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Buresti G, Rondinone BM, Valenti A, Boccuni F, Fortuna G, Iavicoli S, Cristina Dentici M, Persechino B. Measures of Work-life Balance and Interventions of Reasonable Accommodations for the Return to Work of Cancer Survivors: A Scoping Review. Saf Health Work 2024; 15:255-262. [PMID: 39309276 PMCID: PMC11410488 DOI: 10.1016/j.shaw.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 09/25/2024] Open
Abstract
Background Nearly half of patients diagnosed with cancer are in the middle of their traditional working age. The return to work after cancer entails challenges because of the cancer or treatments and associated with the workplace. The study aimed at providing more insight into the occupational outcomes encountered by workers with cancer and to provide interventions, programs, and practices to support their return to work. Methods A scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review guidelines. Relevant studies were systematically searched in PubMed/MEDLINE, SCOPUS and Grey literature from 01 January 2000 to 22 February 2024. Results The literature search generated 3,017 articles; 53 studies were considered eligible for this review. Most of the studies were longitudinal and conducted in Europe. Three macroarea were identified: studies on the impact of cancer on workers in terms of sick leave, employment, return to work, etc.; studies reporting wider issues that may affect workers, such as the compatibility of treatment and work and employment; studies reporting interventions or policies aiming to promote the return to work. Conclusion There is a lack in the literature in defining multidisciplinary interventions combining physical, psycho-behavioural, educational, and vocational components that could increase the return-to-work rates. Future studies should focus on interdisciplinary return to work efforts with multiple stakeholders with the involvement of an interdisciplinary teamwork (healthcare workers and employers) to combine these multidisciplinary interventions at the beginning of sick leave period.
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Affiliation(s)
- Giuliana Buresti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Bruna Maria Rondinone
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Antonio Valenti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Fabio Boccuni
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Grazia Fortuna
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | | | - Maria Cristina Dentici
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
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Zhang N, Yang F, Di W, Wang S, Wu Z. Predictors of return to work among postoperative patients with colorectal cancer. Clin Rehabil 2024:2692155241264773. [PMID: 39056105 DOI: 10.1177/02692155241264773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
OBJECTIVE To describe the status of return to work and identify predictors of return to work among Chinese postoperative patients with colorectal cancer. DESIGN A cross-sectional study. SETTING Conducted in two tertiary hospitals in China. PARTICIPANTS A total of 210 postoperative patients with colorectal cancer were included in the study. MAIN MEASURES Two hundred and ten postoperative patients with colorectal cancer who were working at the time of their diagnosis were assessed with the Perceived Social Support Scale, the Return-To-Work Self-Efficacy Questionnaire, Kessler Psychological Distress Scale, Cancer Fatigue Scale, and Social Impact Scale. Descriptive statistics, univariate logistic regression analysis, and multivariate logistic regression analysis were used for data analysis in SPSS 26.0. RESULTS Around a third of participants (n = 74, 35.2%) returned to work after surgery. Multiple stepwise regression analysis indicated that more family income (odds ratio (OR) = 5.769, 95% confidence interval (CI) = 1.666-19.972), time span after surgery 5-10 months, and ≥10 months (OR = 3.546, 95% CI = 1.084-11.598; OR = 3.077, 95% CI = 1.074-8.818), with a stoma (OR = 0.221, 95% CI = 0.075-0.653), psychological distress (OR = 0.912, 95% CI = 0.843-0.987), cancer fatigue (OR = 0.924, 95% CI = 0.872-0.978), and stigma (OR = 0.928, 95% CI = 0.886-0.971) were significantly associated with return to work. CONCLUSIONS A high proportion of patients with colorectal cancer did not return to work within 1 year after diagnosis. Those with shorter postoperative time, lower family income, stoma, greater psychological stress, higher level of cancer fatigue, and more stigma may have a higher risk in delayed work resumption.
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Affiliation(s)
- Ning Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, China
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Fan Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Wenlong Di
- School of Nursing, China Medical University, Shenyang, Liaoning Province, China
| | - Shujie Wang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, China
| | - Zijing Wu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, China
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Andersen JL, Johansen JS, Urbanska EM, Meldgaard P, Hjorth-Hansen P, Kristiansen C, Stelmach M, Santoni-Rugiu E, Ulhøi MP, Højgaard B, Jensen MS, Dydensborg AB, Dünweber C, Hansen KH. Lung cancer patients with anaplastic lymphoma kinase rearrangement lose affiliation with labor market at diagnosis. Lung Cancer Manag 2024; 13:LMT68. [PMID: 38818369 PMCID: PMC11137781 DOI: 10.2217/lmt-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Accepted: 02/21/2024] [Indexed: 06/01/2024] Open
Abstract
Aim: The main purpose of the present study was to investigate the labor market affiliation of ALK+ NSCLC patients in long-term treatment as well as overall survival and incidence/prevalence. Materials & methods: Nationwide retrospective study of all patients with ALK+ NSCLC in Denmark diagnosed between 2012 and 2018. Results: During the study period ALK+ NSCLC patients had a median overall survival of 44.0 months and a 7.8-fold increase in disease prevalence. Six months prior to diagnosis, 81% of ALK+ NSCLC patients ≤60 years of age were employed. At the end of the 18-month follow-up period, 36% were employed. Conclusion: ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market.
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Affiliation(s)
| | - Jakob Sidenius Johansen
- Department of Oncology, Herlev & Gentofte University Hospital, DK-2730, Herlev, Denmark
- Present address: Employment with Dept. of Oncology, Herlev & Gentofte University hospital, DK-2730, Herlev, Denmark, Denmark ended during the writing of the article
| | - Edyta Maria Urbanska
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, DK-2100, Copenhagen, Denmark
| | - Peter Meldgaard
- Department of Oncology, Aarhus University Hospital, DK-8000, Aarhus, Denmark
| | - Peter Hjorth-Hansen
- Department of Oncology, Aalborg University Hospital, DK-9000, Aalborg, Denmark
| | - Charlotte Kristiansen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, DK-7100, Vejle, Denmark
| | | | - Eric Santoni-Rugiu
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, DK-2100, Copenhagen, Denmark
| | - Maiken Parm Ulhøi
- Department of Oncology, Aarhus University Hospital, DK-8000, Aarhus, Denmark
| | - Betina Højgaard
- VIVE, Copenhagen, Denmark (The Danish Center for Social Science Research), DK-1052, Copenhagen, Denmark
- Present address: Steno Diabetes Center, DK-2730, Herlev, Denmark
| | - Morten Sall Jensen
- VIVE, Aarhus, Denmark (The Danish Center for Social Science Research), DK-8230, Åbyhøj, Denmark
- Present address: Novo Nordisk, Søborg, DK-2860, Denmark
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Brink E, Pilegaard MS, Bonnesen TG, Nielsen CV, Pedersen P. Employment status in cancer patients the first five years after diagnosis-a register-based study. J Cancer Surviv 2024:10.1007/s11764-024-01576-5. [PMID: 38587762 DOI: 10.1007/s11764-024-01576-5] [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: 12/07/2023] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Work is important for identity formation, social status, and economic independency. Although some evidence within the field of work and cancer survivorship exists, no study has so far investigated employment status across all cancer diagnoses. Thus, the aim of the present study was to investigate the impact of all cancer diagnoses on employment status. METHODS Danish cancer patients aged 20-60 years, diagnosed between 2000 and 2015, were identified through Danish registers and matched 1:5 with cancer-free controls. Logistic and linear regression was performed separately in 11 cancer types to assess and compare work status and work participation between cancer patients and cancer-free controls one, three, and five years after diagnosis. RESULTS A total of 111,770 cancer patients and 507,003 cancer-free controls were included. All cancer types had lower chances of working one year after diagnosis (ORs between 0.05 and 0.76), with lung, colorectal, upper gastrointestinal, and blood cancer patients having the lowest chances. After three years, 10 of 11 cancer types had lower chances (ORs between 0.39 and 0.84). After five years, there were minimal differences between cancer patients and controls among most cancer types (ORs between 0.75 and 1.36). CONCLUSION Most cancer patients had lower chances of working compared with the general population until five years after diagnosis. However, patients with certain cancer types experienced lower chances of working all years, despite improvement over time. IMPLICATIONS FOR CANCER SURVIVORS The knowledge will help increase awareness on challenges regarding work-life after cancer. Furthermore, the distinguishing between diagnoses can inform to more targeted vocational rehabilitation.
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Affiliation(s)
- E Brink
- Department of Public Health, Aarhus University, Aarhus, Denmark.
- DEFACTUM, Central Denmark Region, Aarhus, Denmark.
| | - M S Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - T G Bonnesen
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - C V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - P Pedersen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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Korošec D, Vrbnjak D, Štiglic G. Prevalence of mental disorders and high rates of absenteeism from work among healthcare professionals in Slovenia: a retrospective study. BMJ Open 2023; 13:e075718. [PMID: 38070887 PMCID: PMC10729225 DOI: 10.1136/bmjopen-2023-075718] [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] [Received: 05/22/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020. DESIGN Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants). SETTING National databases of the National Institute of Public Health in Slovenia. PARTICIPANTS All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020. RESULTS The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses. CONCLUSION The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.
