 to 1.53), lower education level (OR, 1.15; 95% CI, 1.05 to 1.25), lower income level (OR, 1.46; 95% CI, 1.24 to 1.73), cancer stage II, III or IV (OR, 1.43; 95% CI, 1.13 to 1.82), and mastectomy versus breast-conserving surgery (OR, 1.18; 95% CI, 1.07 to 1.30). Moderate-quality evidence suggested an association with high physical job demands (OR, 2.11; 95%CI, 1.52 to 2.93), African-American ethnicity (OR, 1.89; 95% CI, 1.21 to 2.96), and receipt of chemotherapy (OR, 1.95; 95% CI, 1.36 to 2.79). High-quality evidence demonstrated no significant association with part-time hours, blue-collar work, tumor size, positive lymph nodes, or receipt of radiotherapy or endocrine therapy; moderate-quality evidence suggested no association with age, marital status, or axillary lymph node dissection. Conclusion Addressing high physical and psychological job demands may be important in reducing unemployment after breast cancer surgery.
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Affiliation(s)
- Li Wang
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brian Y. Hong
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sean A. Kennedy
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yaping Chang
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Chris J. Hong
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samantha Craigie
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Henry Y. Kwon
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Beatriz Romerosa
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rachel J. Couban
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Susan Reid
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - James S. Khan
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael McGillion
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victoria Blinder
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jason W. Busse
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
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Walcott-Sapp S, Johnson N, Garreau J. Use of integrative services is associated with maintenance of work schedule during and after cancer treatment. Am J Surg 2018; 215:892-897. [PMID: 29471964 DOI: 10.1016/j.amjsurg.2018.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cancer diagnosis affects employment status. Our health network offers supportive services to cancer patients. We hypothesized patients who used these services were more likely to continue to work during and after treatment. METHODS A mailed survey was used to assess employment before, during, and after treatment, and support services used. Chi-square analysis was performed. RESULTS The response rate was 34% (273/782). 87% of patients worked full or part time before cancer diagnosis, 68.8% continued to work during treatment, and 73.9% returned to work after treatment. 61% of patients used at least one type of support service. Patients who had no change in work status during treatment and who returned to work less than one month after treatment were more likely to use services. CONCLUSIONS Most patients used support services, continued to work during treatment, and returned to pre-cancer employment status. Physicians should encourage patients to pursue supportive therapies.
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Affiliation(s)
- Sarah Walcott-Sapp
- Department of Surgery, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Mail Code: L223, Portland, OR 97239, USA.
| | - Nathalie Johnson
- Surgical Oncology, Legacy Medical Group, 1040 N.W. 22nd Ave., Suite 560, Building 2, Legacy Good Samaritan Medical Center, Portland, OR 97227, USA
| | - Jennifer Garreau
- Surgical Oncology, Legacy Medical Group, 1040 N.W. 22nd Ave., Suite 560, Building 2, Legacy Good Samaritan Medical Center, Portland, OR 97227, USA
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Fassier JB, Lamort-Bouché M, Broc G, Guittard L, Péron J, Rouat S, Carretier J, Fervers B, Letrilliart L, Sarnin P. Developing a Return to Work Intervention for Breast Cancer Survivors with the Intervention Mapping Protocol: Challenges and Opportunities of the Needs Assessment. Front Public Health 2018; 6:35. [PMID: 29527521 PMCID: PMC5829033 DOI: 10.3389/fpubh.2018.00035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/31/2018] [Indexed: 01/02/2023] Open
Abstract
Return to work (RTW) is an important step for breast cancer survivors (BCSs). However, they face many barriers that affect particularly women with low socioeconomic status (SES). Health care, workplace, and insurance actors lack knowledge and collaborate poorly. No intervention to date has proven effective to reduce social disparities in employment after breast cancer. The intervention mapping (IM) protocol is being used in France to develop, implement, and evaluate an intervention to facilitate and sustain RTW after breast cancer [FAciliter et Soutenir le retour au TRAvail après un Cancer du Sein (FASTRACS) project]. The research question of this study was to elicit the needs for RTW after breast cancer from various stakeholders' point of view. The aim of this study was to describe the process and the preliminary results of the needs assessment of the FASTRACS project. Different methods were followed to (a) establish and work with a planning group and (b) conduct a needs assessment to create a logic model of the problem. A planning group was organized to gather the stakeholders with the research team. A review of the literature and indicators was conducted to identify the magnitude of the problem and the factors influencing RTW. A qualitative inquiry was conducted with 12 focus groups and 48 individual semi-structured interviews to explore the needs and experience of the stakeholders. The results of these tasks were the proposition of a charter of partnership to structure the participative process, a review of the scientific evidence and indicators, and the description by the stakeholders of their needs and experience. Many stakeholders disagreed with the concept of "early intervention." They advocated for a better support of BCSs during their RTW, emphasized as a process. Anticipation, intersectoral collaboration, and workplace accommodation were mentioned to fit the needs of the BCS and their environment. A logic model of the problem was elaborated from these data. The ability of the model to consider specific characteristics of women with low SES is discussed, with a view to developing the FASTRACS intervention through the next steps of the IM protocol.
