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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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2
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Owens OL, Dressler EV, Mayfield A, Winkfield KM, Krane LS, Foust M, Sandberg JC. Considerations from employed African-American and white prostate cancer survivors on prostate cancer treatment and survivorship: a qualitative analysis. ETHNICITY & HEALTH 2024; 29:309-327. [PMID: 38317577 PMCID: PMC10987268 DOI: 10.1080/13557858.2024.2312422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To solicit information/suggestions from prostate cancer survivors to improve survivorship experiences specific to work/workability. DESIGN The study employed a qualitative/phenomenological approach. Black/African-American and white prostate cancer survivors who: (1) had prostatectomy or radiation therapy 6-36 months prior, (2) were working for pay within 30 days before having treatment, and (3) expected to be working for pay 6 months later (n = 45) were eligible for this study. Survivors were engaged in 60-to-90-minute structured interviews. Content analysis was used to ascertain prominent themes. RESULTS Participants had the following recommendations for survivors: ask about research on treatment options and side effects; speak with other survivors about cancer diagnosis; and inform family/friends and employers about needed accommodations. Considerations for family/friends emphasized the significance of instrumental (e.g. help finding information) and emotional support (e.g. encouragement). Employer/co-worker considerations most often related to work-related accommodations/support and avoiding stigmatization of the survivor. Considerations for healthcare providers commonly included the provision of unbiased, plain-language communication about treatment options and side effects. No major differences existed by race. CONCLUSIONS Needs of employed PrCA survivors, regardless of their race or treatment type, are commonly related to their desire for informational, instrumental, and/or emotional support from family/friends, employers/co-workers, and healthcare providers. The requested supports are most often related to the side effects of prostate cancer treatment.
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Affiliation(s)
- Otis L Owens
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Emily V Dressler
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Andrew Mayfield
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Karen M Winkfield
- Meharry-Vanderbilt, Alliance, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Spencer Krane
- Department of Urologic Surgery, Southeastern Louisiana Veterans Health Care Center, New Orleans, LA, USA
| | - Melyssa Foust
- Spartanburg Gibbs Cancer Center and Research Institute, Spartanburg, SC, USA
| | - Joanne C Sandberg
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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3
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Liu WH, Fox J, Yates P. Work-related experiences of prostate cancer survivors in Australia: a qualitative study. BMC Public Health 2023; 23:1806. [PMID: 37716940 PMCID: PMC10505317 DOI: 10.1186/s12889-023-16706-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) is the most diagnosed cancer in Australian men, and the number of survivors is growing with advances in diagnosis and treatment. Work participation following PCa diagnosis and treatment becomes a significant aspect of quality of life and survivorship. Using a qualitative phenomenological approach, we explored the work-related experiences of PCa survivors in Australia. METHODS Semi-structured telephone interviews were conducted with 16 men (6 salaried employees, 10 self-employed; 8 diagnosed ≥ 5 years) purposively sampled from a community setting. Interviews were inductively analysed. RESULTS Five main themes emerged: motivations to work; treatment decisions and work; the effects of PCa and its treatment on ability to participate in work; being an employee versus being self-employed; and personal agency. PCa and its treatment side-effects were detrimental to men's work capacity and ability, and could persist over an extended period. Most men expressed a strong desire to retain work or return to work. Discussions with healthcare professionals about work-related consequences were largely missing when treatment decisions were made. Self-employed men faced greater challenges than their salaried counterparts due to high financial burden and limited social and business support. Family, workplace and wider community support, and self-care, enhanced men's work participation experiences. CONCLUSIONS PCa and its treatment substantially and persistently impacted men's working lives, and their experiences were diverse and multifaceted. Self-employed and long-term PCa survivors face greater challenges and are at high risk of poor work outcomes. A systematic approach and involvement of stakeholders at all levels is required to support ongoing work participation.