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Affiliation(s)
- Darja Korošec
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- University of Edinburgh, Usher Institute, Edinburgh, UK
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Schneider J, Hernandez D, Schlander M, Arndt V. Out-of-pocket payments and loss of income among long-term breast cancer survivors in Germany: a multi-regional population-based study. J Cancer Surviv 2023; 17:1639-1659. [PMID: 36459378 PMCID: PMC10539192 DOI: 10.1007/s11764-022-01293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE This study aims to examine the magnitude of out of pocket (OOP) payments and income loss, as well as to identify socioeconomic and clinical factors among long-term breast cancer (BC) survivors in Germany. METHODS We examine data from 2654 long-term BC survivors in Germany that participated in the "CAncEr Survivorship - A multi-Regional population-based study" (CAESAR) and who were at least 5 years post diagnosis. BC-related OOP payments and income loss both within the 12 months prior to the survey were analyzed. Two-part regression models were performed to identify socioeconomic and clinical factors. RESULTS OOP payments were incurred by 51.9% of survivors with a total mean spending of 566 euros. Income loss was present among 9.6% of survivors and averaged 5463 euros among those reporting such. Socioeconomic and clinical factors associated with higher OOP payments (p ≤ 0.05) included age at time of diagnosis (65-79 years), education (10-11 years), (early) retirement, stage of diagnosis (stage III), time from diagnosis (more than 10 years), comorbidities (at least 1), and the use of rehabilitation services. Regarding income loss, age at time of diagnosis (50-59 years), (early) retirement, stage of diagnosis (stage II), time from diagnosis (5-7 years), comorbidities (at least 1), and receiving chemotherapy treatment were associated with higher losses. CONCLUSIONS For some survivors in Germany, financial burden can be considerably high despite comprehensive healthcare and support from social security. IMPLICATIONS FOR CANCER SURVIVORS OOP payments related to domestic help and nursing staff as well as to outpatient care are most frequent.
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Affiliation(s)
- Jana Schneider
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Diego Hernandez
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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7
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Bencina G, Chami N, Hughes R, Weston G, Baxter C, Salomonsson S, Demedts I. Indirect Costs Due to Lung Cancer-Related Premature Mortality in Four European Countries. Adv Ther 2023; 40:3056-3069. [PMID: 37195488 PMCID: PMC10189212 DOI: 10.1007/s12325-023-02509-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/28/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Lung cancer accounts for approximately 20% of all cancer-related deaths and for the loss of 3.2 million disability-adjusted life years (DALYs) annually across Europe. The present study investigated the productivity losses resulting from premature deaths due to lung cancer in four European countries. METHODS The human capital approach (HCA) was used to estimate indirect cost of productivity losses due to premature death due to lung cancer (ICD-10 codes C33-34 malignant neoplasm of trachea, bronchus, and lung) in Belgium, the Netherlands, Norway, and Poland. Years of productive life lost (YPLL) and present value of future lost productivity (PVFLP) were calculated using national age-specific mortality, wages, and employment rates. Data were sourced from the World Health Organization, Eurostat, and the World Bank. RESULTS In 2019, there were 41,468 lung cancer deaths in the included countries resulting in 59,246 YPLL and more than €981 million in productivity losses due to premature mortality. From 2010 to 2015, the PVFLP of lung cancer decreased by 14% in Belgium, 13% in the Netherlands, 33% in Norway, and 19% in Poland. From 2015 to 2019, the PVFLP of lung cancer decreased by 26% in Belgium, 27% in the Netherlands, 14% in Norway, and 38% in Poland. CONCLUSION The results from this study illustrate a decreasing trend in productivity costs of premature mortality due to lung cancer, as illustrated by the decreasing PVFLP between 2010 and 2019. This trend could be driven by a shift in the distribution of deaths towards older age groups due to advancements in the preventative and treatment landscape. These results provide an economic measure of the lung cancer burden which may assist decision-makers in allocating scarce resources amongst competing priorities in the included countries.
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Affiliation(s)
- Goran Bencina
- Center for Observational and Real-World Evidence, MSD Spain, Madrid, Spain
| | | | | | | | | | - Stina Salomonsson
- MSD, Center for Observational and Real-World Evidence, Stockholm, Sweden
| | - Ingel Demedts
- Department of Pulmonary Diseases, AZ Delta, Roeselare, Belgium
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8
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Zapata Bonilla SA, Fried M, Singer S, Hentschel L, Richter S, Hohenberger P, Kasper B, Andreou D, Pink D, Arndt K, Bornhäuser M, Schmitt J, Schuler MK, Eichler M. Working situation and burden of work limitations in sarcoma patients: results from the multi-center prospective PROSa study. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04556-3. [PMID: 36624191 PMCID: PMC10356622 DOI: 10.1007/s00432-022-04556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE We investigated predictors of limitations in work performance, odds of drop out of work, and odds of receiving disability pension in sarcoma patients. METHODS We measured clinical and sociodemographic data in adult sarcoma patients and recorded if the patients received a (1) disability pension at baseline or (2) had dropped out of work 1 year after initial assessment. (3) Work limitations were assessed using the Work-limitations questionnaire (WLQ©). We analyzed exploratively. RESULTS (1) Amongst 364 analyzed patients, odds to receive a disability pension were higher in patients with abdominal tumors, older patients, high grade patients and with increasing time since diagnosis. (2) Of 356 patients employed at baseline, 21% (n = 76) had dropped out of work after 1 year. The odds of dropping out of work were higher in bone sarcoma patients and in patients who received additive radiotherapy ± systemic therapy compared with patients who received surgery alone. Odds of dropping out of work were less amongst self-employed patients and dropped with increasing time since diagnosis. (3) Work limitations were higher in woman and increased with age. Patients with bone and fibrous sarcomas were more affected than liposarcoma patients. Patients with abdominal tumors reported highest restrictions. Sarcoma treatment in the last 6 months increased work limitations. CONCLUSION Work limitations, drop out of work and dependence on a disability pension occurs frequently in patients with sarcoma adding to the burden of this condition. We were able to identify vulnerable groups in both the socioeconomic and disease categories.
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Affiliation(s)
- Sergio Armando Zapata Bonilla
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany.
| | - Marius Fried
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany
| | - Susanne Singer
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Hospital Mainz, Mainz, Germany
| | - Leopold Hentschel
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - Stephan Richter
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Peter Hohenberger
- Division of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany
| | - Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Dimosthenis Andreou
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Munster, Munster, Germany.,Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Daniel Pink
- Sarcoma Center Berlin-Brandenburg, Helios Hospital Bad Saarow, Brandenburg, Germany.,Department of Internal Medicine C, University Hospital Greifswald, Greifswald, Germany
| | - Karin Arndt
- German Sarcoma Foundation, Woelfersheim, Germany
| | - Martin Bornhäuser
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Jochen Schmitt
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU, Dresden, Germany
| | - Markus K Schuler
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Martin Eichler
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
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9
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Chen KB, Yen T, Sun W, Tevaarwerk AJ, Wiegmann DA, Heidrich SM, Sesto ME. Usage of a Web-Based Workplace and Symptom Self-Management Intervention Tool to Improve Work Ability for Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1824-1833. [PMID: 34476769 DOI: 10.1007/s13187-021-02048-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 06/13/2023]
Abstract
This work aimed to evaluate the usage of a web-based intervention (WISE: Work ability Improvement through Symptom and Ergonomic strategies) developed to improve work ability for women recently diagnosed with breast cancer. Twenty-two women undergoing adjuvant treatment for breast cancer were provided access to WISE. This website includes content pages (e.g., information on ergonomics, symptom management, and other work-related resources) and worksheets (e.g., journals to track symptoms or goals). It could be personalized based on individual work activities and symptoms. Measures assessed at 3 months included usage of the website and perceived usefulness. Thirteen of the 22 participants (60%) accessed WISE; 11 personalized their information. Content and worksheet pages had 97 and 79 visits, respectively. Most frequently visited pages were "setting goals" (i.e., prioritize and track symptoms; 45 visits) and "steps to creating your WISE plan" (i.e., incorporate symptom and ergonomic strategies; 16 visits). Median duration time was 11.05 (range 0.35-79.55) minutes. Usefulness of the content and worksheet pages assessed via a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree) was 5.08 (SD = 1.59) and 4.26 (SD = 2.03), respectively. Participants were likely to recommend WISE to other women undergoing cancer treatment (mean = 6.11; SD = 1.05). The majority of participants personalized WISE work and symptom strategies. Overall, participants agreed that WISE content pages were useful and would recommend WISE for other breast cancer survivors. Results support that majority of breast cancer survivors, undergoing treatment with curative intent, accessed a web-based intervention that provided personalized information on workplace and symptom strategies.
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Affiliation(s)
- Karen B Chen
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, Fitts-Woolard Hall, 915 Partners Way, Raleigh, NC, 27695, USA.
| | - Thomas Yen
- Department of Industrial and Systems Engineering, University of Wisconsin, Engineering Centers Building, 1550 Engineering Drive, Madison, WI, 53706, USA
| | - Wenjun Sun
- Department of Industrial and Systems Engineering, University of Wisconsin, Engineering Centers Building, 1550 Engineering Drive, Madison, WI, 53706, USA
| | - Amye J Tevaarwerk
- Department of Medicine, University of Wisconsin Carbone Cancer Center, 6037 Wisconsin Institute Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Douglas A Wiegmann
- Department of Industrial and Systems Engineering, University of Wisconsin, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA
| | - Susan M Heidrich
- School of Nursing, Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Mary E Sesto
- Department of Medicine, School of Medicine and Public Health, 6057 Wisconsin Institute Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
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10
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de Boer AGEM, de Wind A, Coenen P, van Ommen F, Greidanus MA, Zegers AD, Duijts SFA, Tamminga SJ. Cancer survivors and adverse work outcomes: associated factors and supportive interventions. Br Med Bull 2022; 145:60-71. [PMID: 36372773 PMCID: PMC10075241 DOI: 10.1093/bmb/ldac028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH Recent developments are tailored and timely interventions.
