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Juul SJ, Rossetti S, Kicinski M, van der Kaaij MAE, Giusti F, Meijnders P, Aleman BMP, Raemaekers JMM, Kluin-Nelemans HC, Spina M, Fermé C, Renaud L, Casasnovas O, Stamatoullas A, André M, Le Bras F, Plattel WJ, Henry-Amar M, Hutchings M, Maraldo MV. Employment situation among long-term Hodgkin lymphoma survivors in Europe: an analysis of patients from nine consecutive EORTC-LYSA trials. J Cancer Surviv 2024; 18:727-738. [PMID: 36441393 DOI: 10.1007/s11764-022-01305-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/18/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Little is known about the employment situation of long-term Hodgkin lymphoma (HL) survivors despite their young age at diagnosis and the favorable prognosis of the disease. In this cross-sectional study, we aim to describe the employment situation in a cohort of long-term HL survivors compared to the general population and investigate the associations with disease characteristics and treatment exposure. METHODS HL survivors > 25 years (n = 1961) were matched 1:25 to controls (n = 49,025) from the European Union Labour Force Survey. Individual treatment information was obtained from trial records. Employment and socio-demographic characteristics were collected using the Life Situation Questionnaire. Logistic regression models were used to estimate associations between disease and treatment characteristics with employment status and work-related attitudes. RESULTS At employment assessment, 69.7% of survivors (95% CI: 67.6-71.7%) were working; of these, 68.9% (95% CI: 66.3-71.3%) worked full-time, a figure comparable to that of controls (p value 0.17). The risk of not working was associated with increasing age at diagnosis, increasing age at survey, female sex, lower educational level, and relapse history. Of those who were at work during treatment, 16.8% (95% CI: 14.5-19.3%) stated their income had subsequently decreased, which was attributed to their HL by 65.4% (95% CI: 57.5-72.8). Among those not at work, 25.1% (95% CI: 20.7-29.8) survivors were disabled compared to only 14.5% (95% CI: 13.8-15.3%) of controls. CONCLUSIONS In this cohort of HL survivors, employment status was comparable to that of the general population. However, increasing age at follow-up, female sex, lower educational level, and relapse history are risk factors for unemployment, a perceived decrease in income, and disability. IMPLICATIONS FOR CANCER SURVIVORS To further improve follow-up care, special attention should be paid to these vulnerable subgroups.
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Affiliation(s)
- Sidsel J Juul
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
| | - Sára Rossetti
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Francesco Giusti
- EORTC Headquarters, Brussels, Belgium
- Belgian Cancer Registry, Brussels, Belgium
| | - Paul Meijnders
- Department of Radiation Oncology, Iridium Network, University of Antwerp, Antwerpen, Belgium
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - John M M Raemaekers
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hanneke C Kluin-Nelemans
- Department of Hematology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Michele Spina
- Division of Medical Oncology and Immunerelated Tumors, Centro Di Riferimento Oncologico Di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Loïc Renaud
- AP-HP, Hôpital Saint-Louis, Hemato-Oncologie, DMU DHI; Université de Paris, F-75010, Paris, France
| | | | | | - Marc André
- Department of Hematology, CHU UCL NAMUR, Yvoir, Belgium
| | - Fabien Le Bras
- Unité Hémopathies Lymphoïdes, Hôpital Henri Mondor, Créteil, France
| | - Wouter J Plattel
- Department of Hematology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Michel Henry-Amar
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Centre François Baclesse, Caen, France
| | | | - Maja V Maraldo
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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Bradley CJ, Owsley KM. Retirement behavior of cancer survivors: role of health insurance. J Cancer Surviv 2024; 18:499-508. [PMID: 36063307 PMCID: PMC11328929 DOI: 10.1007/s11764-022-01248-2] [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: 03/22/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Workers who rely on employment for health insurance may be unable to reduce work during and following treatment for a serious health condition, potentially harming their health in retirement. In this study, we examine the influence of retiree and employment-contingent insurance on the retirement and health of workers diagnosed with cancer. METHODS This longitudinal cohort study used 2000-2018 Health and Retirement Study data to examine changes in employment, weekly hours worked, and health status measures following a cancer diagnosis. We selected respondents who reported a new cancer diagnosis (n = 354) and a matched, non-cancer sample (n = 1770), restricting both samples to those employed and younger than age 63. RESULTS Following a cancer diagnosis, women with retiree health insurance were 18.6 percentage points less likely to work (95% CI: - 36.3 to - 1.0; p < 0.05) relative to women with employer health insurance, but no retiree insurance. Employed women with cancer but without employment-contingent health insurance increased weekly hours worked by 34% relative to similar non-cancer controls. Men and women with a cancer diagnosis and without employment-contingent health or retiree insurance were also less likely to work (p < 0.05). Among those who stopped working, respondents with cancer and employment-contingent health insurance reported better health status than respondents without employment-contingent health insurance. CONCLUSIONS Cancer survivors with employer and retiree health insurance leave the workforce earlier and report better health status when they stop working than those without equivalent insurance. IMPLICATIONS FOR CANCER SURVIVORS Policies to support health insurance outside of employment may allow cancer survivors to retire earlier and may have positive health benefits.
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Affiliation(s)
- Cathy J Bradley
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Comprehensive Cancer Center, 13001 East 17th Place, Mail Stop B119, Aurora, CO, 80045, USA
| | - Kelsey M Owsley
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA.
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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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Colorectal cancer survivors' experiences of return-to-work: A meta-synthesis of qualitative studies. Eur J Oncol Nurs 2023; 63:102284. [PMID: 36893577 DOI: 10.1016/j.ejon.2023.102284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION This review is to explore the relevant experience of colorectal cancer survivors' return-to-work, reintegrating and analyzing the promoting factors and obstacles of colorectal cancer survivors' return-to-work. METHODS This review followed PRISMA List. Databases including the Cochrane Library, PubMed, Web of Science, EM base, CINAHL, APA PsycInfo, Wangfang Database, CNKI and CBM from inception to October 2022 were searched to collect qualitative studies in the experience of colorectal cancer survivors' return-to-work. Article selection and data extraction were conducted by two researchers used the Joanna Briggs Institute Critical Appraisal Tool for qualitative researches (2016) in Australia. RESULTS Seven studies were included, the thirty-four themes distilled from the literature were grouped into eleven new categories and summed into two integrated findings: (1) facilitators to return-to-work for colorectal cancer survivors: desire and expectation for return-to-work and social dedication, economic needs, support and tolerance from employers and colleagues, work suggestions provided by professionals, health insurance policy of the workplace. (2) obstacles to return-to-work for colorectal cancer survivors: physical problems, psychological barriers, lack of family support, negative attitudes of employers and colleagues, limited information and resources available from professionals, Imperfection of related policies. CONCLUSION This study shows that colorectal cancer survivors' return-to-work is influenced by many factors. We should pay attention to and avoid obstacles, help colorectal cancer survivors recover their physical functions and maintain a positive psychological state, improve the social support for colorectal cancer survivors to return-to-work, so as to achieve comprehensive rehabilitation as soon as possible.