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Affiliation(s)
- Wei-Hong Liu
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
| | - Jennifer Fox
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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4
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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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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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6
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Shemesh B, Opie J, Tsiamis E, Ayton D, Satasivam P, Wilton P, Gough K, Lewis K, O'Brien C, Shub M, Pomery A, Mac Manus C, Millar J, Evans S. Codesigning a patient support portal with health professionals and men with prostate cancer: An action research study. Health Expect 2022; 25:1319-1331. [PMID: 35411697 PMCID: PMC9327875 DOI: 10.1111/hex.13444] [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: 08/11/2021] [Revised: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The supportive care needs of men with prostate cancer (PCa) have been well documented, but little is known about how an online portal may address these. This study sought to determine priority issues facing men with PCa, barriers and enablers to accessing care and whether health professionals (HPs) and men would support the inclusion of a patient-reported outcome (PRO) comparator tool. METHODS We conducted four online focus groups with HPs recruited from healthcare services in Victoria, followed by seven online codesign workshops with men with PCa, recruited through the Victorian Prostate Cancer Outcomes Registry, Prostate Cancer Foundation Australia and the Cancer Council Victoria. Men were eligible to participate if they had lived experience of PCa and access to the internet. We analysed focus groups thematically. Workshops were analysed using descriptive-content analysis. RESULTS HPs (n = 39) highlighted that men had shifting priorities over time, but noted the importance of providing information to men in lay terms to assist in treatment decision-making and side-effect management. HPs identified key enablers to men accessing support services such as practice nurses, partners and having men share their stories with each other. HPs raised financial, cultural, geographic and emotional barriers to accessing supportive care. Inclusion of a PRO comparator tool received mixed support from HPs, with 41% (n = 16) supportive, 49% (n = 19) unsure and 10% (n = 4) not supportive. Men involved in workshops (n = 28) identified informational needs to assist in treatment decision-making and side-effect management as the top priority throughout care. Men described support groups and practice nurses as key enablers. Short consultation times and complex information were described as barriers. Unlike HPs, all men supported the inclusion of a PRO comparator tool in a portal. CONCLUSIONS Our findings suggest that a patient support portal should provide information in lay terms that address the shifting priorities of men with PCa. Men with PCa would welcome the development of a portal to centralize support information and a PRO comparator tool to prompt health-seeking behaviour. Future research will implement these findings in the development of a portal, and pilot and evaluate the portal within a population-based sample. PATIENT OR PUBLIC CONTRIBUTION This project adopted a codesign approach including both men with PCa and HPs involved in PCa care. Men with PCa also formed part of the study's steering committee and consumer advisory groups. HPs were consulted in a serious of online focus groups. Subsequently, men with PCa and their support persons participated in workshops. Men with PCa were also involved in the preparation of this manuscript.
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Affiliation(s)
- Benjamin Shemesh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacinta Opie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ellie Tsiamis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Prassannah Satasivam
- Department of Surgery, Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Wilton
- The Victorian Agency for Health Information (VAHI), Melbourne, Victoria, Australia
| | - Karla Gough
- Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Katrina Lewis
- Patient Experience and Consumer Participation, Alfred Health, Melbourne, Victoria, Australia
| | - Colin O'Brien
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Max Shub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | - Jeremy Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Susan Evans
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
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7
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Nitecki R, Albright BB, Johnson MS, Moss HA. Employment outcomes among cancer patients in the United States. Cancer Epidemiol 2022; 76:102059. [PMID: 34826800 PMCID: PMC10066711 DOI: 10.1016/j.canep.2021.102059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cancer diagnosis and treatment can lead to disruptions in employment, which can, in turn, lead to financial problems and uninsurance. We used a nationally representative survey to describe predictors of non-employment among cancer patients compared to a matched cohort of individuals without cancer. METHODS This was a retrospective study of the 2005-2018 nationally representative Medical Expenditure Panel Survey. We included respondents aged 18-64 and identified the cohort with current cancer by healthcare utilization related to a cancer diagnosis in the given year. We propensity-score matched controls to cancer cases in a 2:1 ratio. Survey weights were applied to generate national estimates of non-employment among the study cohort compared to the overall U.S. POPULATION The Adjusted Wald test was used to compare employment outcomes between groups. Weighted multivariable linear regression was utilized to assess factors independently associated with non-employment. RESULTS An estimated annual mean of 3.9 million cancer patients in the U.S. were included. Relative to controls, cancer patients had higher rates of part-year (36.0% vs 28.3%, P < 0.0001) and full-year non-employment (22.7% vs 17.5%, P < 0.0001). In a multivariable model, cancer diagnosis was associated with a 6.8% higher risk of part-year non-employment, 4.1% higher risk of full-year non-employment, and 14.8% lower individual earnings relative to the matched U.S. POPULATION Sub-groups of cancer patients at high risk of negative employment outcomes included those enrolled in Medicaid, those without a high school degree, and those with high healthcare utilization. Low family income was the strongest predictor of non-employment. CONCLUSION Cancer patients were at greater risk of non-employment relative to matched controls and adverse employment outcomes disproportionately affected cancer patients from vulnerable populations.