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Affiliation(s)
- Angela G E M de Boer
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Astrid de Wind
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Pieter Coenen
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Fenna van Ommen
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Michiel A Greidanus
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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11
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Ma S, Olchanski N, Cohen JT, Ollendorf DA, Neumann PJ, Kim DD. The Impact of Broader Value Elements on Cost-Effectiveness Analysis: Two Case Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1336-1343. [PMID: 35315331 DOI: 10.1016/j.jval.2022.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/29/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to explore the impact of including broader value elements in cost-effectiveness analyses by presenting 2 case studies, one on human papillomavirus (HPV) infection and one on early-stage Hodgkin's lymphoma (ESHL). METHODS We identified broader value elements (eg, patient and caregiver time, spillover health effects, productivity) from the Second Panel's Impact Inventory and the ISPOR Special Task Force's value flower. We then evaluated the cost-effectiveness of HPV vaccination versus no vaccination (case 1) and combined modality therapy (CMT) versus chemotherapy alone for treatment of adult ESHL (case 2) using published simulation models. For each case study, we compared incremental cost-effectiveness ratios considering health sector impacts only (the "base-case" scenario) with incremental cost-effectiveness ratios incorporating broader value elements. RESULTS For vaccination of US girls against HPV before sexual debut versus no vaccination, the base-case result was $38 334 per disability-adjusted life-year averted. Including each broader value element made cost-effectiveness progressively more favorable, with HPV vaccination becoming cost-saving (ie, reducing costs and averting more disability-adjusted life-years) when the analysis incorporated productivity costs. For CMT versus chemotherapy alone in patients with ESHL, the base-case result indicated that CMT was cost-saving. Including all elements made this treatment's net monetary benefits (the sum of its averted resource costs and the net value of its health impacts) less favorable, even as the contribution from CMT's near-term health benefits grew. CONCLUSIONS Including broader value elements can substantially influence cost-effectiveness ratios, although the direction and the magnitude of their impact can differ across interventions and disease context.
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Affiliation(s)
- Siyu Ma
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
| | - Natalia Olchanski
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Joshua T Cohen
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Daniel A Ollendorf
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Peter J Neumann
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - David D Kim
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
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12
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Petersen KS, Madsen LS, Nielsen CV, Labriola M, Stapelfeldt CM. "To have and then lose the safety net" - Female cancer survivors' experiences of the process of becoming ready to return to work. Work 2021; 70:1121-1130. [PMID: 34864711 DOI: 10.3233/wor-213623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Validation studies have not been able to confirm the stage-specific understanding as operationalised in the readiness for return to work (RRTW) questionnaire. OBJECTIVE To explore retrospectively how working female cancer survivors experienced the process of becoming ready to RTW during and beyond participation in an occupational rehabilitation intervention and thereby expand the understanding of the RRTW construct. METHODS A qualitative research design was employed. Thirteen female cancer survivors were included for semi-structured interviews one to two years after they had completed active treatment and returned to work. The RRTW construct guided data generation and analysis. Content analysis was performed in four analytical steps that combined a concept-driven and a data-driven analytic strategy. RESULTS Three themes were identified; "To have and then lose the safety net", "Realise a changed life situation", "Strive to balance work and everyday life". In a time span of approximately one to two years (from receiving treatment, being enrolled in an intervention and to gradually returning to work); the identified themes were interdependent of each other as one theme gradually evolved to the next theme in the process of engaging in sustained work participation. CONCLUSIONS The present study points towards continuous development of the RRTW construct and whether the addition of a preparedness dimension would improve validity.
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Affiliation(s)
- K S Petersen
- Department of Health Science and Technology, Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - L S Madsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark
| | - C V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark.,Regional Hospital West Jutland, Herning, Denmark
| | - M Labriola
- Norwegian Research Centre (NORCE), Bergen, Norway
| | - C M Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark
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13
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Factors associated with returning to work and work ability of colorectal cancer survivors. Support Care Cancer 2021; 30:2349-2357. [PMID: 34743239 DOI: 10.1007/s00520-021-06638-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of this current study was to describe the status of returning to work and work ability of colorectal cancer survivors and identify the key factors associated with returning to work and work ability of Chinese colorectal cancer patients. METHODS A cross-sectional observational study was performed in 212 colorectal cancer survivors who have worked before their colorectal cancer diagnosis. We evaluated patient's return to work (Yes/No), work ability, and factors by questionnaires of the Work Ability Index (WAI), M. D. Anderson Symptom Inventory for Gastrointestinal (MDASI-GI), and the Self-Report Psychosocial Adjustment to Illness Scale (PAIS-SR). Logistic regression analysis and linear regression were used to find the potential predictors with returning to work and work ability. RESULTS Participants mostly 145 have returned to work (68.4%). Work ability and psychosocial adjustment of colorectal cancer survivors were at a moderate level. After completing treatment, the patient still had many symptoms, and these symptoms were distress to live. In the two models, survivors with higher family monthly income per capita and lower psychosocial adjustment scores were more likely to have higher work ability and return to work. Survivors with lower symptom distress were more likely to have higher work ability (r = - 0.038, p = 0.010). Survivors with higher work ability were more likely to return to work (OR = 1.193, 95% CI = (1.116,1.274)). CONCLUSION This study confirmed that symptom distress and psychosocial adjustment were significantly associated with colorectal cancer survivors' returning to work and work ability, which should be considered in future intervention research.
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14
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Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period. Sci Rep 2021; 11:12858. [PMID: 34145368 PMCID: PMC8213801 DOI: 10.1038/s41598-021-92306-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022] Open
Abstract
Due to advances in medical science and technology, the number of cancer survivors continues to increase. The workplace needs and employment difficulties cancer survivors face after treatment need to be addressed to protect these individuals’ right to work and to maintain the overall labor force of the country. We conducted a retrospective cohort study with a follow-up period from 2004 to 2010. All data analyzed in the study were obtained from the Labor Insurance Database, the Taiwan Cancer Registry of the Ministry of Health and Welfare, and the National Health Insurance Research Database. The relationships between risk factors and the presence of returning to work were analyzed by a Cox proportional hazard model. The survival rates of patients with different cancer stages were evaluated using Kaplan–Meier survival analysis. Among the employees with an initial diagnosis of cancer, 70.4% remained employed through 1 year after the diagnosis, accounting for 83.4% of all cancer survivors; only 51.1% remained employed through 5 years after the diagnosis, accounting for 78.7% of all cancer survivors, a notable decrease. Age, gender, salary, treatment method, company size, and cancer stage were the factors that affected whether employees could return to work or not. The long-term survival of people diagnosed with cancer depends on their chances of returning to work. Strengthening existing return-to-work policies and assisting cancer survivors with returning to work after the treatment should be priorities for protecting these individuals’ right to work and for maintaining the overall labor force.
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15
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Hernandez D, Schlander M. Income loss after a cancer diagnosis in Germany: An analysis based on the socio-economic panel survey. Cancer Med 2021; 10:3726-3740. [PMID: 33973391 PMCID: PMC8178494 DOI: 10.1002/cam4.3913] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS Cancer treatments often require intensive use of healthcare services and limit patients' ability to work, potentially causing them to become financially vulnerable. The present study is the first attempt to measure, on the German national level, the magnitude of absolute income loss after a cancer diagnosis. METHODS This study analyzes data from the Socio-Economic Panel (SOEP) survey, one of the largest and most comprehensive household surveys in Germany, consisting of approximately 20,000 individuals, who are traced annually. The empirical strategy consists of ordinary least squares (OLS) and multinomial logistic estimators to measure changes in job income, work status, working hours, and pension as a result of reporting a cancer diagnosis for the period between 2009 and 2015. Sample consistency checks were conducted to limit measurement error biases. RESULTS Our results show that job incomes dropped between 26% and 28% within the year a cancer diagnosis was reported. The effect persisted for two years after the diagnosis and was no longer observable after four years. The finding was linked to an increased likelihood of unemployment and a reduction of working hours by 24%. Pension levels, on the other hand, were not affected by a cancer diagnosis. CONCLUSIONS These findings suggest that many cancer patients are exposed to financial hardship in Germany, particularly when the cancer diagnosis occurs during their working age and before requirements to obtain a pension are met. Further research seems warranted to identify particularly vulnerable patient groups.