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Affiliation(s)
- Jean-Baptiste Fassier
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Service de médecine et santé au travail, Hospices civils de Lyon, Lyon, France
| | - Marion Lamort-Bouché
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Guillaume Broc
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laure Guittard
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle IMER, Hospices civils de Lyon, Lyon, France
| | - Julien Péron
- Laboratoire de Biométrie et Biologie Evolutive LBBE – UMR 5558, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Service d’oncologie médicale. Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Hospices civils de Lyon, Pierre-Bénite, France
| | - Sabrina Rouat
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
| | - Julien Carretier
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
| | - Béatrice Fervers
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
- Faculté Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Philippe Sarnin
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
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26
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Petersson LM, Vaez M, Nilsson MI, Saboonchi F, Alexanderson K, Olsson M, Wennman-Larsen A. Sickness absence following breast cancer surgery: a two-year follow-up cohort study. Scand J Caring Sci 2017; 32:715-724. [DOI: 10.1111/scs.12502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Lena-Marie Petersson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Marjan Vaez
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Marie I. Nilsson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
- Division of Social Work; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
- Department of Social Work; Karolinska University Hospital; Stockholm Sweden
| | - Fredrik Saboonchi
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Red Cross University College; Stockholm Sweden
- Stress Research Institute; University of Stockholm; Stockholm Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Mariann Olsson
- Division of Social Work; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
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Kvillemo P, Mittendorfer-Rutz E, Bränström R, Nilsson K, Alexanderson K. Sickness Absence and Disability Pension After Breast Cancer Diagnosis: A 5-Year Nationwide Cohort Study. J Clin Oncol 2017; 35:2044-2052. [PMID: 28459607 DOI: 10.1200/jco.2015.66.0613] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To explore future diagnosis-specific sickness absence and disability pension among women with breast cancer compared with women without breast cancer. Also, to examine associations with disease-related and sociodemographic factors among those with breast cancer. Methods Longitudinal register data on 3,547 women living in Sweden (age 20 to 65 years) who were first diagnosed with breast cancer in 2005, and a matched comparison cohort (n = 14,188), were analyzed for the annual prevalence of diagnosis-specific sickness absence and disability pension over 5 years. Logistic regressions were used to explore associations of disease-related and sociodemographic factors with future sickness absence and disability pension among women with breast cancer. Results Immediately after being diagnosed with breast cancer, the proportion of women with sickness absence was high but decreased continuously from the 1st through 5th year after diagnosis (71%, 40%, 30%, 22%, and 19%, respectively). In comparison, the range for women without breast cancer was 17% to 11%, respectively. The higher prevalence of sickness absence after breast cancer was mainly a result of breast cancer diagnosis, not a mental diagnosis, or other somatic diagnoses. Advanced cancer at diagnosis, > 90 days sickness absence before diagnosis, low education, and being born outside Sweden were associated with higher odds ratios for sickness absence and disability pension (odds ratio range, 1.40 to 6.45). Conclusion The level of sickness absence increased substantially in women with breast cancer during the first year after diagnosis and approached the level of breast cancer-free women in the following years; however, even in the first year, most women were not on sickness absence for a substantial time, and even in high-risk groups, many were not on sickness absence or disability pension in the following years. Information about relatively low future sickness absence and disability pension levels can be used by patients when planning their work, by health care professionals, and by social insurance officers. Employers and Occupational Health Services need this information to adequately handle workplace adjustments.
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Affiliation(s)
- Pia Kvillemo
- All authors: Karolinska Institutet, Stockholm, Sweden
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Krabbe LM, Schmidt S. Interventionen zur Förderung der beruflichen Wiedereingliederung für Krebspatienten. Urologe A 2016; 55:1233-6. [DOI: 10.1007/s00120-016-0200-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thorsen L, Dahl AA, Nystad R, Kiserud CE, Geirdal AØ, Smeland S. Baseline characteristics in female cancer patients with unimproved work status after an outpatient rehabilitation program and health changes during the intervention. SPRINGERPLUS 2016; 5:1009. [PMID: 27398282 PMCID: PMC4936990 DOI: 10.1186/s40064-016-2663-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 06/24/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE To improve work ability and health-related quality of life (HRQOL) cancer patients were offered a "Rapid-Return to Work" program. However, several patients did not improve their work status after completing the program. The first aim of this study was to identify the proportion of patients with unimproved work status 6 months after the program (follow-up). The second aim was to identify baseline characteristics associated with unimproved work status and the third aim to measure changes in HRQOL from baseline to follow-up in the unimproved compared to the improved group. METHODS The program consisted of patient education, group discussions and physical activity during a full day weekly for 7 weeks. All patients completed a questionnaire at baseline and follow-up, covering demographic-, cancer-related-, co-morbidity and lifestyle variables, HRQOL (EORTC QLQ-C30) and fatigue (Fatigue Questionnaire). RESULTS 106 female cancer patients completed the program and responded to the follow-up. Thirty-six percent had unimproved work status. Patients in the unimproved group more frequently were in paired relations and had more fatigue at baseline than the improved group. Whereas patients in the improved group increased in 14 of 19 HRQOL parameters, the unimproved group increased in seven of these parameters. Both groups experienced improvement concerning fatigue. CONCLUSION After the program more than one third of the participants did not improve their work status. Patients in paired relations and with more fatigue at baseline were more likely to have unimproved work status. Those within the unimproved group experienced less improvement in HRQOL parameters during the program than those in the improved group.