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Affiliation(s)
- Roni Nitecki
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Benjamin B Albright
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
| | | | - Haley A Moss
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
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8
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Long-term outcomes among localized prostate cancer survivors: prospective predictors for return-to-work three years after cancer rehabilitation. Support Care Cancer 2022; 30:843-854. [PMID: 34392427 PMCID: PMC8636403 DOI: 10.1007/s00520-021-06376-6] [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: 07/24/2020] [Accepted: 06/19/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed at (1) investigating the work status of men treated by radical prostatectomy due to diagnosis of localized prostate cancer (LPCa) three years after having attended a cancer rehabilitation program and (2) identifying prospective risk factors for not working at this time point. METHODS In a longitudinal, questionnaire-based multicenter study, 519 working-age LPCa survivors reported on their work status 12 and 36 months following rehabilitation. Chi-square tests/t tests and multivariable logistic regression analysis were used to identify prospective factors associated with not working at 36 months follow-up. RESULTS Nearly three quarter of LPCa survivors (N = 377, 73%) worked 3 years after post-acute rehabilitation. Most participants (N = 365, 71%) showed continuous return-to-work (RTW) patterns as they worked both 1 and 3 years following rehabilitation. Multivariable regression analysis revealed older age, low or middle socio-economic status as well as resigned and unambitious work behavior and fatigue at the time of attending the rehabilitation program to be prospective factors for not working at 36 months follow-up. Low socio-economic status [Odds ratio (OR) 4.81, 95% confidence interval (CI) 2.07-11.16] and unambitious work behavior [OR 4.48, 95% CI 2.16-9.31] were the strongest predictors. CONCLUSION Long-term work retention is a realistic goal among LPCa survivors. The results contribute to the identification of at-risk LPCa survivors early in the RTW process. Special attention should be paid to social inequality. Further, interventions related to the management of fatigue and work-related coping styles could improve long-term RTW, as these were relevant, but potentially modifiable factors impeding work retention.
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9
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Marques ML, Alunno A, Boonen A, Ter Wee MM, Falzon L, Ramiro S, Putrik P. Methodological aspects of design, analysis and reporting of studies with work participation as an outcome domain in patients with inflammatory arthritis: results of two systematic literature reviews informing EULAR points to consider. RMD Open 2021; 7:rmdopen-2020-001522. [PMID: 33542048 PMCID: PMC7868290 DOI: 10.1136/rmdopen-2020-001522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/06/2021] [Accepted: 01/14/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To summarise the methodological aspects in studies with work participation (WP) as outcome domain in inflammatory arthritis (IA) and other chronic diseases. Methods Two systematic literature reviews (SLRs) were conducted in key electronic databases (2014–2019): search 1 focused on longitudinal prospective studies in IA and search 2 on SLRs in other chronic diseases. Two reviewers independently identified eligible studies and extracted data covering pre-defined methodological areas. Results In total, 58 studies in IA (22 randomised controlled trials, 36 longitudinal observational studies) and 24 SLRs in other chronic diseases were included. WP was the primary outcome in 26/58 (45%) studies. The methodological aspects least accounted for in IA studies were as follows (proportions of studies positively adhering to the topic are shown): aligning the studied population (16/58 (28%)) and sample size calculation (8/58 (14%)) with the work-related study objective; attribution of WP to overall health (28/58 (48%)); accounting for skewness of presenteeism/sick leave (10/52 (19%)); accounting for work-related contextual factors (25/58 (43%)); reporting attrition and its reasons (1/58 (2%)); reporting both aggregated results and proportions of individuals reaching predefined meaningful change or state (11/58 (16%)). SLRs in other chronic diseases confirmed heterogeneity and methodological flaws identified in IA studies without identifying new issues. Conclusion High methodological heterogeneity was observed in studies with WP as outcome domain. Consensus around various methodological aspects specific to WP studies is needed to improve quality of future studies. This review informs the EULAR Points to Consider for conducting and reporting studies with WP as an outcome in IA.
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Affiliation(s)
- Mary Lucy Marques
- Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands .,Rheumatology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Alessia Alunno
- Rheumatology Unit, University of Perugia Department of Medicine, Perugia, Umbria, Italy
| | - Annelies Boonen
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands.,Department of Health Services Research, Universiteit Maastricht Care and Public Health Research Institute, Maastricht, Limburg, The Netherlands
| | - Marieke M Ter Wee
- Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Rheumatology and immunology, AI&I, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Louise Falzon
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, New York, USA
| | - Sofia Ramiro
- Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.,Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, Limburg, The Netherlands
| | - Polina Putrik
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands.,Department of Health Services Research, Universiteit Maastricht Care and Public Health Research Institute, Maastricht, Limburg, The Netherlands
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10
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Skaczkowski G, Asahina A, Wilson C. Returning to Work After Cancer in Australia: What Facilitates a Positive Return to Work Experience? JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:41-49. [PMID: 33125606 DOI: 10.1007/s10926-020-09881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study examined the impact of task-based and relationship-based social support received in the workplace on cancer survivors' retrospective satisfaction with their return to work experience. Methods Cancer survivors (N = 159), completed an online questionnaire assessing their satisfaction with the return to work experience, overall job satisfaction, contact with employers and co-workers while absent, perceived task-based and relationship-based social support received at the time of returning to work, and the perceived emotional quality of workplace relationships. Results Survivors reported that contact with employers, but not co-workers, while absent from work was associated with a more positive return to work experience. Additionally, greater perceived task-based and relationship-based social support at the time of returning to work were significantly correlated with greater satisfaction with returning to work. Importantly, the impact of task-based and relationship-based social support was fully mediated by the perceived emotional quality of workplace relationships. Job satisfaction independently predicted variance in return to work satisfaction. Conclusions Supporting effective return to work after cancer involves consideration of the workplace social context. Greater resources are needed to help workplaces foster and maintain social connections with employees who are absent from work for cancer treatment.