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Appleton R, Nanton V, Ahmed N, Loew J, Roscoe J, Muthuswamy R, Patel P, Dale J, Ahmedzai SH. A Web-Based Prostate Cancer-Specific Holistic Needs Assessment (CHAT-P): Multimethod Study From Concept to Clinical Practice. JMIR Cancer 2022; 8:e32153. [PMID: 36260380 DOI: 10.2196/32153] [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: 08/04/2021] [Revised: 05/03/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Men with prostate cancer experience immediate and long-term consequences of the disease and its treatment. They require both long-term monitoring for recurrence or progression and follow-up to identify and help manage psychosocial and physical impacts. Holistic Needs Assessment aims to ensure patient-centered continuing cancer care. However, paper-based generic tools have had limited uptake within cancer services, and there is little evidence of their impact. With the expansion of remote methods of care delivery and to enhance the value of generic tools, we developed a web-based Composite Holistic Needs Assessment Adaptive Tool-Prostate (CHAT-P) specifically for prostate cancer. OBJECTIVE This paper described the context, conceptual underpinning, and approach to design that informed the development of CHAT-P, starting from the initial concept to readiness for deployment. Through this narrative, we sought to contribute to the expanding body of knowledge regarding the coproduction process of innovative digital systems with potential for enhanced cancer care delivery. METHODS The development of CHAT-P was guided by the principles of coproduction. Men with prostate cancer and health care professionals contributed to each stage of the process. Testing was conducted iteratively over a 5-year period. An initial rapid review of patient-reported outcome measures identified candidate items for inclusion. These items were categorized and allocated to overarching domains. After the first round of user testing, further items were added, improvements were made to the adaptive branching system, and response categories were refined. A functioning version of CHAT-P was tested with 16 patients recruited from 3 outpatient clinics, with interviewers adopting the think-aloud technique. Interview transcripts were analyzed using a framework approach. Interviews and informal discussions with health care professionals informed the development of a linked care plan and clinician-facing platform, which were incorporated into a separate feasibility study of digitally enhanced integrated cancer care. RESULTS The findings from the interview study demonstrated the usability, acceptability, and potential value of CHAT-P. Men recognized the benefits of a personalized approach and the importance of a holistic understanding of their needs. Preparation for the consultation by the completion of CHAT-P was also recognized as empowering. The possible limitations identified were related to the importance of care teams responding to the issues selected in the assessment. The subsequent feasibility study highlighted the need for attention to men's psychological concerns and demonstrated the ability of CHAT-P to capture red flag symptoms requiring urgent investigation. CONCLUSIONS CHAT-P offers an innovative means by which men can communicate their concerns to their health care teams before a physical or remote consultation. There is now a need for a full evaluation of the implementation process and outcomes where CHAT-P is introduced into the clinical pathway. There is also scope for adapting the CHAT-P model to other cancers.
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Affiliation(s)
- Rebecca Appleton
- Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Veronica Nanton
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nisar Ahmed
- Medical School, University of Sheffield, Sheffield, United Kingdom
| | - Joelle Loew
- Lucerne School of Business, Lucerne, Switzerland
| | - Julia Roscoe
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Prashant Patel
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sam H Ahmedzai
- Medical School, University of Sheffield, Sheffield, United Kingdom
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The Economic Burden of Cancer in Canada from a Societal Perspective. Curr Oncol 2022; 29:2735-2748. [PMID: 35448197 PMCID: PMC9025082 DOI: 10.3390/curroncol29040223] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Cancer patients and their families experience considerable financial hardship; however, the current published literature on the economic burden of cancer at the population level has typically focused on the costs from the health system’s perspective. This study aims to estimate the economic burden of cancer in Canada from a societal perspective. The analysis was conducted using the OncoSim-All Cancers model, a Canadian cancer microsimulation model. OncoSim simulates cancer incidence and deaths using incidence and mortality data from the Canadian Cancer Registry and demography projections from Statistics Canada. Using a phase-based costing framework, we estimated the economic burden of cancer in Canada in 2021 by incorporating published direct health system costs and patients’ and families’ costs (out-of-pocket costs, time costs, indirect costs). From a societal perspective, cancer-related costs were CAD 26.2 billion in Canada in 2021; 30% of costs were borne by patients and their families. The economic burden was the highest in the first year after cancer was diagnosed (i.e., initial care). During this time, patients and families’ costs amounted to almost CAD 4.8 billion in 2021. This study provides a comprehensive estimate of the economic burden of cancer, which could inform cost–benefit analyses of proposed cancer prevention interventions.
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Jaffe SA, Guest DD, Sussman AL, Wiggins CL, Anderson J, McDougall JA. A sequential explanatory study of the employment experiences of population-based breast, colorectal, and prostate cancer survivors. Cancer Causes Control 2021; 32:1213-1225. [PMID: 34176063 PMCID: PMC8492490 DOI: 10.1007/s10552-021-01467-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/18/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE Cancer treatment often leads to work disruptions including loss of income, resulting in long-term financial instability for cancer survivors and their informal caregivers. METHODS In this sequential explanatory study, we conducted a cross-sectional survey of employment experiences among ethnically diverse, working-age individuals diagnosed with breast, colorectal, or prostate cancer. Following the survey, we conducted semi-structured interviews with cancer survivors and informal caregivers to explore changes in employment status and coping techniques to manage these changes. RESULTS Among employed survivors (n = 333), cancer caused numerous work disruptions including issues with physical tasks (53.8%), mental tasks (46.5%) and productivity (76.0%) in the workplace. Prostate cancer survivors reported fewer work disruptions than female breast and male and female colorectal cancer survivors. Paid time off and flexible work schedules were work accommodations reported by 52.6% and 36.3% of survivors, respectively. In an adjusted regression analysis, household income was positively associated with having received a work accommodation. From the qualitative component of the study (survivors n = 17; caregivers n = 11), three key themes emerged: work disruptions, work accommodations, and coping mechanisms to address the disruptions. Survivors and caregivers shared concerns about lack of support at work and resources to navigate issues caused by changes in employment. CONCLUSIONS This study characterized employment changes among a diverse group of cancer survivors. Work accommodations were identified as a specific unmet need, particularly among low-income cancer survivors. Addressing changes in employment among specific groups of cancer survivors and caregivers is critical to mitigate potential long-term consequences of cancer.