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Affiliation(s)
- Diego Hernandez
- Division of Health EconomicsGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Michael Schlander
- Division of Health EconomicsGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
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16
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Endo M. How do gynecologists face to social problems among women cancer survivors? J Obstet Gynaecol Res 2021; 47:1651-1653. [PMID: 33763951 DOI: 10.1111/jog.14703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/18/2021] [Accepted: 01/30/2021] [Indexed: 12/28/2022]
Abstract
In recent decades, surgical techniques, new anticancer drugs' development, and radiation equipment have led to continuous improvements in cancer survival rates and quality of life of cancer survivors (CSs). While 61.0% of gynecological cancer survivors (GCS) in Japan belonged to a working-age group (20-64 years old), the number of working GCS within the working-age population has increased. In Japan, it seems that there has been more interest in striking a balance between cancer treatment and work, especially since 2016 when the Cancer Control Act was amended and national guidelines for working CSs were published. Maintaining employment after gynecological cancer diagnosis remains an important issue for not only GCS and their families but also employers and society. GCS suffered from various symptoms including cancer-related fatigue, pain, menopausal symptoms, lymphedema, and psychological distress, which made maintaining employment difficult for them. Full return to work (RTW) rate at 365 days after the initial days of sick leave among was 77.6% and median time to full RTW among GCSs was 172 days. Five-year work continuance rate after RTW among GCSs was 63.4%. It is better for gynecologists to write a certificate for workplace in words of not "symptoms," but "caseness words (such as, workable as long as it is sedentary or clerical work. Partial RTW (4-h work, 6-h work) might be desirable for a while after RTW," in order to support GCSs' maintaining employment.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
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17
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Nishiura C, Inoue Y, Kashino I, Nanri A, Endo M, Eguchi M, Kochi T, Kato N, Shimizu M, Imai T, Nishihara A, Yamamoto M, Okazaki H, Tomita K, Miyamoto T, Yamamoto S, Nakagawa T, Honda T, Ogasawara T, Sasaki N, Hori A, Kabe I, Mizoue T, Dohi S. Diagnosis-specific cumulative incidence of return-to-work, resignation, and death among long-term sick-listed employees: Findings from the Japan Epidemiology Collaboration on Occupational Health Study. J Epidemiol 2021; 32:431-437. [PMID: 33716270 PMCID: PMC9359901 DOI: 10.2188/jea.je20200541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away. Methods We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012–2013 among employees of 11 Japanese private companies (n = 1,209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis. Results During the 3.5-year period (follow-up rate: 99.9%), 1,014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00–F99) to 95.3% for circulatory diseases (I00–I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00–D48), of which the cumulative incidence of death reached 14.2% by 1.5 years. Conclusion Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.
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Affiliation(s)
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Ikuko Kashino
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Akiko Nanri
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University
| | - Motoki Endo
- Department of Public Health, Juntendo University Graduate School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ai Hori
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
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18
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Returning to work in lung cancer survivors-a multi-center cross-sectional study in Germany. Support Care Cancer 2020; 29:3753-3765. [PMID: 33211206 PMCID: PMC8163665 DOI: 10.1007/s00520-020-05886-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022]
Abstract
Purpose To investigate the work situation of lung cancer survivors and to identify the factors associated with their returning to work. Methods Descriptive analysis and logistic regression were used to evaluate study population characteristics and independent factors of subsequently returning to work. To analyze time to return to work, Cox regression was used. Results The study sample included 232 lung cancer survivors of working age from 717 enrolled participants in the multi-center cross-sectional LARIS (Quality of Life and Psychosocial Rehabilitation in Lung Cancer Survivors) study. About 67% of the survivors were not employed during the survey. More than 51% of the survivors who were employed before their illness did not return to their work. The survivors who had returned to their careers were younger, associated with higher household income, lower fatigue score, and stable relationship and vocational training. Patients who received social service counseling showed a higher chance of regaining their career. Conclusions Lung cancer survivors were found to be associated with a high risk of unemployment and very low professional reintegration after interruption due to illness. More comprehensive studies are needed to support lung cancer survivors and targeting of patients in need of special attention in rehabilitation that would benefit from the findings in the present study. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-020-05886-z.
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19
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Engan HK, Oldervoll LM, Bertheussen GF, Gaarder MH, Nielsen RA, Paraponaris A, Stene GB, Sandmæl JA, Tandstad T, Torp S. Long-term work outcomes and the efficacy of multidisciplinary rehabilitation programs on labor force participation in cancer patients - a protocol for a longitudinal prospective cohort study. J Public Health Res 2020; 9:1739. [PMID: 33381469 PMCID: PMC7753323 DOI: 10.4081/jphr.2020.1739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background. Many cancer survivors experience late effects of cancer treatment and therefore struggle to return to work. Norway provides rehabilitation programs to increase labor force participation for cancer survivors after treatment. However, the extent to which such programs affect labor force participation has not been appropriately assessed. This study aims to investigate i) labor force participation, sick leave and disability rates among cancer survivors up to 10 years after being diagnosed with cancer and identify comorbidities contributing to long-term sick leave or disability pensioning; ii) how type of cancer, treatment modalities, employment sectors and financial- and sociodemographic factors may influence labor force participation; iii) how participation in rehabilitation programs among cancer survivor affect the longterm labor force participation, the number of rehospitalizations and incidence of comorbidities. Design and methods. Information from four medical, welfare and occupational registries in Norway will be linked to information from 163,279 cancer cases (15.68 years old) registered in the Norwegian Cancer Registry from 2004 to 2016. The registries provide detailed information on disease characteristics, comorbidities, medical and surgical treatments, occupation, national insurance benefits and demographics over a 10-year period following a diagnosis of cancer. Expected impact of the study for Public Health. The study will provide important information on how treatment, rehabilitation and sociodemographic factors influence labor force participation among cancer survivors. Greater understanding of work-related risk factors and the influence of rehabilitation on work-participation may encourage informed decisions among cancer patients, healthcare and work professionals and service planners.
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Affiliation(s)
| | - Line M Oldervoll
- LHL Clinics Trondheim, Norway.,Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro F Bertheussen
- Clinic for Physical Medicine and Rehabilitation, St. Olav's University Hospital, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Martine H Gaarder
- The Cancer Clinic, St. Olav's University Hospital, Trondheim, Norway
| | - Roy A Nielsen
- Fafo Institute for Labour and Social Research, Norway
| | - Alain Paraponaris
- Aix Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, Aix-Marseille School of Economics, France.,Southeastern Health Observatory (ORS PACA), Faculté de Médecine, Marseille, France
| | - Guro B Stene
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Torgrim Tandstad
- The Cancer Clinic, St. Olav's University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Steffen Torp
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Tønsberg, Norway
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20
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Louwerse I, van Rijssen HJ, Huysmans MA, van der Beek AJ, Anema JR. Predicting Long-Term Sickness Absence and Identifying Subgroups Among Individuals Without an Employment Contract. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:371-380. [PMID: 32030546 PMCID: PMC7406482 DOI: 10.1007/s10926-020-09874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Today, decreasing numbers of workers in Europe are employed in standard employment relationships. Temporary contracts and job insecurity have become more common. This study among workers without an employment contract aimed to (i) predict risk of long-term sickness absence and (ii) identify distinct subgroups of sick-listed workers. Methods 437 individuals without an employment contract who were granted a sickness absence benefit for at least two weeks were followed for 1 year. We used registration data and self-reported questionnaires on sociodemographics, work-related, health-related and psychosocial factors. Both were retrieved from the databases of the Dutch Social Security Institute and measured at the time of entry into the benefit. We used logistic regression analysis to identify individuals at risk of long-term sickness absence. Latent class analysis was used to identify homogenous subgroups of individuals. Results Almost one-third of the study population (n = 133; 30%) was still at sickness absence at 1-year follow-up. The final prediction model showed fair discrimination between individuals with and without long-term sickness absence (optimism adjusted AUC to correct for overfitting = 0.761). Four subgroups of individuals were identified based on predicted risk of long-term sickness absence, self-reported expectations about recovery and return to work, reason of sickness absence and coping skills. Conclusion The logistic regression model could be used to identify individuals at risk of long-term sickness absence. Identification of risk groups can aid professionals to offer tailored return to work interventions.
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Affiliation(s)
- Ilse Louwerse
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands.
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands.
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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21
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Zhao J, Han X, Nogueira L, Zheng Z, Jemal A, Yabroff KR. Health Insurance Coverage Disruptions and Access to Care and Affordability among Cancer Survivors in the United States. Cancer Epidemiol Biomarkers Prev 2020; 29:2134-2140. [PMID: 32868319 DOI: 10.1158/1055-9965.epi-20-0518] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/30/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lack of health insurance is associated with having problems with access to high-quality care. We estimated prevalence and evaluated associations of insurance coverage disruptions and access to health care and affordability among cancer survivors in the United States. METHODS Adult cancer survivors ages 18 to 64 years with current private or public health insurance were identified from the 2011 to 2018 National Health Interview Survey (n = 7,186). Health insurance coverage disruption was measured as self-reports of any time in the prior year without coverage. Outcomes included preventive services use, problems with care affordability, and cost-related medication nonadherence in the prior year. We used separate multivariable logistic models to evaluate associations between coverage disruptions and study outcomes by current insurance coverage. RESULTS Among currently insured survivors, 3.7% [95% confidence interval (95% CI), 3.0%-4.4%] with private, and 7.8% (95% CI, 6.5%-9.4%) with public insurance reported coverage disruptions in 2011 to 2018. We estimated that approximately 260,000 survivors ages 18 to 64 years had coverage disruptions in 2018. Among privately and publicly insured survivors, those with coverage disruptions were less likely to report all preventive services use (16.9% vs. 36.2%; 14.6% vs. 25.3%, respectively) and more likely to report any problems with care affordability (55.0% vs. 17.7%; 71.1% vs. 38.4%, respectively) and any cost-related medication nonadherence (39.4% vs. 10.1%; 36.5% vs. 16.3%, respectively) compared with those continuously insured (all P < 0.05). CONCLUSIONS Coverage disruptions in the prior year were associated with problems with health care access and affordability among currently insured survivors. IMPACT Reducing coverage disruptions may help improve access and affordability for survivors.
