Long-term survivors with adult acute leukemia in complete remission: complications and return to work

Cancer and the risk for taking early retirement pension: a Danish cohort study

AIMS

The purpose of this study was to determine the risk for taking early retirement pension (ERP) in cancer survivors who were working at the time of diagnosis.

METHODS

We conducted a nationwide and population based cohort study including 44,905 persons aged 30-60 years diagnosed with selected cancers in the period 1981-2000 and 211,562 randomly sampled cancer-free controls. Information on socioeconomic status, demography and physical and psychiatric comorbidity was obtained from Danish administrative registries.

RESULTS

We analyzed the risk for ERP adjusted for known risk factors and found that cancer patients has an excess risk of ERP compared to cancer-free controls (RR, 1.60; 95% CI, 1.55-1.65 and RR, 1.55; 95% CI, 1.46-1.65 for women and men, respectively). The observed risk factors for taking ERP were late age, dissimilated disease, manual job, sickness leave the year before taking ERP, physical and psychological comorbidity, low education and low income. Three risk categories were identified (high, medium and low) by cancer site and we found that in the high risk category, people diagnosed with leukemia, prostate cancer or ovary cancer had a more than two-fold increased risk for ERP and the risk remained increased with up to 8 years of follow-up.

CONCLUSIONS

We observed a significantly increased risk for taking early retirement up to 8 years after the cancer diagnosis and that the magnitude of the risk was dependent of cancer sites.

Health behaviors of cancer survivors: examining opportunities for cancer control intervention

PURPOSE

A population-based investigation was conducted to examine the prevalence of health behaviors (smoking, alcohol use, physical activity, and cancer screening) of cancer survivors by age, time since diagnosis, and cancer site. Understanding health behaviors of survivors is imperative, as many survivors are living longer and are at risk for cancer recurrence, second cancers, and complications from treatment.

METHODS

Using the National Health Interview Survey, this study examined the prevalence of smoking and alcohol use as well as whether cancer survivors (n = 7,384) are meeting current recommendations for physical activity and cancer screening compared with noncancer controls (n = 121,347).

RESULTS

Cancer survivors are similar to controls with respect to smoking status and alcohol consumption after adjusting for group differences. However, younger survivors (18 to 40 years) are at greater risk for continued smoking than controls. Survivors are 9% more likely to meet physical activity recommendations compared with controls. chi2 tests indicate no significant differences in smoking, alcohol consumption, and physical activity by time since diagnosis, but differences by cancer site exist. Female cancer survivors are 34% and 36% more likely to meet mammogram and Papanicolaou smear screening recommendations, respectively, compared with controls. Similar screening patterns were found for prostate-specific antigen screening in men.

CONCLUSION

This study provides benchmark approximations of the prevalence of risky health behaviors of survivors by time since diagnosis and cancer site. As part of the collective effort to reduce late effects of cancer treatment, oncologists may be in the best position to offer initial guidance for promoting healthy lifestyle behaviors among cancer survivors.