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Affiliation(s)
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Andrew L Sussman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Community and Family Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Charles L Wiggins
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- New Mexico Tumor Registry, Albuquerque, NM, USA
| | - Jessica Anderson
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Jean A McDougall
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
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Minamitani M, Mukai T, Yamashita H, Katano A, Nakagawa K. Effects on annual income changes after radical radiotherapy versus after prostatectomy in patients with localized prostate cancer with a specific employment status: A web-based pilot study. PLoS One 2021; 16:e0258116. [PMID: 34591929 PMCID: PMC8483344 DOI: 10.1371/journal.pone.0258116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
Men with localized prostate cancers are insured for undergoing radical radiotherapy or prostatectomy. However, limited information is available on the influence of cancer treatments on patients’ employment status in Japan. Therefore, in this web-based survey, we aimed to compare the effects of post-treatment changes on the annual income of patients with prostate cancer after undergoing radical radiotherapy and prostatectomy and to identify the risk factors associated with the decrease in annual income. We investigated the clinical characteristics and demographics including pre-treatment working status, self-employment, non-regular employment, working for wage or salary, and joblessness of patients with localized prostate cancer. Multivariable logistic regression was performed to analyze the effects of various factors on the change in the annual income of self-employed and non-regularly employed workers. Seventy-eight eligible patients with localized prostate cancer had undergone radiotherapy, and 128 patients had undergone prostatectomy. Among self-employed and non-regularly employed workers, post-treatment income decline rates in those who underwent radiotherapy were smaller but not significant (12% vs. 42%, P = 0.074). Multivariable logistic regression analysis revealed that initial treatment for prostate cancer was the only significant risk factor for the post-treatment income decline among self-employed and non-regularly employed workers. Radiotherapy was associated with a smaller decrease in income (odds ratio, 0.22; 95% confidence interval, 0.052–0.95; P = 0.042). Our novel results implied the effectiveness of radiotherapy in preventing post-treatment income decline among patients with prostate cancer based on specific employment status: self-employed or non-regularly employed.
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Affiliation(s)
| | - Tomoya Mukai
- Graduate Schools for Law and Politics, The University of Tokyo, Tokyo, Japan
| | - Hideomi Yamashita
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Atsuto Katano
- Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiichi Nakagawa
- Department of Comprehensive Radiation Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Law CK, Brewer K, Brown C, Wilson K, Bailey L, Hague W, Simes JR, Stevenson A, Solomon M, Morton RL. Return to work following laparoscopic-assisted resection or open resection for rectal cancer: Findings from AlaCaRT-Australasian Laparoscopic Cancer of the Rectum Trial. Cancer Med 2021; 10:552-562. [PMID: 33280266 PMCID: PMC7877361 DOI: 10.1002/cam4.3623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maintaining employment for adults with cancer is important, however, little is known about the impact of surgery for rectal cancer on an individual's capacity to return to work (RTW). This study aimed to determine the impact of laparoscopic vs. open resection on RTW at 12 months. METHODS Analyses were undertaken among participants randomized in the Australian Laparoscopic Cancer of the Rectum Trial (ALaCaRT), with work status available at baseline (presurgery), and 12 months. Multivariable logistic regression, adjusted for sociodemographic and clinical characteristics estimated the effect of surgery on RTW in any capacity, or return to preoperative work status at 12 months. RESULTS About 228 of 449 (51%) surviving trial participants at 12 months completed work status questionnaires; mean age was 62 years, 66% males, 117 of these received laparoscopic resection (51%). Of 228, 120 were employed at baseline (90 full-time, 30 part-time). Overall RTW in 120 participants in paid work at baseline was 78% (84% laparoscopic, 70% open surgery). Those employed full-time were more likely to RTW at 12 months (OR, 3.55; 95% CI, 1.02-12.31). Those with distant metastases at baseline were less likely to RTW (OR, 0.07; 95% CI, <0.01-0.83). Laparoscopic surgery was associated with a higher rate of RTW but did not reach statistical significance (OR 2.88; 95% CI, 0.95-8.76). CONCLUSIONS Full-time work presurgery and the presence of metastatic disease predicts RTW status at 12 months. A laparoscopic-assisted surgical approach to rectal cancer may facilitate more patients to RTW, however, larger sample sizes are likely needed to confirm this result.
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Affiliation(s)
- Chi Kin Law
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Kate Brewer
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Chris Brown
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Kate Wilson
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Lisa Bailey
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Wendy Hague
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - John R. Simes
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
| | - Andrew Stevenson
- Faculty of Medicine and Biomedical SciencesUniversity of QueenslandHerstonQldAustralia
| | - Michael Solomon
- Institute of Academic SurgeryRoyal Prince Alfred HospitalUniversity of SydneySydneyNSWAustralia
| | - Rachael L. Morton
- NHMRC Clinical Trials CentreThe University of SydneyCamperdownNSWAustralia
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Abstract
Prostate cancer is the most common malignancy diagnosed in North American men. Although medical advances have improved survival rates, men treated for prostate cancer experience side-effects that can reduce their work capacity, increase financial stress, and affect their career and/or retirement plans. Working-age males comprise a significant proportion of new prostate cancer diagnoses. It is important, therefore, to understand the connections between prostate cancer and men’s work lives. This scoping review aimed to summarize and disseminate current research evidence about the impact of prostate cancer treatment on men’s work lives. Electronic databases were searched to identify peer-reviewed articles published between 2006 and 2020 that reported on the impact of prostate cancer treatment on men’s work. Following scoping review guidelines, 21 articles that met inclusion criteria were identified and analyzed. Evidence related to the impact of prostate cancer on work was grouped under three themes: (1) work outcomes after prostate cancer treatment; (2) return to work considerations, and (3) impact of prostate cancer treatment on men’s finances. Findings indicate that men’s return to work may be more gradual than expected after prostate cancer treatment. Some men may feel pressured by financial stressors and masculine ideals to resume work. Diverse factors including older age and social benefits appear to play a role in shaping men’s work-related plans after prostate cancer treatment. The findings provide direction for future research and offer clinicians a synthesis of current knowledge about the challenges men face in resuming work in the aftermath of prostate cancer treatment.