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Affiliation(s)
- Lene Thorsen
- National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, P.O. Box 4953, 0424 Nydalen, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, P.O. Box 4953, 0424 Nydalen, Oslo, Norway ; University of Oslo, Oslo, Norway
| | - Roy Nystad
- The Outpatient Cancer Rehabilitation Unit, Department of Clinical Service, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, P.O. Box 4953, 0424 Nydalen, Oslo, Norway
| | - Amy Ø Geirdal
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Sigbjørn Smeland
- University of Oslo, Oslo, Norway ; Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Bae KR, Kwon SY. The Workplace Experiences of Breast Cancer Survivors: A Survey of an Online Community. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.4.208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Sun Young Kwon
- Knowledge Management Institute, Sungkyunkwan University, Seoul, Korea
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de Boer AGEM, Taskila TK, Tamminga SJ, Feuerstein M, Frings‐Dresen MHW, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev 2015; 2015:CD007569. [PMID: 26405010 PMCID: PMC6483290 DOI: 10.1002/14651858.cd007569.pub3] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer patients are 1.4 times more likely to be unemployed than healthy people. Therefore it is important to provide cancer patients with programmes to support the return-to-work (RTW) process. This is an update of a Cochrane review first published in 2011. OBJECTIVES To evaluate the effectiveness of interventions aimed at enhancing RTW in cancer patients compared to alternative programmes including usual care or no intervention. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, in the Cochrane Library Issue 3, 2014), MEDLINE (January 1966 to March 2014), EMBASE (January 1947 to March 2014), CINAHL (January 1983 to March, 2014), OSH-ROM and OSH Update (January 1960 to March, 2014), PsycINFO (January 1806 to 25 March 2014), DARE (January 1995 to March, 2014), ClinicalTrials.gov, Trialregister.nl and Controlled-trials.com up to 25 March 2014. We also examined the reference lists of included studies and selected reviews, and contacted authors of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of the effectiveness of psycho-educational, vocational, physical, medical or multidisciplinary interventions enhancing RTW in cancer patients. The primary outcome was RTW measured as either RTW rate or sick leave duration measured at 12 months' follow-up. The secondary outcome was quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, assessed the risk of bias and extracted data. We pooled study results we judged to be clinically homogeneous in different comparisons reporting risk ratios (RRs) with 95% confidence intervals (CIs). We assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS Fifteen RCTs including 1835 cancer patients met the inclusion criteria and because of multiple arms studies we included 19 evaluations. We judged six studies to have a high risk of bias and nine to have a low risk of bias. All included studies were conducted in high income countries and most studies were aimed at breast cancer patients (seven trials) or prostate cancer patients (two trials).Two studies involved psycho-educational interventions including patient education and teaching self-care behaviours. Results indicated low quality evidence of similar RTW rates for psycho-educational interventions compared to care as usual (RR 1.09, 95% CI 0.88 to 1.35, n = 260 patients) and low quality evidence that there is no difference in the effect of psycho-educational interventions compared to care as usual on quality of life (standardised mean difference (SMD) 0.05, 95% CI -0.2 to 0.3, n = 260 patients). We did not find any studies on vocational interventions. In one study breast cancer patients were offered a physical training programme. Low quality evidence suggested that physical training was not more effective than care as usual in improving RTW (RR 1.20, 95% CI 0.32 to 4.54, n = 28 patients) or quality of life (SMD -0.37, 95% CI -0.99 to 0.25, n = 41 patients).Seven RCTs assessed the effects of a medical intervention on RTW. In all studies a less radical or functioning conserving medical intervention was compared with a more radical treatment. We found low quality evidence that less radical, functioning conserving approaches had similar RTW rates as more radical treatments (RR 1.04, 95% CI 0.96 to 1.09, n = 1097 patients) and moderate quality evidence of no differences in quality of life outcomes (SMD 0.10, 95% CI -0.04 to 0.23, n = 1028 patients).Five RCTs involved multidisciplinary interventions in which vocational counselling was combined with patient education, patient counselling, and biofeedback-assisted behavioral training or physical exercises. Moderate quality evidence showed that multidisciplinary interventions involving physical, psycho-educational and vocational components led to higher RTW rates than care as usual (RR 1.11, 95% CI 1.03 to 1.16, n = 450 patients). We found no differences in the effect of multidisciplinary interventions compared to care as usual on quality of life outcomes (SMD 0.03, 95% CI -0.20 to 0.25, n = 316 patients). AUTHORS' CONCLUSIONS We found moderate quality evidence that multidisciplinary interventions enhance the RTW of patients with cancer.