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Affiliation(s)
- Jingxuan Zhao
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia.
| | - Xuesong Han
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Leticia Nogueira
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Zhiyuan Zheng
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - K Robin Yabroff
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
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Endo M, Muto G, Imai Y, Mitsui K, Nishimura K, Hayashi K. Predictors of post-cancer diagnosis resignation among Japanese cancer survivors. J Cancer Surviv 2020; 14:106-113. [PMID: 31721037 DOI: 10.1007/s11764-019-00827-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE In Japan, due to the increased incidence of cancer among the working population, it has become more important to support employees to achieve a balance between cancer treatment and work. This study aimed to clarify the predictors of resigning from employment after being diagnosed with cancer (post-cancer diagnosis [PCD] resignation) among Japanese employees. METHODS As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2017. The investigators analyzed the risk factors for PCD resignation using a logistic regression model, including age at diagnosis, sex, cancer type, cancer stage, year of diagnosis, whether the patient held a managerial role, type of employment, and company size. RESULTS Of 750 employed Japanese CSs, 93 (12.4%) resigned from their jobs. The non-managers resigned more often (14.6%) than the managers (7.6%) (p = 0.007). The temporary workers exhibited the highest PCD resignation rates (22.2%), while the PCD resignation rates of the self-employed workers and permanent workers were 15.2% and 7.6%, respectively (p < 0.001). As the result of multivariate analysis, being female (odds ratio [OR], 3.67; 95%CI, 1.71-7.87), having hematological cancer (OR, 4.23; 95%CI, 1.37-13.04), having advanced cancer (OR, 2.48; 95%CI, 1.52-4.03), and being a temporary worker (OR, 2.51; 95%CI, 1.40-4.50) were identified as predictors of PCD resignation. CONCLUSIONS In total, 12.4% of Japanese employees quit their jobs after being diagnosed with cancer. Being female or a temporary worker and having advanced cancer were identified as predictors of PCD resignation. Regarding cancer type, hematological cancer was most strongly associated with PCD resignation. IMPLICATION OF CANCER SURVIVORS CSs who are females and temporary workers and have advanced cancer should be followed-up more carefully after cancer diagnosis for their work sustainability, by medical professionals, companies, and society.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Go Muto
- Department of Hygiene, Kitasato University School of Medicine, Tokyo, Japan
| | - Yuya Imai
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kiyomi Mitsui
- Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Tokyo, Japan
| | - Katsuji Nishimura
- Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Kazuhiko Hayashi
- Department of Chemotherapy and Palliative Care, Tokyo Women's Medical University Hospital, Tokyo, Japan
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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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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:701-710. [PMID: 30778742 PMCID: PMC6838305 DOI: 10.1007/s10926-019-09831-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J H A M Verbeek
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Finnish Institute of Occupational Health, Kuopio, Finland
| | - M M E M Bos
- Department of Internal Medicine, Reinier de Graaf Groep, Delft, The Netherlands
| | - G Fons
- Department of Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J E M Kitzen
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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Endo M, Haruyama Y, Muto G, Imai Y, Mitsui K, Mizoue T, Wada H, Kobashi G, Tanigawa T. Recurrent sick leave and resignation rates among female cancer survivors after return to work: the Japan sickness absence and return to work (J-SAR) study. BMC Public Health 2019; 19:1248. [PMID: 31510964 PMCID: PMC6737646 DOI: 10.1186/s12889-019-7509-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To date, there have not been any workforce-based Japanese cohort studies investigating work sustainability after return to work (RTW). The objective of this study was to investigate the post-RTW cumulative recurrent sick leave rate and cumulative resignation rate among female cancer survivors. METHODS Among Japanese employees who were registered in the Japan sickness absence and return to work (J-SAR) study, the subjects were those female employees who returned to work after sick leave due to newly clinically diagnosed cancer (C01-C99; ICD-10), based on a physician's certificate, between 2000 and 2011. The last day of the follow-up period was December 31, 2012. The recurrent sickness leave rate and resignation rate were calculated using competing risk survival analysis. RESULTS Of 223 cancer survivors, 61 took further physician-certified sick leave after their RTW. The median duration of the post-RTW work period among all cancer survivors was 10.6 years. The work continuance rates of the female cancer survivors were 83.2 and 60.4% at 1 and 5 years after they returned to work, respectively. There was a steep reduction in the work continuance rate during the first post-RTW year. There were considerable differences in the work continuance rate according to the primary cancer site. Cumulative recurrent sick leave rates of 11.8 and 28.9% were seen at 1 and 5 years after the subjects returned to work. The cumulative resignation rate was 5.0 and 10.7% at 1 and 5 years after the subjects returned to work. Most recurrent sick leave occurred in the first year after the subjects returned to work, followed by the second year. CONCLUSIONS Sixty percent of female cancer survivors were still working at 5 years after returning to work, although the work continuance rates for different types of cancer varied significantly.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo University School of Medicine, Tochigi, Japan
| | - Go Muto
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuya Imai
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Kiyomi Mitsui
- Department of Hygiene, Public Health and Preventive Medicine, Showa University, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo University School of Medicine, Tochigi, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan
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26
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Lear-Claveras A, Ubalde-Lopez M, Serra Saurina L. Labor market situation after an episode of sickness absence due to malignant neoplasia. Evidence from a Spanish cohort. BMC Public Health 2019; 19:506. [PMID: 31053064 PMCID: PMC6499967 DOI: 10.1186/s12889-019-6792-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Due to the progress in screening and cancer treatments, survivor's prognosis has improved enabling a more likely return to work. However, return to work after a cancer diagnosis may be complex because of an unbalanced health status and work demands relationship that may push them out of the labor market. The aim of this study is to assess the risk of dropping out of the labor market due to unemployment, partial retirement, and permanent disability during the year following an episode due to a malignant neoplasm compared to other non-malignant pathologies. METHODS Cohort study of 9699 workers affiliated with the Social Security System in Catalonia, who had a sickness absence episode between 2012 and 2013 due to malignant neoplasm, mental, musculoskeletal disorders, cardiovascular diseases and injuries. Competing risk regression models were applied to assess the risk of dropping out of the labor market, by calculating subhazard ratios (SHR) in both sexes. Models were adjusted for age, occupational category, type of contract, economic activity, annual median salary and duration of the SA episode as potential confounders. RESULTS Sickness absence due to malignant neoplasia represented 1.7% out of the 9699 episodes included between 2012 and 2013. Although, 80% of individuals continued working in the year following an episode due to malignant neoplasm, women showed a trend towards exiting the labor market because of partial retirement [SHR = 8.4(1.5-45.5)] and permanent disability [SHR = 5.8(1.5-22.9)] compared to non-malignant pathologies. There were no significant differences for unemployment either in women [SHR = 0.4(0.2-0.9)] and in men [SHR = 0.2(0.1-0.6)]. CONCLUSIONS Although return to work is a common pathway among cancer survivors, partial retirement and permanent disability seem to be potential pathways to exit the labor market among women.
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Affiliation(s)
- Ana Lear-Claveras
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain
| | - Monica Ubalde-Lopez
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain. .,IMIM - Parc Salut Mar, Barcelona, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Laura Serra Saurina
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain.,IMIM - Parc Salut Mar, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Arndt V, Koch-Gallenkamp L, Bertram H, Eberle A, Holleczek B, Pritzkuleit R, Waldeyer-Sauerland M, Waldmann A, Zeissig SR, Doege D, Thong MSY, Brenner H. Return to work after cancer. A multi-regional population-based study from Germany. Acta Oncol 2019; 58:811-818. [PMID: 30777496 DOI: 10.1080/0284186x.2018.1557341] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: With improving prognosis, the ability to return to work after cancer has become a realistic goal but only little is known regarding details such as sustainability, financial consequences, and potential determinants of return to work in long-term survivors in Germany. Methods: We studied return to work in a population-based sample of 1558 long-term cancer survivors, diagnosed in 1994-2004 with breast, colorectal or prostate cancer before age 60 (mean 50.1). Information regarding employment status and financial difficulties was obtained via mailed questionnaires from patients who were identified by six population-based cancer registries in Germany. Cumulative incidence of return to work was determined by time-to-event analysis with consideration of competing events. Chi2 tests and multiple logistic regression modeling were employed to identify potential sociodemographic and clinical determinants of return to work. Results: Within a mean period since diagnosis of 8.3 years, 63% of all working-age cancer survivors initially returned to their old job and another 7% took up a new job. Seventeen percent were granted a disability pension, 6% were early retired (not cancer-related), 4% became unemployed, and 1% left the job market for other reasons. Resumption of work occurred within the first 2 years after diagnosis in 90% of all returnees. Cancer-related reduction of working hours was reported by 17% among all returnees and 6% quit their job due to cancer within 5 years past return to work. The probability of return to work was strongly related with age at diagnosis, tumor stage, education, and occupational class but did not differ with respect to the tumor site, gender nor marital status. Conclusions: Most long-term survivors after breast, colorectal, or prostate cancer of working-age are able to return to work. However, financial problems might arise due to a reduction in working hours. An additional provision of targeted interventions for high-risk groups should be discussed.