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Affiliation(s)
- Wellam F Yu Ko
- University of British Columbia, School of Nursing, Vancouver, BC, Canada
| | - John L Oliffe
- University of British Columbia, School of Nursing, Vancouver, BC, Canada
| | - Joan L Bottorff
- University of British Columbia, School of Nursing, Kelowna, BC, Canada
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Ghasempour M, Shabanloei R, Rahmani A, Jafarabadi MA, Abri F, Khajehgoodari M. The Relation of Readiness for Return to Work and Return to Work Among Iranian Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1237-1242. [PMID: 31456144 DOI: 10.1007/s13187-019-01588-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Return to work after completion of cancer treatments has many benefits for patients, families, and society. Readiness for return to work (RRTW) seems to be an effective factor for return to work in cancer survivors. Therefore, the present study was to investigate return to work and its relation to RRTW among Iranian survivors of cancer. This descriptive-correlational study examined a total of 227 survived cancer patients with completed primary treatments and without active cancer symptoms. Data were collected by the return to work and RRTW questionnaires and analyzed with descriptive statistics and inferential statistics using SPSS software. Upon completion of initial treatment, 166 (73.2%) of survivor participants returned to work, of which 78 (34.4%) and 88 (38.4%) participants returned to full-time and part-time works, respectively. ANOVA test showed a significant difference between RRTW and the type of return to work. In addition, results of regression analysis revealed that there was a positive significant relationship between RRTW and the rate of return to work before and after the adjustment of variables (p ≤ 0.05). Considering the findings of the study, there is a necessary need planning for rehabilitation programs by nursing managers concerning these patients to facilitate their return to work.
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Affiliation(s)
- Mostafa Ghasempour
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Shabanloei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Azad Rahmani
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Abri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Khajehgoodari
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Saim A, Gernier F, Licaj I, Rod J, Velten M, Klein D, Mercier M, Joly F. [Long-term occupational situation after cancer: A French registry-based study]. Bull Cancer 2020; 107:867-880. [PMID: 32919610 DOI: 10.1016/j.bulcan.2020.06.004] [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: 11/14/2019] [Revised: 04/16/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Few studies have explored the long-term occupational situation after cancer. The aim of our study were to study the employment status among long-term cancer survivors and to compare it to cancer-free controls from the general population at 5, 10 or 15 years after cancer diagnosis. METHODS From data of a registry-based study, long-term survivors from breast,cervical and colorectal cancer, randomly selected from three tumor registries in France, were compared to cancer-free controls randomly selected from electoral lists. We selected active cancer survivors and cancer-free controls aged less than 60 at the time of the survey. We have studied the employment status of cases vs. controls and the factors associated with employment status. RESULTS At 5, 10 or 15 years after diagnosis, we did not observe any significant difference in employment status between cases and controls. Among cases, 17% had lost their jobs. Older age, lower incomes, lower education, a short-term employment contract, the presence of co-morbidities, fatigue and a worse quality of life were associated with job loss. DISCUSSION Although the employment status of the cases was comparable to that of the controls, efforts should be intensified to make it easier for patients diagnosed with cancer to return to work.
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Affiliation(s)
- Akila Saim
- Université de Caen Basse-Normandie, Caen, France; Centre François-Baclesse, UMR 1086 Inserm « ANTICIPE », Caen, France
| | - François Gernier
- Centre François-Baclesse, UMR 1086 Inserm « ANTICIPE », Caen, France; Centre de lutte contre le cancer François-Baclesse, département de recherche clinique, UNICANCER, Caen, France.
| | - Idlir Licaj
- Centre François-Baclesse, UMR 1086 Inserm « ANTICIPE », Caen, France; Centre de lutte contre le cancer François-Baclesse, département de recherche clinique, UNICANCER, Caen, France
| | - Julien Rod
- Centre François-Baclesse, UMR 1086 Inserm « ANTICIPE », Caen, France; CHU de Caen, département de pédiatrie, Caen, France
| | - Michel Velten
- Centre Paul-Strauss, département de biostatistique et d'épidémiologie, EA3430, Strasbourg, France; Hôpitaux universitaires de Strasbourg, Inserm IRFAC UMR-S 1113, Strasbourg, France; Registre des cancers du Bas-Rhin, Strasbourg, France
| | | | - Mariette Mercier
- Université of Franche-Comté, EA3181, Besançon, France; Université de Franche-Comté, Inserm UMR 1098, Besançon, France
| | - Florence Joly
- Université de Caen Basse-Normandie, Caen, France; Centre François-Baclesse, UMR 1086 Inserm « ANTICIPE », Caen, France; Centre de lutte contre le cancer François-Baclesse, département de recherche clinique, UNICANCER, Caen, France; CHU de Caen, département d'oncologie, Caen, France
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13
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Ullrich A, Rath HM, Otto U, Kerschgens C, Raida M, Hagen-Aukamp C, Bergelt C. Identifying Expectations of Delayed Return to Work in Patients with Prostate Cancer at the Beginning of a Cancer Rehabilitation Program. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:183-193. [PMID: 31734853 DOI: 10.1007/s10926-019-09860-3] [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: 06/10/2023]
Abstract
Purpose To investigate factors associated with expectations of delayed return to work (RTW) in patients with prostate cancer recently admitted to a cancer rehabilitation program. Methods In this multicenter study, data about expected time until RTW and potential correlates (personal, medical, psychosocial and work-related factors) were obtained from 822 employed cancer rehabilitation participants at the beginning of the program. Participants expecting early RTW (≤ 3 months) and delayed RTW (> 3 months) were compared. Hierarchical multivariate logistic regression was applied to study which factors are associated with expecting delayed RTW. Results In total, 171 cancer rehabilitation participants (21%) expected delayed RTW. Group comparison showed education, type of occupation, income, number of comorbid conditions, tumor stage according to the staging system of the Union for International Cancer Control (UICC), anxiety and depression, quality-of-life functioning scales, urinary and treatment-related symptoms, duration of sick leave, subjective work ability, perceived ability to return to the former job, intention to apply for a disability pension, effort-reward-imbalance and occupational stress to be associated in bivariate analysis with participants' expectations. Multivariate analysis revealed UICC tumor stage III (compared to stages I/II, OR 2.36), lower subjective work ability (OR 0.82), perceived inability to return to the former job (OR 1.88) and intention to apply for a disability pension (OR 1.94) to increase the likelihood of expecting delayed RTW. Conclusions Negative or non-beneficial RTW expectations, which are related to self-perception and behavioral intention, seem to be key factors for expecting delayed RTW. Interventions to early identify and adjust such expectations might empower cancer rehabilitation participants to develop appropriate expectations for work recovery.