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Affiliation(s)
- Angela GEM de Boer
- Academic Medical CentreCoronel Institute of Occupational HealthMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Tyna K Taskila
- The Work FoundationCentre for Workforce Effectiveness21 Palmer StreetLondonUKSW1V 3PF
| | - Sietske J Tamminga
- Academic Medical CentreCoronel Institute of Occupational HealthMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Michael Feuerstein
- Uniformed Services University of the Health SciencesDepartments of Medical and Clinical Psychology and Preventive Medicine and Biometrics4301 Jones Bridge RoadBethesdaUSAMD 20814‐4799
| | - Monique HW Frings‐Dresen
- Academic Medical Center, University of AmsterdamCoronel Institute of Occupational Health and Research Center for Insurance MedicineMeibergdreef 9PO Box 22700AmsterdamNetherlands1100 DE
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupPO Box 310KuopioFinland70101
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Azarkish F, Mirzaii Najmabadi K, Latifnejad Roudsari R, Homaei Shandiz F. Factors Related to Return to Work in Women After Breast Cancer in Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e19978. [PMID: 26473073 PMCID: PMC4601229 DOI: 10.5812/ircmj.19978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 06/18/2014] [Accepted: 07/03/2014] [Indexed: 11/16/2022]
Abstract
Background: Most women are diagnosed with breast cancer (BC) when they are still at the appropriate age for employment. The increasing survival rates of patients with BC call for more attention to their ability to return to work. Objectives: The aim of this study was to identify factors related to the return to work in Iranian women underwent BC treatment. Patients and Methods: A total of 175 women with BC, who met the inclusion criteria, were enrolled in this cross-sectional study. The subjects were recruited from four hospitals affiliated to Mashhad university of medical sciences. These hospitals are oncology referral centers in eastern Iran. All records of employed women with BC were studied in four hospitals of Mashhad city, Iran, during 2000 - 2010. The researchers designed a questionnaire, which consisted of questions regarding social/demographic, health/disease, and work characteristics. The questionnaires were completed through interviews. Data were analyzed using SPSS software, version 11.5. Results: The mean age of the patients at the time of interview was 44.3 ± 6.72 years. Mean age of “Return- to-work” group was 42.71 and “No return-to-work” group was 51.06. Most women (80%) were married. At the time of the interview, 80% had returned to work after a BC diagnosis. Older patients (OR = 0.796; 95% CI, 0.625 - 0.907, P = 0.002), and those with a great deal of work experience (OR = 0.861; 95% CI, 0.752 - 0.986, P = 0.030) were less likely to return to work. Also, women who had no pain or surgery scar (OR = 23.03; 95% CI, 4.53 - 117.02, P < 0.001) as well as those who had no lymphedema after the BC treatment were more likely to return to work (OR = 22.373; 95% CI, 4.04 - 23.892, P < 0.001). Conclusions: The results of this study show the factors related to the return-to-work after BC treatment in working women in Mashhad city, Iran. These predictors should be taken into account in order to improve the patient’s life quality.
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Affiliation(s)
| | - Khadijeh Mirzaii Najmabadi
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
- Corresponding Author: Khadijeh Mirzaii Najmabadi, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran. Tel: +98-5118546025, Fax: +98-5118597313, E-mail:
| | - Robab Latifnejad Roudsari
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
| | - Fatemeh Homaei Shandiz
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
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Shipp S, McKinstry C, Pearson E. The impact of colorectal cancer on leisure participation: A narrative study. Br J Occup Ther 2015. [DOI: 10.1177/0308022614562794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction The prevalence of cancer is increasing and, with enhanced early detection and treatment, survival rates have also improved. During cancer treatment and survivorship, occupational participation is significantly impacted, with leisure affected. This field has attracted limited research interest however, particularly involving men with colorectal cancer. Symptoms including cancer-related fatigue and pain may reduce ability to engage in usual leisure occupations. Method A qualitative narrative study was conducted to enhance understanding of leisure participation during and following cancer treatment. In-depth interviews were undertaken with four men with colorectal cancer attending for review at a specialist cancer centre. Audio-recorded interview data were transcribed verbatim and thematically analysed. Results All men interviewed reported significant disruption to their usual leisure occupations. Participants described participating in passive leisure occupations during treatment over more active or community-based occupations due to challenges such as having a colostomy bag and fatigue. The men described generally returning to their chosen leisure occupations and the significance this held for their wellbeing. Conclusion Given the impact of colorectal cancer on participation in leisure occupations for men, occupational therapists can assist these men to either resume previous leisure occupations or commence alternative leisure occupations to improve their quality of life.