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Affiliation(s)
- Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heike Bertram
- Cancer Registry of North Rhine-Westphalia, Münster, Germany
| | - Andrea Eberle
- Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | | | | | | | - Annika Waldmann
- Ministry of Health and Consumer Protection, Hamburg Cancer Registry, Hamburg, Germany
- Institute of Social Medicine and Epidemiology, University Lübeck, Lübeck, Germany
| | | | - Daniela Doege
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Melissa S. Y. Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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28
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Vayr F, Savall F, Bigay-Game L, Soulat JM, Chouaid C, Herin F. Lung cancer survivors and employment: A systematic review. Lung Cancer 2019; 131:31-39. [PMID: 31027695 DOI: 10.1016/j.lungcan.2019.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this systematic review is to identify, in a comprehensive manner, the impact of lung cancer on the employment status of survivors. METHODS The Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) statement was used as a formal guideline. The systematic review includes scientific papers published between January 2000 and October 2018. The search strategy queried the database MEDLINE. Inclusion criteria comprised: (1) inclusion of patients diagnosed with lung cancer (LC) (2); assessment of employment status or employment outcomes or work adjustments or return to work (3); inclusion of scientific papers published in peer-reviewed journals (4); inclusion of articles written either in English or in French. Literature reviews were not included. RESULTS A total of 642 scientific papers were retrieved. Twenty-three articles were included in the systematic review: 5 longitudinal studies and 18 cross-sectional studies. LC survivors are 2-3 times more likely to be unemployed as compared with control groups. Previous studies highlight a median duration of sickness absence increased for LC survivors compared to control groups. The strongest decline in earnings was observed among LC survivors as compared to other cancer types. CONCLUSIONS LC is associated with a significant impact on employment of patients. The promising results of recent therapeutic strategies could lead to a better social and professional prognosis. A reduction of indirect costs is to be expected.
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Affiliation(s)
- Flora Vayr
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France
| | - Frédéric Savall
- INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France; Laboratory of Molecular Anthropology AMIS, UMR 5288 CNRS, France
| | - Laurence Bigay-Game
- Pneumology Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France
| | - Jean-Marc Soulat
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France; INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France
| | - Christos Chouaid
- Pneumology Department, Centre Hospitalier Intercommunal Creteil, Ile de France, France
| | - Fabrice Herin
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France; INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France.
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29
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De Blasi G, Bouteyre E, Rollin L. Giving up work after cancer: An exploratory qualitative study of three clinical cases. Work 2019; 60:105-115. [PMID: 29733033 DOI: 10.3233/wor-182712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Enabling cancer survivors to resume employment has become a public health issue in France, but not all survivors wish to or would benefit from doing so. OBJECTIVE This French exploratory qualitative study was designed to identify the psychological factors that influence the decision of some cancer survivors not to return to work, despite their doctor's permission. METHODS We conducted semi structured interviews with two women and one man. Each interview lasted around 90 minutes. Qualitative analysis of the interviews (clinical case studies) highlighted a number of similarities and differences among these three patients. RESULTS Comparisons revealed six similarities: 1. the issue of income and its importance had no part in the decision-making process; 2. patients anticipated work return problems; 3. they therefore abandoned their plans to go back; 4. work lost its meaning for them; 5. repressed affects surfaced or they reassessed their career plans; and 6. their life trajectories were disrupted, with the stages being telescoped together. There were also two differences: 1. feelings of social exclusion for two participants, and 2. gendered experiences of quitting employment. CONCLUSIONS Health professionals and job retention support services need to take this clinical reality into account and acknowledge that not all patients wish to resume work or would benefit from doing so.
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Affiliation(s)
- Géraldine De Blasi
- Department of Occupational and Environmental Medicine (CCPPE), Rouen University Hospital, Rouen, France.,Clinical Psychopathology, Language and Subjectivity Laboratory (LPCLS - EA 3278), Aix-Marseille University, Aix-en-Provence, France
| | - Evelyne Bouteyre
- Clinical Psychopathology, Language and Subjectivity Laboratory (LPCLS - EA 3278), Aix-Marseille University, Aix-en-Provence, France
| | - Laetitia Rollin
- Department of Occupational and Environmental Medicine (CCPPE), Rouen University Hospital, Rouen, France.,Biology and Health Information Processing Team (TIBS), Computer Science, Information Processing and Systems Laboratory (LITIS - EA 4108), Rouen University Hospital, Rouen, France
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Armaou M, Schumacher L, Grunfeld EA. Cancer Survivors' Social Context in the Return to Work Process: Narrative Accounts of Social Support and Social Comparison Information. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:504-512. [PMID: 28980114 DOI: 10.1007/s10926-017-9735-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose Returning to work is a process that is intertwined with the social aspects of one's life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients' perceptions of the role of their social context in relation to returning to work following treatment. Methods Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers' support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions Two functions of the social context of returning to work after cancer were apparent in the participants' narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one's readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual's successful return to the workplace.
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Affiliation(s)
- M Armaou
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
| | - L Schumacher
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - E A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London, WC1E 7HX, UK
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Return to work in European Cancer survivors: a systematic review. Support Care Cancer 2018; 26:2983-2994. [PMID: 29845421 DOI: 10.1007/s00520-018-4270-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE Return to work (RTW) of cancer survivors (CSs) fluctuates in different contexts. This systematic review searched for recent data on the RTW rate of CSs in Europe, investigating associated factors. METHODS Bibliographic search covered the period from January 2010 to February 2018, with no language restrictions. European population-based studies assessing RTW rate after cancer diagnosis were included. We excluded studies focusing on a specific cancer diagnosis. RESULTS Twelve observational studies were selected. The cohorts investigated included 280 to 46,720 individuals from Northwestern and Central Europe diagnosed with cancer from 1987 to 2010. The median interval between diagnosis and documented RTW was 2 years (0.2-23.4 years). RTW rates of CSs ranged from 39 to 77%. RTW of individuals employed at the time of diagnosis ranged from 60 to 92%, the latter registered in a sample with good prognosis. Personal factors, work-related factors, and cancer-related factors were all associated with RTW. Healthcare team interventions facilitated reintegration to work. CONCLUSIONS Data from Mediterranean and Central European countries are urgently needed to understand whether RTW is an issue for CSs there as well and whether socio-rehabilitative interventions are required to mitigate the potential negative impact of cancer on individuals and society.
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Su TT, Azzani M, Tan FL, Loh SY. Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia. Support Care Cancer 2018; 26:1617-1624. [PMID: 29209834 DOI: 10.1007/s00520-017-3987-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors. METHODS A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors. RESULTS A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning > RM 2000) is a protective factor against the risk of reduced wages or wage loss. CONCLUSIONS Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.
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Affiliation(s)
- T T Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - M Azzani
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - F L Tan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - S Y Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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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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Endo M, Haruyama Y, Muto G, Kiyohara K, Mizoue T, Kojimahara N, Yamaguchi N. Work Sustainability Among Male Cancer Survivors After Returning to Work. J Epidemiol 2017; 28:88-93. [PMID: 29093353 PMCID: PMC5800885 DOI: 10.2188/jea.je20160152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have investigated the work continuance rate among cancer survivors after return to work (RTW). The objective of this study was to clarify work sustainability after RTW among Japanese male cancer survivors. Methods We collected data on male cancer survivors from an occupational health register. Inclusion criteria were as follows: employees who returned to work after an episode of sick leave due to clinically certified cancer diagnosed between January 1, 2000 and December 31, 2011. Results Of 1,033 male employees who were diagnosed with cancer, 786 employees (76.1%) returned to work after their first episode of sick leave due to cancer. Work continuance rates among all subjects were 80.1% 1 year after RTW and 48.5% 5 years after RTW. The mean duration of work after RTW was 4.5 years. The work continuance rates varied significantly by cancer type. The “Lung” and “Hepatic, Pancreatic” cancer groups had the shortest duration of work (0.9 year after RTW). Conclusions Of workers who returned to work after their first episode of leave after cancer, 50% continued to work after 5 years in large-scale companies. There was a steep decrease in work continuance rates during the first year after RTW, with considerable differences according to cancer site.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Tokyo Women's Medical University
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, School of Medicine
| | - Go Muto
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine
| | - Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
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Duijts SFA, van der Beek AJ, Bleiker EMA, Smith L, Wardle J. Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing. BMC Public Health 2017; 17:640. [PMID: 28784134 PMCID: PMC5547521 DOI: 10.1186/s12889-017-4659-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 07/31/2017] [Indexed: 11/10/2022] Open
Abstract
Background Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made. Methods Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed. Results In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year follow-up. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13–0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00–0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23–93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors. Conclusions When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status.
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Affiliation(s)
- Saskia F A Duijts
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Eveline M A Bleiker
- The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Aas RW, Haveraaen LA, Brouwers EPM, Skarpaas LS. Who among patients with acquired brain injury returned to work after occupational rehabilitation? The rapid-return-to-work-cohort-study. Disabil Rehabil 2017; 40:2561-2570. [PMID: 28724317 DOI: 10.1080/09638288.2017.1354234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Acquired brain injury (ABI) is known to be severely disabling. On average, 40% of employees return to work (RTW) within two years after injury. There is, however, limited research on what might contribute to successful RTW. AIM To examine factors that might impact the time-to first RTW for patients with ABI, participating in a RTW-program. METHODS The study was designed as a cohort study of patients on sick leave due to mild or moderate ABI (n = 137). The mean age of the patients was 51 years, and 58% were men. The most common diagnoses were stroke (75%) and traumatic brain injury (12%). Data were collected through questionnaires, and combined with register data on sickness absence. Survival analyses were used to analyse the effect of different variables on time to first RTW (full or partial), at one- and two-year follow-up. RESULTS Generally, women (HR = 0.447; CI: 0.239-0.283) had higher RTW-rates than men, and patients with non-comorbid impairments returned to work earlier than patients with multiple impairments. Although not statistically significant, receiving individual consultations and participating in group-sessions were generally associated with a delayed RTW at both follow-up-times. The only service-related factor significantly associated with delayed RTW was meetings with the social insurance office (HR = 0.522; CI: 0.282-0.965), and only at one-year follow-up. CONCLUSIONS Women and patients with non-comorbid impairments returned to work earlier than men and patients with multiple impairments. There seems to be an association between intense and long-lasting participation in the RTW program and prolonged time-to first-RTW, even after controlling for level of cognitive impairments and comorbidity. Implications for Rehabilitation Acquired brain injury (ABI) is known to be severely disabling, and persons with ABI often experience difficulties in regard to returning to work. This study provides information on prognostic factors that might contribute to return to work (RTW) for patients with acquired brain injury, both at the individual level, but also in regard to service and timing characteristics. Knowledge about such factors provide rehabilitation professionals with information about effective service components that might help patients with ABI to RTW, and thus makes it possible to adapt and adjust the services to the patient's situation. Furthermore, having more knowledge on factors that contribute to RTW gives clinics the opportunity to select patients that might benefit the most from these services, thereby making them more effective.