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Affiliation(s)
- Anneke Ullrich
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Hilke Maria Rath
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ullrich Otto
- Rehabilitation Clinics Hartenstein GmbH, Clinic Quellental, Bad Wildungen, Germany
| | | | - Martin Raida
- HELIOS Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | | | - Corinna Bergelt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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14
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Chen YY, Wang CC, Wu WT, Lai CH, Ho CL, Hsu YY, Chen WL. Trajectories of returning to work and its impact on survival in survivors with oral cancer: A 5-year follow-up study. Cancer 2019; 126:1225-1234. [PMID: 31809559 DOI: 10.1002/cncr.32643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/26/2019] [Accepted: 11/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND A return to work (RTW) is a challenge for survivors of oral cancer. Further light could be shed on the RTW of patients with oral cancer, which remains largely uninvestigated. The objective of this study was to investigate the trajectories of RTW and their impact on survival in workers with oral cancer. METHODS In total, 12,222 workers who were newly diagnosed with oral cancer were identified during the period from 2004 to 2015 and were included in this cohort study. The associations between independent variables and RTW were analyzed using Cox proportional hazard models. RESULTS Overall, 8793 workers returned to work in the first years after a diagnosis of oral cancer. Chemotherapy (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99) and radiation therapy (HR, 0.83; 95% CI, 0.75-0.92) were inversely associated with RTW. Patients who had received surgical treatment (HR, 1.24; 95% CI, 1.01-1.53) were more likely to RTW. Employees with stage I (HR, 1.66; 95% CI, 1.47-1.87), stage II (HR, 1.52; 95% CI, 1.35-1.72), and stage III (HR, 1.32; 95% CI, 1.16-1.51) disease were associated with an increased likelihood of RTW in the fifth year after diagnosis. Kaplan-Meier survival analysis demonstrated better survival for the RTW group versus the non-RTW group in patients with stage III and IV oral cancer (P < .001). The fully adjusted HR indicated that the RTW group had significantly better outcomes than the non-RTW group in all-cause mortality (P < .001; HR, 0.36; 95% CI, 0.33-0.39). CONCLUSIONS Sociodemographic and medical factors affect the RTW of cancer survivors. RTW may have a beneficial effect on survival of patients with oral cancer.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of General Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, Republic of China
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ya-Yuan Hsu
- Division of Labor Market, Institute of Labor, Occupational Safety, and Health, Ministry of Labor, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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15
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Financial toxicity associated with treatment of localized prostate cancer. Nat Rev Urol 2019; 17:28-40. [PMID: 31792431 DOI: 10.1038/s41585-019-0258-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2019] [Indexed: 12/13/2022]
Abstract
Financial toxicity is a broad term to describe the economic consequences and subjective burden resulting from a cancer diagnosis and treatment. As financial toxicity is associated with poor disease outcomes, recognition of this problem and calls for strategies to identify and support those most at risk are increasing. Men with localized prostate cancer face treatment choices including active surveillance, prostatectomy or radiotherapy. The fact that potential patient out-of-pocket costs might influence decision making has rarely been acknowledged and, overall, the risk of financial toxicity for men with localized prostate cancer remains poorly studied. This shortfall requires a work-up in the context of prostate cancer and a multidimensional framework for considering a patient's risk of financial toxicity. The major elements of this framework are direct and indirect costs, patient-specific values, expectations of possible financial burdens, and individual economic circumstances. Current data indicate that total cost patterns probably differ by treatment modality: surgery might have an increased short-term effect, whereas radiotherapy might have an increased long-term risk of financial toxicity. Specific thresholds of patient income levels or out-of-pocket costs that predict risk of financial toxicity are difficult to identify. Compared with other malignancies, prostate cancer might have a lower overall risk of financial toxicity, but persistent post-treatment urinary, bowel or sexual adverse effects are likely to increase this risk.
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16
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Candon D. The joint effect of health shocks and eligibility for social security on labor supply. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:969-988. [PMID: 31093845 DOI: 10.1007/s10198-019-01053-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
This paper investigates whether or not suffering a health shock, and becoming eligible for social security, have a joint effect on labor supply. Despite millions of people experiencing both of these events each year, no paper has focused exclusively on the joint effect that these events may have on work outcomes. This is surprising given that experiencing a health shock may impact on how a worker responds to becoming eligible for social security. With data from the Health and Retirement Study, I model weekly hours of work as a function of health shocks, social security eligibility, and their interaction. I find that this interaction leads to a 3-4 h reduction in weekly hours of work for men, but has no effect for women. The results are robust to using different work outcomes, age groups, health shock definitions, subgroups, as well as falsification and placebo tests. The results appear to be driven by men who would have had to return to work with impaired health. Policies that promote a more flexible work situation for older men may alleviate these problems in the future.
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Affiliation(s)
- David Candon
- School of Economics, University of Edinburgh, 30 Buccleuch Place, Edinburgh, EH8 9JT, UK.
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17
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Lo JC. Employment pathways of cancer survivors-analysis from administrative data. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:637-645. [PMID: 30604311 DOI: 10.1007/s10198-018-1025-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
The incidence of cancer and its survival rate have been increasing worldwide, resulting in a greater number of cancer survivors. Since one's job often forms a central basis for self-esteem and provides financial security, knowing whether and how cancer can affect the employment of employed cancer survivors are important issues. While the past studies generally used survey data, this study utilizes pre-existing administrative data and employs the difference-in-differences model. We take newly diagnosed cancer patients in 2012, aged from 15 to 60 years and employed upon diagnosis, as the study group (N = 12694) and the propensity-score matching-adjusted non-cancer employed population as the control group. Monthly employment information for 2011-2014 was retrieved for both groups. We define the pre-event period as the months before the diagnosis and the post-event period as the months from the diagnosis and afterwards. A pseudo-date symbolizing the index point for cancer diagnosis is assigned to the control group. The logistic regression results show that the impact of cancer on the employment status of cancer survivors is significantly negative for both genders. However, if the differences in employment status between the study and control groups prior to the incidence of cancer are significant, then some past research that used only post-period observations might have rendered biased estimates. The employment pathways indicate that 88% of female cancer survivors employed upon diagnosis continue to work during the full 12 months after diagnosis. Further analyses on earnings demonstrate the possibility of cancer survivors retaining their job, but at lower pay.