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Affiliation(s)
- Sarah Shipp
- Occupational Therapist, Western Health, Department of Occupational Therapy, Footscray Hospital, Australia
| | - Carol McKinstry
- Senior Lecturer, La Trobe University, La Trobe Rural Health School, Bendigo, Australia
| | - Elizabeth Pearson
- PhD Candidate, La Trobe University, La Trobe Rural Health School, Bendigo, Australia
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Ghasempour M, Rahmani A, Davoodi A, Sheikhalipour Z, Ziaeei JE, Abri F. Return to work and its relation to financial distress among Iranian cancer survivors. Asian Pac J Cancer Prev 2015; 16:2257-61. [PMID: 25824747 DOI: 10.7314/apjcp.2015.16.6.2257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Return to work after treatment completion is important for both cancer survivors and society. Financial distress is one of the factors that may influence the return to work in cancer survivors. However, this relationship has not been well investigated. This study aimed to determine the rate of return to work and its relation to financial distress among Iranian cancer survivors. MATERIALS AND METHODS This descriptive-correlational study was undertaken among 165 cancer survivors who completed their initial treatments and had no signs of active cancer. The Return to Work questionnaire and Financial Distress/Financial Well-Being Scale were used for data collection. Data were analyzed using SPSS statistical software. RESULTS After initial treatments, 120 cancer survivors (72%) had returned to work, of which 50 patients (42%) had returned to full-time work and 70 (58%) reduced their work hours and returned to part-time work. Cancer survivors also reported high levels of financial distress. In addition, the financial distress was lower among patients who had returned completely to work, in comparison to patients who had quit working for cancer-related reasons (p=0.001) or returned to work as part-time workers (p=0.001). CONCLUSIONS The findings showed that a high percent of Iranian cancer survivors had not returned to their jobs or considerably reduced working hours after treatment completion. Accordingly, due to high levels of financial distress experienced by participants and its relation to return to work, designing rehabilitation programs to facilitate cancer survivor return to work should be considered.
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Affiliation(s)
- Mostafa Ghasempour
- Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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Islam T, Dahlui M, Majid HA, Nahar AM, Mohd Taib NA, Su TT. Factors associated with return to work of breast cancer survivors: a systematic review. BMC Public Health 2014; 14 Suppl 3:S8. [PMID: 25437351 PMCID: PMC4251139 DOI: 10.1186/1471-2458-14-s3-s8] [Citation(s) in RCA: 247] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The breast cancer survival rate is the highest among all types of cancers, and survivors returning to work after completing treatment is extremely important in regards to economy and rehabilitation. The aim of this systematic review study is to identify the prevalence of breast cancer survivors who return to work (RTW) and the factors associated to RTW. METHODS A computer based literature search was carried out. "PubMed, Cochrane Library, Embase, Web of Science, and Science Direct" databases were searched systematically. Our search strategy identified a total of 12,116 papers of which 26 studies met the inclusion criteria and quality assessment. These were original papers published between January 2003 and January 2013. RESULTS The trends in RTW differ among countries for the breast cancer survivors. The time to RTW after successful cancer treatment also varies among the countries and by ethnicity. The prevalence of the RTW varies from 43% to 93% within one year of diagnosis. The prevalence of the RTW for the Netherland is the lowest in the world (43%). The United States survivors showed the highest RTW (93%) within 12 months of the diagnosis. Numerous barriers and facilitators were identified as factors that affect RTW. For instance, socio-demographic factors such as education and ethnicity; treatment oriented factors such as chemotherapy; work related factors such as heavy physical work; disease related factors such as poor health condition and fatigue; and psychological factors such as depression and emotional distress, act as barriers of RTW. In contrast, social, family, employer support, and financial independency emerge as key facilitators in enabling breast cancer survivors to return and continue work. CONCLUSION Minimising these identified barriers and strengthening these facilitators could further improve the work condition and increase the percentage of RTW among the breast cancer survivors.