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Affiliation(s)
- Randi Wågø Aas
- a Presenter - Making Sense of Science , Stavanger , Norway.,b Faculty of Health Sciences , Oslo and Akershus University College for Applied Sciences , Oslo , Norway.,c Faculty of Social Sciences , University of Stavanger , Stavanger , Norway
| | | | - Evelien P M Brouwers
- d Tranzo, Tilburg School of Social and Behavioral Sciences , Tilburg University , Tilburg , The Netherlands
| | - Lisebet Skeie Skarpaas
- a Presenter - Making Sense of Science , Stavanger , Norway.,b Faculty of Health Sciences , Oslo and Akershus University College for Applied Sciences , Oslo , Norway
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Arboe B, Olsen MH, Goerloev JS, Duun-Henriksen AK, Johansen C, Dalton SO, Brown PDN. Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation. Clin Epidemiol 2017; 9:321-329. [PMID: 28652814 PMCID: PMC5476433 DOI: 10.2147/clep.s134603] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Autologous stem cell transplantation (ASCT) is the standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL) or transformed indolent lymphoma (TIL). The treatment is mainly considered for younger patients still available for the work market. In this study, social outcomes after ASCT in terms of return to work (RTW) are described. Patients and methods Information from national administrative registers was combined with clinical information on patients, who received ASCT for relapse of DLBCL or TIL between 2000 and 2012. A total of 164 patients were followed until RTW, disability or old-age pension, death, or December 31, 2015, whichever came first. A total of 205 patients were followed with disability pension as the event of interest. Cox models were used to determine cause-specific hazards. Results During follow-up, 82 (50%) patients returned to work. The rate of returning to work in the first year following ASCT was decreased for patients being on sick leave at the time of relapse (hazard ratio [HR] 0.3 [0.2;0.5]) and increased for patients aged ≥55 years (HR 1.9 [1.1;3.3]). In all, 56 (27%) patients were granted disability pension. Being on sick leave at the time of relapse was positively associated with receiving a disability pension in the first 2 years after ASCT (HR 3.7 [1.8;7.7]). Conclusion Patients on sick leave at the time of relapse have a poorer prognosis regarding RTW and have a higher rate of disability pension. Furthermore, patients >55 are more likely to RTW compared to younger patients. These results indicate an unmet need for focused social rehabilitation.
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Affiliation(s)
- Bente Arboe
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet.,Unit of Survivorship Research, The Danish Cancer Society Research Center
| | - Maja Halgren Olsen
- Unit of Survivorship Research, The Danish Cancer Society Research Center
| | | | | | - Christoffer Johansen
- Unit of Survivorship Research, The Danish Cancer Society Research Center.,Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Income generated by women treated with magnetic resonance imaging-based brachytherapy: A simulation study evaluating the macroeconomic benefits of implementing a high-end technology in a public sector healthcare setting. Brachytherapy 2017; 16:981-987. [PMID: 28600140 DOI: 10.1016/j.brachy.2017.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/03/2017] [Accepted: 05/07/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To estimate the difference in income generated if all women presenting in our institute over a 5-year period were treated with MRI-based image-guided brachytherapy (MR-IGBT) instead of conventional radiograph-based brachytherapy (CR-BT). METHODS AND MATERIALS Outcome data from 463 patients (94 treated with MR-IGBT) treated in our institute was used to simulate cumulative women-days of work and cumulative income over 5 years for 5526 patients expected to be treated in this period. The average daily income for a woman was derived from the National Sample Survey Organization (NSSO) survey data. Outcomes from both unmatched and propensity score-matched data sets were simulated. RESULTS The cumulative income in 5 years ranged between Rs 101-168 million if all patients presenting at our institute underwent MR-IGBT. The simulated excess income ranged from Rs 4-45 million after 5 years, which represented 6-66% of the expenditure incurred for acquiring the required equipment and manpower for practicing exclusive MR-IGBT. CONCLUSIONS Using outcome data from a prospective cohort of patients treated with MR-IGBT in our institute, we demonstrated that significant economic gains may be realized if MR-IGBT was used instead of CR-BT.
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Soejima T, Kamibeppu K. Are cancer survivors well-performing workers? A systematic review. Asia Pac J Clin Oncol 2016; 12:e383-e397. [DOI: 10.1111/ajco.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 02/06/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Takafumi Soejima
- Department of Family Nursing; School of Health Sciences and Nursing; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing; School of Health Sciences and Nursing; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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Sveistrup J, Mortensen OS, Rosenschöld PM, Engelholm SA, Petersen PM. Employment and sick leave in patients with prostate cancer before, during and after radiotherapy. Scand J Urol 2016; 50:164-9. [PMID: 26754420 DOI: 10.3109/21681805.2015.1119190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine employment outcomes after radiotherapy (RT) for prostate cancer (PCa). MATERIALS AND METHODS The Danish DREAM database contains information about social benefits paid to Danish citizens. Data are recorded prospectively every week. From the database, it is possible to assess whether a patient is working, on sick leave or retired at a certain time. Data on 417 Danish citizens treated with RT for PCa at Rigshospitalet, Copenhagen, between 1 January 2005 and 1 May 2010 were obtained from the database. The data were collected during a 2 year period from 1 year before RT to 1 year after RT. RESULTS Among patients of working age, 75% were still available for work 1 year after RT. The degree of sick leave increased almost continuously in the year before the start of RT and reached a maximum of 56% during RT. After RT it gradually declined. There was no significant difference between the number of patients on sick leave 1 year after RT compared to 1 year before RT (p = 0.23). Patients spent a significantly higher number of weeks on sick leave in the year after the start of RT compared to the year before RT (p = 0.001). CONCLUSION Except for a transient increase in sick leave during treatment, RT did not seem to affect the working lives of patients with PCa significantly.
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Affiliation(s)
- Joen Sveistrup
- a Department of Oncology , Rigshospitalet , Copenhagen , Denmark
| | - Ole S Mortensen
- b Department of Occupational Medicine , Køge Hospital , Køge , Denmark
| | | | | | - Peter M Petersen
- a Department of Oncology , Rigshospitalet , Copenhagen , Denmark
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Lost workdays in uterine cervical cancer survivors compared to the general population: impact of treatment and relapse. J Cancer Surviv 2015; 10:514-23. [DOI: 10.1007/s11764-015-0496-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 11/02/2015] [Indexed: 01/03/2023]
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Endo M, Haruyama Y, Takahashi M, Nishiura C, Kojimahara N, Yamaguchi N. Returning to work after sick leave due to cancer: a 365-day cohort study of Japanese cancer survivors. J Cancer Surviv 2015; 10:320-9. [PMID: 26318185 PMCID: PMC4801999 DOI: 10.1007/s11764-015-0478-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Abstract
Purpose More employees are experiencing a cancer diagnosis during their working-age years, yet there have been no large-scale Japanese studies investigating sick leave due to cancer. We clarified differences in the cumulative partial and full return to work (RTW) rates between different cancer types among Japanese cancer survivors. Methods Data on Japanese employees who experienced an episode of sick leave due to clinically certified cancer diagnosed between 1 January 2000 and 31 December 2011 were obtained from an occupational health register. Subject outcomes within the 365-day period following their initial day of sick leave were utilized for this study. We investigated the cumulative partial/full and full RTW rates by using survival analysis with competing risks and predictors of time to RTW by a Fine-Gray proportional hazard regression model. Results One thousand two hundred seventy-eight subjects (1033 males and 245 females) experienced their first episode of sick leave due to cancer during the 12-year follow-up period. Of the subjects, 47.1 % returned to work full time within 6 months of their initial day of sick leave absence, and 62.3 % by 12 months. The cumulative RTW rate varied significantly by cancer type. There were considerable differences in the range of cumulative full RTW rates between the two categories (“lower full RTW rate” groups (“lung,” “hepatic, pancreatic,” “esophageal,” and “blood” cancer groups) vs. “higher full RTW rate” groups (“gastric,” “intestinal,” “breast,” “female genital,” “male genital,” “urinary”): 6.3 to 14.3 % vs. 11.4 to 28.3 % at 60 days, 10.6 to 22.4 % vs. 27.0 to 50.0 % at 120 days, 21.3 to 34.7 % vs. 38.5 to 65.4 % at 180 days, 34.3 to 42.9 % vs. 66.0 to 79.5 % at 365 days). Additionally, older age may be associated with a longer time to full RTW. Conclusions More than half of the subjects returned to work full-time within the 365-day period following their initial day of sick leave, with cumulative RTW rates varying by cancer type. Older employees may require a longer time to full RTW. Implications of Cancer Survivors It is very important for companies (especially small- and medium-sized companies) to establish and improve their RTW support system for cancer survivors, with knowledge that the median time to RTW is expected to be at least a few months.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666.