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Affiliation(s)
- Joan C Lo
- Institute of Economics, Academia Sinica, Nankang, Taipei, Taiwan.
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18
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Gruß I, Hanson G, Bradley C, McMullen C, Ritzwoller D, Hodge S, Varga A, Banegas MP. Colorectal cancer survivors' challenges to returning to work: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13044. [PMID: 31006931 DOI: 10.1111/ecc.13044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/22/2019] [Accepted: 03/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the challenges and needs of colorectal cancer (CRC) survivors in maintaining employment and returning to work (RTW) from the perspectives of both CRC survivors and employers in the United States. METHODS Semi-structured interviews with CRC survivors (n = 10) and employers (n = 4) were transcribed, coded and thematically analysed using NVivo 12 software. RESULTS Workplace challenges for survivors included the following: inadequate availability of paid and unpaid leave, limited availability of workplace accommodations, and employers' lack of knowledge about CRC and the recovery process. Survivors were concerned about the lack of adequate financial resources to take unpaid leave and the need to relearn control of bodily functions. Workplace challenges for employers of cancer survivors included the following: limited institutional flexibility to provide individualised accommodations, communication with frontline managers about leave availability for employees and communication with employees about legal protections and limitations. Employers perceived that employees were unwilling to take leave. CONCLUSION Colorectal cancer survivors in the US face difficult, sometimes insurmountable, challenges when trying to balance their physical and financial needs within the constraints of employment. Employers recognise challenges associated with this concern. Multi-level interventions-ranging from flexible work schedules to training for frontline managers-might facilitate the RTW process.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Ginger Hanson
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Cathy Bradley
- Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
| | - Carmit McMullen
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Debra Ritzwoller
- Kaiser Permanente Colorado Institute for Health Research, Aurora, Colorado
| | - Stephanie Hodge
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Alexandra Varga
- Kaiser Permanente Center for Health Research, Portland, Oregon
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19
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McLennan V, Ludvik D, Chambers S, Frydenberg M. Work after prostate cancer: a systematic review. J Cancer Surviv 2019; 13:282-291. [PMID: 30900159 DOI: 10.1007/s11764-019-00750-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/09/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE Research in the field of vocational rehabilitation, specifically for prostate cancer, remains rare despite increasing recognition of the role of vocational interventions in other cancer groups. The aim of this review was to compile and evaluate current trends, facilitators and barriers associated with returning to work after a prostate cancer diagnosis. METHOD The literature search was conducted in March 2018 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Forty-seven original research papers published in English in peer-reviewed journals were identified. The included studies comprised a total of 20,083 prostate cancer patients with a mean age of 61 years. RESULTS The studies implied a good overall return to work prognosis in prostate cancer patients; however, these findings are not generalisable to those with physically demanding or low paid jobs, comorbid conditions or poor physical functioning. CONCLUSION The limited research investigating the long-term implications of prostate cancer indicates that there may be problems related to job retention and early unwanted retirement. Facilitators and barriers to employment after prostate cancer are identified and implications for vocational interventions and further research are discussed. IMPLICATIONS FOR CANCER SURVIVORS This review helps to shed light on the barriers and facilitators to employment among prostate cancer survivors, as well as the need for further research and development in vocational rehabilitation interventions for this population.
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Affiliation(s)
- Vanette McLennan
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia. .,School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.
| | - Dominika Ludvik
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,University of Technology Sydney, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Mark Frydenberg
- Department of Surgery, Monash University, Clayton, Australia
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20
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Murray K, Lam KBH, McLoughlin D, Sadhra SS. Factors in Removing Job Restrictions for Cancer Survivors in the United Kingdom Royal Air Force. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:25-30. [PMID: 29460091 DOI: 10.1007/s10926-018-9758-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose To identify personal, occupational and clinical factors associated with the lifting of restrictions on duties among Royal Air Force (RAF) personnel who have returned to work after surviving primary cancer treatment. Methods A retrospective cohort of 205 RAF personnel aged 18-58 with cancer diagnosed between 2001 and 2011 was followed-up until May 2012. Personal, occupational, and clinical information was extracted from occupational health and primary care records. Predictors of the lifting of (a) employment restrictions on UK duties at 18 months after diagnosis and (b) the lifting of all deployment restrictions at the end of the study were analysed using logistic and Cox regression models. Results At 18 months, 62% of the cancer survivors had restrictions on their UK duties lifted. The positive independent predictors of unrestricted UK duties are testicular cancer (OR 5.34; 95% CI 1.21-23.6) and no treatment being required (16.8; 1.11-255.2). The lifting of all employment restrictions and return to full deployability was achieved by 41% of the participants (median time 2.1 years), with testicular cancer (HR 2.69; 95% CI 1.38-5.26) and age at diagnosis (1.05; 1.01-1.09) being the positive independent predictors of faster lifting of all restrictions. Conclusion Diagnostic group, prognosis and type of treatment are not the only predictor of employment outcome after cancer. Patient-centred factors such as smoking, age, fatigue, job status, job type and length of employment are also important predictors of return to pre-morbid job function in cancer survivors in the RAF.