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van Muijen P, Duijts SFA, Bonefaas-Groenewoud K, van der Beek AJ, Anema JR. Factors associated with work disability in employed cancer survivors at 24-month sick leave. BMC Cancer 2014; 14:236. [PMID: 24693855 PMCID: PMC3976500 DOI: 10.1186/1471-2407-14-236] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/25/2014] [Indexed: 11/30/2022] Open
Abstract
Background Identification of factors associated with work disability in cancer survivors on long term sick leave may support these survivors in choosing effective measures to facilitate vocational rehabilitation and return to work. Therefore, this study aims to disclose factors associated with work disability in cancer survivors at 24 months of sick leave. Methods A cross sectional study was conducted. The study population consisted of employed sick-listed cancer survivors, aged between 18 and 64 years. They received a questionnaire at 24-month sick leave, the maximum period of sick leave allowed by Dutch social security legislation. Data were linked with the outcome of work disability assessment, as performed by the Dutch social security agency. A hierarchical multivariate logistic regression analysis was performed to identify factors associated with work disability. Results Data of 351 valid cases were analysed. The multivariate analysis showed that, for cancer survivors at 24-month sick leave, Dutch nationality, higher education, receiving hormone therapy, metastatic disease, physical limitations and low self-reported work ability were associated with an increased risk for work disability. Conclusions This study identified factors associated with work disability of employed cancer survivors at 24 months of sick leave. The results of the current study may serve as a starting point to investigate the course of work disability beyond the maximum period of 24 months of sick leave. In order to enhance work participation of cancer survivors beyond this term, prospective data on work disability in the Netherlands are required.
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Affiliation(s)
- Peter van Muijen
- Department of Public and Occupational Health, EMGO + Institute/VU University Medical Center, P,O, Box 7057, 1007 MB Amsterdam, The Netherlands.
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Hsu T, Ennis M, Hood N, Graham M, Goodwin PJ. Quality of Life in Long-Term Breast Cancer Survivors. J Clin Oncol 2013; 31:3540-8. [DOI: 10.1200/jco.2012.48.1903] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose There is considerable interest in the quality of life (QOL) of long-term breast cancer (BC) survivors. We studied changes in QOL from time of BC diagnosis to long-term survivorship and compared QOL in long-term survivors to that of age-matched women with no history of BC. Patients and Methods In all, 535 women with localized BC (T1-3N0-1M0) were recruited from 1989 to 1996 and followed prospectively, completing QOL questionnaires at diagnosis and 1 year postdiagnosis. Between 2005 and 2007, those alive without distant recurrence were recontacted to participate in a long-term follow-up (LTFU) study. A control group was recruited from women presenting for screening mammograms, and both groups completed LTFU QOL questionnaires. Longitudinal change in BC survivors and differences between BC survivors and controls were assessed in eight broad categories with clinically significant differences set at 5% and 10% of the breadth of each QOL scale. Results A total of 285 patients with BC were included in the study, on average 12.5 years postdiagnosis. Longitudinally, clinically significant improvements were observed in overall QOL by 1 year postdiagnosis with further improvements by LTFU. Some clinically significant improvements over time were seen in all categories. A total of 167 controls were recruited. Deficits were observed in self-reported cognitive functioning (5.3% difference) and financial impact (6.3% difference) in BC survivors at LTFU compared with controls. Conclusion Long-term BC survivors show improvement in many domains of QOL over time, and they appear to have similar QOL in most respects to age-matched noncancer controls, although small deficits in cognition and finances were identified.
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Affiliation(s)
- Tina Hsu
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Marguerite Ennis
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Nicky Hood
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Margaret Graham
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Pamela J. Goodwin
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
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Tan FL, Loh SY, Su TT, Veloo VW, Ng LL. Return to work in multi-ethnic breast cancer survivors--a qualitative inquiry. Asian Pac J Cancer Prev 2013; 13:5791-7. [PMID: 23317258 DOI: 10.7314/apjcp.2012.13.11.5791] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Return-to-work (RTW) can be a problematic occupational issue with detrimental impact on the quality of life of previously-employed breast cancer survivors. This study explored barriers and facilitators encountered during the RTW process in the area of cancer survivorship. MATERIALS AND METHODS Six focus groups were conducted using a semi-structured interview guide on 40 informants (employed multiethnic survivors). Survivors were stratified into three groups for successfully RTW, and another three groups of survivors who were unable to return to work. Each of the three groups was ethnically homogeneous. Thematic analysis using a constant comparative approach was aided by in vivo software. RESULTS Participants shared numerous barriers and facilitators which directly or interactively affect RTW. Key barriers were physical-psychological after-effects of treatment, fear of potential environment hazards, high physical job demand, intrusive negative thoughts and overprotective family. Key facilitators were social support, employer support, and regard for financial independence. Across ethnic groups, the main facilitators were financial-independence (for Chinese), and socialisation opportunity (for Malay). A key barrier was after-effects of treatment, expressed across all ethnic groups. CONCLUSIONS Numerous barriers were identified in the non-RTW survivors. Health professionals and especially occupational therapists should be consulted to assist the increasing survivors by providing occupational rehabilitation to enhance RTW amongst employed survivors. Future research to identify prognostic factors can guide clinical efforts to restore cancer survivors to their desired level/type of occupational functioning for productivity and wellbeing.