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Miyako Takahashi
- Division of Cancer Survivorship Research, National Cancer Center, Tokyo, Japan
| | - Chihiro Nishiura
- Department of Safety and Health, Tokyo Gas Co. Ltd., Tokyo, Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666
| | - Naohito Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666
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Horsboel TA, Nielsen CV, Nielsen B, Andersen NT, De Thurah A. Wage-subsidised employment as a result of permanently reduced work capacity in a nationwide cohort of patients diagnosed with haematological malignancies. Acta Oncol 2015; 54:743-9. [PMID: 25752974 DOI: 10.3109/0284186x.2014.999871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients with haematological malignancies have a poorer labour market prognosis than the general population. We have previously found that they have low rates of return to work, and a higher risk of being granted disability pension, than individuals without a history of these diseases. The aim of this study was to further investigate the labour market prognosis for these patients, by comparing the risk of being granted wage-subsidised (WS) employment as a result of permanently reduced work capacity among patients diagnosed with haematological malignancies to a reference cohort, and to determine if relative risks differ between subtypes of haematological malignancies. MATERIAL AND METHODS We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until they were granted WS employment, disability pension, anticipatory pension, old age pension, emigration, death or until 26 February 2012, whichever came first. RESULTS A total of 310 (10%) patients and 795 (3%) reference individuals had their work capacity permanently reduced to an extent that they were granted WS employment during the follow-up period. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies, and four years after diagnosis they ranged from 2.47 (95% CI 1.46-4.16) for patients with Hodgkin lymphoma to 10.83 (95% CI 7.15-16.40) for patients with chronic myeloid leukaemia. CONCLUSION All eight subtypes of haematological malignancies were associated with an increased risk of being granted WS employment due to permanently reduced work capacity compared to the reference cohort. The relative risks differed according to haematological malignancy subtype, and the highest was found for patients with chronic myeloid leukaemia.
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MESH Headings
- Adult
- Age Factors
- Cohort Studies
- Denmark/epidemiology
- Employment, Supported/statistics & numerical data
- Female
- Hematologic Neoplasms/classification
- Hematologic Neoplasms/complications
- Hematologic Neoplasms/epidemiology
- Hodgkin Disease/complications
- Hodgkin Disease/economics
- Hodgkin Disease/epidemiology
- Humans
- Insurance, Disability
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/economics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/epidemiology
- Male
- Middle Aged
- Multiple Myeloma/complications
- Multiple Myeloma/economics
- Multiple Myeloma/epidemiology
- Pensions/statistics & numerical data
- Retirement/statistics & numerical data
- Return to Work/statistics & numerical data
- Risk
- Sex Factors
- Survivors
- Work Capacity Evaluation
- Young Adult
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Affiliation(s)
- Trine A Horsboel
- Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University , Denmark
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de Jong M, de Boer AGEM, Tamminga SJ, Frings-Dresen MHW. Quality of working life issues of employees with a chronic physical disease: a systematic review. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:182-96. [PMID: 24832893 DOI: 10.1007/s10926-014-9517-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. METHODS A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. RESULTS From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. CONCLUSION This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes.
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Affiliation(s)
- Merel de Jong
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands,
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Murray K, Lam KBH, McLoughlin DC, Sadhra SS. Predictors of return to work in cancer survivors in the Royal Air Force. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:153-159. [PMID: 25038986 DOI: 10.1007/s10926-014-9516-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Return to work (RTW) is beneficial for cancer survivors, employers and society. However, little is known about predictors of RTW in the military environment. METHODS A cohort of 194 Royal Air Force (RAF) personnel aged 18-58 who survived primary cancer treatment between 2001 and 2011 were followed up for 18 months. Information was obtained from occupational health and primary care records. Personal, occupational and clinical predictors of RTW were identified by Cox proportional hazards regression. RESULTS The median sickness absence before RTW was 107 days. Six months after diagnosis 54 % of participants had RTW, and reached 80 % by 12 months. Time taken to RTW was predicted by age at diagnosis, rank, trade group, pre-diagnosis sickness absence, site of cancer, treatment modality, and prognosis. RTW at 18 months were predicted by higher rank (HR = 2.31; 95 % CI 1.46-3.65), and having melanoma (9.75; 4.97-19.13). Those receiving chemotherapy were significantly less likely to have RTW compared to other treatment modalities (0.18; 0.10-0.32). CONCLUSIONS Rank, cancer diagnostic group, and treatment modality are the most important predictors of RTW in cancer survivors in the RAF. These predictors can be used to inform rehabilitation programmes and decisions on RTW.
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Affiliation(s)
- Kenneth Murray
- Royal Air Force Centre of Aviation Medicine, Henlow, SG16 6DN, UK
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Glimelius I, Ekberg S, Linderoth J, Jerkeman M, Chang ET, Neovius M, Smedby KE. Sick leave and disability pension in Hodgkin lymphoma survivors by stage, treatment, and follow-up time—a population-based comparative study. J Cancer Surviv 2015; 9:599-609. [DOI: 10.1007/s11764-015-0436-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
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Tiedtke C, Dierckx de Casterlé B, Donceel P, de Rijk A. Workplace support after breast cancer treatment: recognition of vulnerability. Disabil Rehabil 2014; 37:1770-6. [DOI: 10.3109/09638288.2014.982830] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lundh MH, Lampic C, Nordin K, Ahlgren J, Bergkvist L, Lambe M, Berglund A, Johansson B. Sickness absence and disability pension following breast cancer - A population-based matched cohort study. Breast 2014; 23:844-51. [PMID: 25305791 DOI: 10.1016/j.breast.2014.09.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 08/21/2014] [Accepted: 09/08/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare sickness absence and disability pension in a population-based cohort of women with breast cancer (n = 463) from 1 year pre-diagnosis until 3 years post-diagnosis with a matched control group (n = 2310), and to investigate predictors of sickness absence during the 2nd and 3rd year post-diagnosis. RESULTS Following breast cancer, the proportion of disease-free women with sickness absence decreased post-diagnosis (1st-3rd year; 78%-31%-19%), but did not reach the pre-diagnostic level (14%; P < 0.05). Post-diagnosis, patients were more likely than controls to be sickness absent (1st-3rd year; P < 0.001). No between-group differences were observed for disability pension post-diagnosis (P > 0.05). Among patients, chemotherapy, baseline fatigue and pre-diagnosis sick days predicted sickness absence during the 2nd, 3rd, and 2nd and 3rd year post-diagnosis, respectively (P < 0.05). CONCLUSIONS Breast cancer is associated with increased sickness absence 3 years post-diagnosis. In a clinical setting, prevention and treatment of side effects are important in reducing long-term consequences.
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Affiliation(s)
- Marie Høyer Lundh
- Regional Cancer Centre, Uppsala University Hospital, SE-751 85 Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden.
| | - Claudia Lampic
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, 23300, SE-141 83 Huddinge, Sweden
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden; Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, NO-5020 Bergen, Norway
| | - Johan Ahlgren
- Department of Oncology, Örebro University Hospital, SE-70185 Örebro, Sweden; Centre for Research and Development, Uppsala University, County of Gävleborg, SE-801 88 Gävle, Sweden
| | - Leif Bergkvist
- Department of Surgery and Centre for Clinical Research, Uppsala University, Västmanland County Hospital, SE-721 89 Västerås, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala University Hospital, SE-751 85 Uppsala, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77 Stockholm, Sweden
| | - Anders Berglund
- Regional Cancer Centre, Uppsala University Hospital, SE-751 85 Uppsala, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Birgitta Johansson
- Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
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Horsboel TA, Bültmann U, Nielsen CV, Nielsen B, Andersen NT, de Thurah A. Are fatigue, depression and anxiety associated with labour market participation among patients diagnosed with haematological malignancies? A prospective study. Psychooncology 2014; 24:408-15. [PMID: 25174733 DOI: 10.1002/pon.3658] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/22/2014] [Accepted: 08/01/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The objectives of this study are to examine levels of fatigue, depression and anxiety following diagnosis of a haematological malignancy, to determine the incidence of return to work (RTW) and long-term sickness absence (LTSA) during 1-year follow-up and to examine whether fatigue, depression and anxiety are associated with RTW and LTSA in this group of cancer patients. METHODS Questionnaire-based data on fatigue, depression and anxiety were obtained at baseline. In all, 196 patients returned the questionnaire. Of these, 106 patients were on sick leave and 90 patients were working. They were all followed prospectively for 1 year using register-based data on labour market participation. RESULTS At baseline, high levels of fatigue, depression and anxiety were more prevalent among sickness absent patients than in those working. Half of the sickness absent patients returned to work during follow-up, and only 10 (11%) working patients experienced LTSA. Sickness absent patients with highest scores of physical fatigue were less likely to RTW than those with lowest scores (RRadj 0.43, 95% CI 0.23-0.78). Similar, we found an association between symptoms of anxiety and RTW (p = 0.048). This association was though non-significant in multivariable analyses (p = 0.068). No significant association was found between depression and RTW. CONCLUSION Half of sickness absent patients returned to work, and only a few of working patients experienced LTSA during follow-up. Patients reporting high levels of physical fatigue were less likely to RTW. There was a similar tendency for anxiety, whereas we found no association between depression and RTW. Larger prospective studies are needed.
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Affiliation(s)
- Trine A Horsboel
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark; Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark
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