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Affiliation(s)
- Kenneth Murray
- Royal Air Force Centre of Aviation Medicine, Henlow, SG16 6DN, UK
| | - Kin Bong Hubert Lam
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | | | - Steven S Sadhra
- Institute of Occupational and Environmental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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21
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Nakamura ZM, Deal AM, Nyrop KA, Choi SK, Wood WA, Muss HB. Associations of functional, psychosocial, medical, and socio-demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer. Psychooncology 2018; 28:167-173. [DOI: 10.1002/pon.4928] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/06/2018] [Accepted: 10/17/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Zev M. Nakamura
- Department of Psychiatry; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Allison M. Deal
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Kirsten A. Nyrop
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Department of Medicine, Division of Hematology/Oncology; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Seul Ki Choi
- Department of Health Behavior, Gillings School of Global Public Health; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - William A. Wood
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Department of Medicine, Division of Hematology/Oncology; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Hyman B. Muss
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Department of Medicine, Division of Hematology/Oncology; University of North Carolina at Chapel Hill; Chapel Hill NC USA
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22
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Candon D. The effect of cancer on the labor supply of employed men over the age of 65. ECONOMICS AND HUMAN BIOLOGY 2018; 31:184-199. [PMID: 30292988 DOI: 10.1016/j.ehb.2018.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 07/21/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
This paper investigates the relationship between cancer diagnosis and the labor supply of employed men over the age of 65. While almost 60% of male cancers are diagnosed in men over the age of 65, no previous research has examined the effect that cancer has on this age group, which is surprising given the relevance of this group to public policy. With data from the Health and Retirement Study, I show that cancer has a significant negative effect on the labor supply of these workers. Using a combination of linear regression models and propensity score matching, I find that respondents who are diagnosed with cancer work 3 fewer hours per week than their non-cancer counterparts. They are also 10 percentage points more likely to stop working. This reduction seems to be driven by a deterioration in physical and mental health.
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Affiliation(s)
- David Candon
- School of Economics, University of Edinburgh, 30 Buccleuch Place, Edinburgh EH8 9JT, UK.
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23
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Yu Ko WF, Oliffe JL, Johnson JL, Bottorff JL. The Connections Between Work, Prostate Cancer Screening, Diagnosis, and the Decision to Undergo Radical Prostatectomy. Am J Mens Health 2018; 12:1670-1680. [PMID: 29938564 PMCID: PMC6142122 DOI: 10.1177/1557988318781720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer diagnosis can occur at a time when men's work and careers are central to their masculine identity, sense of purpose, and family life. In Canada, an aging male population, along with medical advances, has resulted in increasing numbers of working men being diagnosed with, and treated for, prostate cancer. Little is known about the linkages between men's work and their experiences of prostate cancer. In this qualitative study, 24 Western Canadian men were interviewed to distil the connections between work, prostate cancer screening, diagnosis, and the decision to undergo radical prostatectomy. Data were analyzed using constant comparison in the context of masculinities theory. The findings demonstrated that work was central to men's masculine identities and afforded financial security, social status, and a sense of personal growth. However, work-related strain and demands were also found to affect participants' health and distance them from their families. A diagnosis of prostate cancer tended to diminish the importance of work, wherein participants focused on optimizing their health and strengthening family relations. In deciding on radical prostatectomy as a treatment to eradicate prostate cancer, few men considered the implications for returning to work. The current study findings indicate that clinicians and patients should explicitly explore and discuss how surgery side effects may affect work and career plans during treatment decision-making.
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Affiliation(s)
- Wellam F. Yu Ko
- School of Nursing, University of British
Columbia, Vancouver, BC, Canada
| | - John L. Oliffe
- School of Nursing, University of British
Columbia, Vancouver, BC, Canada
| | - Joy L. Johnson
- Faculty of Health Sciences, Simon Fraser
University, Burnaby, BC, Canada
| | - Joan L. Bottorff
- School of Nursing, University of British
Columbia Okanagan Campus, Kelowna, BC, Canada
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24
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Bennett D, Kearney T, Donnelly DW, Downing A, Wright P, Wilding S, Wagland R, Watson E, Glaser A, Gavin A. Factors influencing job loss and early retirement in working men with prostate cancer-findings from the population-based Life After Prostate Cancer Diagnosis (LAPCD) study. J Cancer Surviv 2018; 12:669-678. [PMID: 30058009 PMCID: PMC6153559 DOI: 10.1007/s11764-018-0704-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/13/2018] [Indexed: 12/17/2022]
Abstract
Purpose To investigate factors associated with job loss and early retirement in men diagnosed with prostate cancer (PCa) 18–42 months previously. Methods Men ≤ 60 years at diagnosis who completed the Life After Prostate Cancer Diagnosis (LAPCD) survey were identified. Men who moved from employment at diagnosis to unemployment (EtoU) or retirement (EtoR) at survey (18–42 months post-diagnosis) were compared to men remaining in employment (EtoE). Sociodemographic, clinical and patient-reported factors were analysed in univariable and multivariable analysis. Results There were 3218 men (81.4%) in the EtoE, 245 (6.2%) in EtoU and 450 (11.4%) in the EtoR groups. Men with stage IV disease (OR = 4.7 95% CI 3.1–7.0, relative to stage I/II) and reporting moderate/big bowel (OR = 2.5, 95% CI 1.6–3.9) or urinary problems (OR = 2.0, 95% CI 1.4–3.0) had greater odds of becoming unemployed. Other clinical (≥ 1 comorbidities, symptomatic at diagnosis) and sociodemographic (higher deprivation, divorced/separated), living in Scotland or Northern Ireland (NI)) factors were predictors of becoming unemployed. Men who were older, from NI, with stage IV disease and with caring responsibilities had greater odds of retiring early. Self-employed and non-white men had lesser odds of retiring early. Conclusion PCa survivors who retire early following diagnosis do not report worse urinary or bowel problems compared to men remaining in employment. However, we identified clinical and sociodemographic factors which increased unemployment risk in PCa survivors. Implications for Cancer Survivors Targeted support and engagement with PCa survivors at risk of unemployment, including their families and employers, is needed. Electronic supplementary material The online version of this article (10.1007/s11764-018-0704-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Damien Bennett
- Northern Ireland Cancer Registry, Mulhouse Building, Queen's University Belfast, Mulhouse Rd., Belfast, BT12 6DP, Northern Ireland.