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Affiliation(s)
- Foo Lan Tan
- Institute of Postgraduate Studies, Department of Rehabilitation Medicine, Faculty of Medicine, Kuala Lumpur Hospital, University of Malaya, Kuala Lumpur, Malaysia
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Prognostic factors of work disability in sick-listed cancer survivors. J Cancer Surviv 2013; 7:582-91. [PMID: 23800959 DOI: 10.1007/s11764-013-0297-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Sick-listed cancer survivors may face lasting side-effects, even after a successful completion of treatment. As a consequence, they are at risk of work disability, which may lead to job loss. Knowledge of prognostic factors of work disability may support cancer survivors in their trajectory of vocational rehabilitation. The purpose of this study was to identify prognostic factors of work disability in sick-listed cancer survivors. METHODS From the first day of sick leave, a cohort of 131 cancer survivors was followed for 24 months. Included participants were aged between 20 and 63 years. Data were collected, using questionnaires, at 10 months after reporting sick. The level of work disability, i.e., entitlement for disability compensation, was assessed by an insurance physician and a labour expert at 24 months. Univariate and multiple logistic regression analyses were performed. RESULTS In the univariate analysis, 14 variables were found to be associated with the level of work disability at 24 months. These factors were related to socio-demographics, health characteristics, work-related characteristics, and return to work (RTW) expectations. Multiple logistic regression showed that at 10-month sick leave, perception of health care providers on cancer survivors' work ability and experienced influence on RTW, both reported by workers, were significantly associated with the level of work disability at 24 months. CONCLUSION It seems in the interest of cancer survivors to take an active role in planning their RTW trajectory and to discuss RTW with their health care providers. IMPLICATIONS FOR CANCER SURVIVORS The potential role healthcare providers may play in counselling cancer survivors on RTW must not be underestimated. Cancer survivors may benefit in having control on their RTW trajectory.
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Hubbard G, Gray NM, Ayansina D, Evans JMM, Kyle RG. Case management vocational rehabilitation for women with breast cancer after surgery: a feasibility study incorporating a pilot randomised controlled trial. Trials 2013; 14:175. [PMID: 23768153 PMCID: PMC3698180 DOI: 10.1186/1745-6215-14-175] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
Background There is a paucity of methodologically robust vocational rehabilitation (VR) intervention trials. This study assessed the feasibility and acceptability of a VR trial of women with breast cancer to inform the development of a larger interventional study. Methods Women were recruited in Scotland and randomised to either a case management VR service or to usual care. Data were collected on eligibility, recruitment and attrition rates to assess trial feasibility, and interviews conducted to determine trial acceptability. Sick leave days (primary outcome) were self-reported via postal questionnaire every 4 weeks during the first 6 months post-surgery and at 12 months. Secondary outcome measures were change in employment pattern, quality of life and fatigue. Results Of the 1,114 women assessed for eligibility, 163 (15%) were eligible. The main reason for ineligibility was age (>65 years, n = 637, 67%). Of those eligible, 111 (68%) received study information, of which 23 (21%) consented to participate in the study. Data for 18 (78%) women were analysed (intervention: n = 7; control: n = 11). Participants in the intervention group reported, on average, 53 fewer days of sick leave over the first 6 months post-surgery than those in the control group; however, this difference was not statistically significant (p = 0.122; 95% confidence interval −15.8, 122.0). No statistically significant differences were found for secondary outcomes. Interviews with trial participants indicated that trial procedures, including recruitment, randomisation and research instruments, were acceptable. Conclusions Conducting a pragmatic trial of effectiveness of a VR intervention among cancer survivors is both feasible and acceptable, but more research about the exact components of a VR intervention and choice of outcomes to measure effectiveness is required. VR to assist breast cancer patients in the return to work process is an important component of cancer survivorship plans. Trial registration ISRCTN29666484
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Affiliation(s)
- Gill Hubbard
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Highland Campus, Centre for Health Science, Old Perth Road, Inverness IV2 3JH, UK.
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Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013; 119 Suppl 11:2151-9. [DOI: 10.1002/cncr.28067] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Anja Mehnert
- Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Angela de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; Amsterdam the Netherlands
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology; Uniformed Services University of the Health Sciences; Bethesda Maryland
- Department of Preventive Medicine and Biometrics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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Noeres D, Park-Simon TW, Grabow J, Sperlich S, Koch-Gießelmann H, Jaunzeme J, Geyer S. Return to work after treatment for primary breast cancer over a 6-year period: results from a prospective study comparing patients with the general population. Support Care Cancer 2013; 21:1901-9. [DOI: 10.1007/s00520-013-1739-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 01/28/2013] [Indexed: 01/03/2023]
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Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study. J Cancer Surviv 2013; 7:191-202. [PMID: 23378060 DOI: 10.1007/s11764-012-0258-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/28/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed. METHODS We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined. RESULTS The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2-15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8-5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1-4.7), distress (OR = 3.9, 95 % CI, 1.7-9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1-6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group. CONCLUSIONS Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.