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Affiliation(s)
- Gemma Skaczkowski
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Melbourne, Australia
| | - Akira Asahina
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Carlene Wilson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Melbourne, Australia.
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Tagai EK, Hudson SV, Diefenbach MA, Xu J, Bator A, Marziliano A, Miller SM. Social and medical risk factors associated with supportive needs in the first year following localized prostate cancer treatment. J Cancer Surviv 2020; 15:110-118. [PMID: 32681305 PMCID: PMC7872345 DOI: 10.1007/s11764-020-00916-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/10/2020] [Indexed: 01/18/2023]
Abstract
Purpose: Individuals who completed treatment for prostate cancer (PCa) often
report poor coping and practical concerns when adapting to new roles in
their lives—and strong patient-provider communication is critical for
this period. However, there is limited research identifying factors
associated with supportive needs after the completion of PCa treatment. This
study aimed to identify the social and medical risk factors associated with
supportive needs for adapting among individuals who completed treatment for
localized PCa. Methods: Using baseline data from a study evaluating a web-based support
system for patients in the first year following treatment for localized PCa,
self-efficacy for re-entry (e.g., maintaining relationships, symptom
management), medical interactions, and practical concerns (e.g., insurance,
exercise) were assessed. Multivariable regression analyses were completed to
identify risk factors for low readiness. Results: Participants (N=431) with lower health literacy or income, or with
depressive symptoms had lower self-efficacy for re-entry, more negative
interactions with medical providers, and more practical concerns
(ps<.05). Lastly, Non-Hispanic White
participants reported greater readiness compared to all other races
(ps<.05). Conclusions: Multiple social and medical risk factors are associated with greater
supportive needs when adapting to new roles after PCa treatment.
Understanding the risk factors for supportive needs in this period is
critical. Future research is needed to help providers identify and support
individuals at risk for poorer coping and greater practical concerns after
treatment completion. Implications for Cancer Survivors: Identifying individuals with greater supportive needs following
treatment for localized PCa treatment will help ensure successful adaptation
to new roles.
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Affiliation(s)
- Erin K Tagai
- Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, 125 Patterson St, New Brunswick, NJ, 08901, USA.,Division of Population Science, Rutgers Cancer Institute of New Jersey, The State University of New Jersey, 195 Little Albany St, New Brunswick, NJ, 08903, USA
| | - Michael A Diefenbach
- Center for Health Innovation and Outcomes Research, Feinstein Institute for Medical Research, Northwell Health, 300 Community Dr, Manhasset, NY, 11030, USA
| | - Jenny Xu
- Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Alicja Bator
- Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, 125 Patterson St, New Brunswick, NJ, 08901, USA
| | - Allison Marziliano
- Center for Health Innovation and Outcomes Research, Feinstein Institute for Medical Research, Northwell Health, 300 Community Dr, Manhasset, NY, 11030, USA
| | - Suzanne M Miller
- Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
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de Boer AGEM, Greidanus MA, Dewa CS, Duijts SFA, Tamminga SJ. Introduction to special section on: current topics in cancer survivorship and work. J Cancer Surviv 2020; 14:101-105. [PMID: 32206965 PMCID: PMC7182612 DOI: 10.1007/s11764-020-00868-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/22/2023]
Abstract
Work is a key contributor to quality of life and an important aspect of cancer survivorship. We call attention to current topics in cancer survivorship and work with 12 articles on cancer survivorship and work in this special section. The focus is on less studied diagnostic groups such as gastrointestinal cancer and prostate cancer, and on long-term effects of cancer diagnosis and treatment on work. Furthermore, studies are included on topics not generally studied including cognitive limitations and pain, the role of the employer on work outcomes among different types of cancer survivors and some countries not typically covered in the existing literature on work and cancer survivorship. We conclude that to improve sustainable work participation in cancer survivors, personalised, tailored interventions should be provided. A prerequisite for this is the identification of groups and individuals at high risk for adverse work outcomes. In order to develop such interventions, research involving new approaches such as matching data registries, participatory approaches and the involvement of many stakeholders and survivors with these different types of cancer diagnoses is necessary. IMPLICATIONS FOR CANCER SURVIVORS: The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included Implications for Cancer Survivors. The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included.
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Affiliation(s)
- A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - C S Dewa
- Departments of Psychiatry and Behavioral Sciences and Public Health Sciences, University of California, Davis, CA, USA
| | - S F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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