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Arm morbidity and sick leave among working women shortly after breast cancer surgery. Eur J Oncol Nurs 2013; 17:101-6. [DOI: 10.1016/j.ejon.2012.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/14/2012] [Accepted: 05/15/2012] [Indexed: 11/17/2022]
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Abstract
Breast cancer and return to work (RTW) is a global issue affected by many factors. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) can be used to address disease/treatment, person and work related factors that can impact the RTW process for breast cancer survivors. The work environment, treatment and sociodemographic factors can affect the timeliness of RTW. While conventional treatment methods are critical for survival, there are other strategies that may provide comfort and relief that can improve functioning in the workplace. Although the number of studies addressing this is increasing, certain issues such as differences in RTW rates, RTW needs and accountability need further investigation. A thorough understanding of the independent and combined effects of disease/treatment, work and person related factors can assist in the appropriate implementation of RTW strategies for breast cancer survivors. For many breast cancer survivors, returning to work is used as a gauge of healing and control over breast cancer, providing encouragement for the future.
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van Muijen P, Weevers N, Snels I, Duijts S, Bruinvels D, Schellart A, van der Beek A. Predictors of return to work and employment in cancer survivors: a systematic review. Eur J Cancer Care (Engl) 2012; 22:144-60. [DOI: 10.1111/ecc.12033] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - I.A.K. Snels
- Dutch Workers Insurance Authority; Amsterdam; the Netherlands
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Rick O, Kalusche EM, Dauelsberg T, König V, Korsukéwitz C, Seifart U. Reintegrating cancer patients into the workplace. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:702-8. [PMID: 23264814 DOI: 10.3238/arztebl.2012.0702] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023]
Abstract
BACKGROUND In Germany at present, 64% of women and 59% of men who receive a diagnosis of cancer are still alive five years later. 45% of men and 57% of women with cancer are still of working age. Cancer can markedly harm their ability to work. METHODS We analyzed data from selected publications to calculate the percentage of cancer patients in Germany who are now returning to work. RESULTS The efficacy of oncological rehabilitation has not been demonstrated by a randomized controlled trial, nor is it clear whether the existing studies have accounted for potentially confounding variables. A combined assessment of reports from various countries reveals that 63% of cancer patients who are of working age go back to work after being unable to work for an average of five months. The situation varies markedly across countries: In Germany, the percentage of women with breast cancer who return to work is only 59%, compared to 80% in the USA and 82% in the United Kingdom. Younger and better educated patients are more likely to return to work, as are those who have received less invasive treatment with fewer complications. CONCLUSION Most cancer patients of working age go back to work, but the percentages vary widely from one country to another, perhaps reflecting differences in social systems.
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Hedayati E, Johnsson A, Alinaghizadeh H, Schedin A, Nyman H, Albertsson M. Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment. Scand J Caring Sci 2012; 27:380-7. [DOI: 10.1111/j.1471-6712.2012.01046.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Høyer M, Nordin K, Ahlgren J, Bergkvist L, Lambe M, Johansson B, Lampic C. Change in working time in a population-based cohort of patients with breast cancer. J Clin Oncol 2012; 30:2853-60. [PMID: 22778312 DOI: 10.1200/jco.2011.41.4375] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We examined changes in working time 16 months after a breast cancer diagnosis and identified factors associated with job discontinuation and/or decreased working time. PATIENTS AND METHODS This was a population-based cohort study with 735 patients identified in the Regional Breast Cancer Quality Register of Central Sweden. The study sample consisted of 505 women (age < 63 years at diagnosis) who completed questionnaires at baseline and at follow-up (on average 4 and 16 months after diagnosis, respectively). Clinical register data and questionnaire data on sociodemographic factors were obtained at baseline. Self-reported work-related data were obtained at follow-up. Odds ratios were estimated by using logistic regression models. RESULTS Compared with prediagnosis working time, 72% reported no change in working time, 2% reported an increase, 15% reported a decrease, and 11% did not work at follow-up. Chemotherapy increased the likelihood (odds ratio [OR], 2.45; 95% CI, 1.38 to 4.34) of job discontinuation/decreased working time. Among chemotherapy recipients, associated factors included full-time work prediagnosis (OR, 3.25; 95% CI, 1.51 to 7.01), cancer-related work limitations (OR, 5.26; 95% CI, 2.30 to 12.03), and less value attached to work (OR, 3.69; 95% CI, 1.80 to 7.54). In the nonchemotherapy group, older age (OR, 1.09; 95% CI, 1.02 to 1.17) and less value attached to work (OR, 5.00; 95% CI, 2.01 to 12.45) were associated with the outcome. CONCLUSION The majority of women treated for breast cancer returned to their prediagnosis working time. Chemotherapy and cancer-related work limitations are important factors to take into account in identifying women in need of support. Moreover, it is important to consider the woman's own valuation of labor market participation.
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Affiliation(s)
- Marie Høyer
- Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden.
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Lilliehorn S, Hamberg K, Kero A, Salander P. Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women. Scand J Caring Sci 2012; 27:267-74. [DOI: 10.1111/j.1471-6712.2012.01026.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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