| | - Therese Kearney
- Northern Ireland Cancer Registry, Mulhouse Building, Queen's University Belfast, Mulhouse Rd., Belfast, BT12 6DP, Northern Ireland
| | - David W Donnelly
- Northern Ireland Cancer Registry, Mulhouse Building, Queen's University Belfast, Mulhouse Rd., Belfast, BT12 6DP, Northern Ireland
| | - Amy Downing
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Penny Wright
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK
| | - Sarah Wilding
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Eila Watson
- Faculty Health and Life Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Mulhouse Building, Queen's University Belfast, Mulhouse Rd., Belfast, BT12 6DP, Northern Ireland
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Ullrich A, Rath HM, Otto U, Kerschgens C, Raida M, Hagen-Aukamp C, Bergelt C. Return to work in prostate cancer survivors - findings from a prospective study on occupational reintegration following a cancer rehabilitation program. BMC Cancer 2018; 18:751. [PMID: 30029637 PMCID: PMC6053748 DOI: 10.1186/s12885-018-4614-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/20/2018] [Indexed: 01/21/2023] Open
Abstract
Background This prospective multicentre-study aimed to analyze return to work (RTW) among prostate cancer survivors 12 months after having attended a cancer rehabilitation program and to identify risk factors for no and late RTW. Methods Seven hundred eleven employed prostate cancer survivors treated with radical prostatectomy completed validated self-rating questionnaires at the beginning, the end, and 12 months post rehabilitation. Disease-related data was obtained from physicians and medical records. Work status and time until RTW were assessed at 12-months follow-up. Data were analyzed by univariate analyses (t-tests, chi-square-tests) and multivariate logistic regression models (OR with 95% CI). Results The RTW rate at 12-months follow-up was 87% and the median time until RTW was 56 days. Univariate analyses revealed significant group differences in baseline personal characteristics and health status, psychosocial well-being and work-related factors between survivors who had vs. had not returned to work. Patients’ perceptions of not being able to work (OR 3.671) and feeling incapable to return to the former job (OR 3.162) were the strongest predictors for not having returned to work at 12-months follow-up. Being diagnosed with UICC tumor stage III (OR 2.946) and patients’ perceptions of not being able to work (OR 4.502) were the strongest predictors for late RTW (≥ 8 weeks). Conclusions A high proportion of prostate cancer survivors return to work after a cancer rehabilitation program. However, results indicate the necessity to early identify survivors with low RTW motivation and unfavorable work-related perceptions who may benefit from intensified occupational support during cancer rehabilitation. Electronic supplementary material The online version of this article (10.1186/s12885-018-4614-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anneke Ullrich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Hilke Maria Rath
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany
| | - Ullrich Otto
- Rehabilitation Clinics Hartenstein GmbH, Clinic Quellental, Bad Wildungen, Germany
| | | | - Martin Raida
- HELIOS Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | | | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany
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von Mechow S, Graefen M, Haese A, Tennstedt P, Pehrke D, Friedersdorff F, Beyer B. Return to work following robot-assisted laparoscopic and open retropubic radical prostatectomy: A single-center cohort study to compare duration of sick leave. Urol Oncol 2018; 36:309.e1-309.e6. [PMID: 29551549 DOI: 10.1016/j.urolonc.2018.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 01/16/2018] [Accepted: 02/13/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE To compare the duration of sick leave in patients with localized prostate cancer after robot-assisted radical prostatectomy (RARP) and open retropubic RP (ORP) at a German high-volume prostate cancer center. METHODS The data of 1,415 patients treated with RP at Martini Klinik, Prostate Cancer Center between 2012 and 2016 were, retrospectively, analyzed. Information on employment status, monthly revenues and days of work missed due to sickness were assessed via online questionnaire. Additional data were retrieved from our institutional database. Medians and interquartile ranges (IQR) were reported for continuous data. Cox proportional hazard analysis was performed to compare both surgical techniques for return to work time after RP. RESULTS Median time elapsed between surgery and return to work comprised 42 days in patients undergoing RARP (IQR: 21-70) and ORP (IQR: 28-84, P = 0.05). In Cox regression analysis, surgical approach showed no impact on return to work time (RARP vs. ORP hazard ratio = 1, 95% CI: 0.91-1.16, P = 0.69). Return to work time was significantly associated with employment status, physical workload and monthly income (all P<0.001). Limitation of this study is the nonrandomized design in a single-center. CONCLUSIONS As the surgical approach did not show any influence on the number of days missed from work in patients undergoing RP, no superiority of either RARP or ORP could be identified for return to work time in a German cohort. Both surgical approaches are safe options usually allowing the patients to resume normal activities including work after an appropriate convalescence period.
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Affiliation(s)
- Stefanie von Mechow
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Charité University Hospital, Berlin, Germany.
| | - Markus Graefen
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Haese
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Pierre Tennstedt
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Pehrke
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Burkhard Beyer
- Martini Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Outcomes across the return-to-work process in PC survivors attending a rehabilitation measure—results from a prospective study. Support Care Cancer 2017; 25:3007-3015. [DOI: 10.1007/s00520-017-3790-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/07/2017] [Indexed: 10/19/2022]
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Cheung K, Ching SYS, Chan A, Cheung D, Cheung SYP. The impact of personal-, disease- and work-related factors on work ability of women with breast cancer living in the community: a cross-sectional survey study. Support Care Cancer 2017; 25:3495-3504. [PMID: 28612159 DOI: 10.1007/s00520-017-3773-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aims of this study were to identify the work ability (WA) of breast cancer (BC) survivors during the course of their illness, and the relationships between personal-, disease-, and work-related factors, and their WA. METHODS This is a cross-sectional survey study. One hundred fifty-one participants with the response rate of 88.9% were recruited from the community in 2014 and 2015. RESULTS BC survivors' WA was at its highest before diagnosis, and then dropped to the lowest during treatment. Although their current WA had improved, it has not bounced back to that before diagnosis. The resignation rate was 35.8%. Factors positively associated with current WA included (a) age and year of diagnosis, (b) physical and psychological health and (c) WA before diagnosis or during treatment, working years, work control and mastery. However, compliance with appropriate healthy eating habits and believing in personal health controlled by chance were negatively associated with current WA. Furthermore, the participants would more likely to have higher current WA if they (a) were more optimistic with good stress management; (b) currently were not receiving treatment or other illnesses; (c) perceived less effects of their health problems, physical workloads or their cancer diagnoses on their work and (d) perceived continue to work in the next 2 years, with good ability to handle physical and mental work. CONCLUSIONS This study confirmed that most BC survivors continued to work after their diagnoses. The factors affecting their WA were multifactorial. It is important to enhance their positive thinking.
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Affiliation(s)
- Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China.
| | - Siu Yin Shirley Ching
- School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Amy Chan
- Hong Kong Breast Cancer Foundation, 16/F, Jupiter Tower, 9 Jupiter Street, North Point, Hong Kong, China
| | - Doris Cheung
- Hong Kong Breast Cancer Foundation, 16/F, Jupiter Tower, 9 Jupiter Street, North Point, Hong Kong, China
| | - Suk Yee Polly Cheung
- Hong Kong Breast Cancer Foundation, 16/F, Jupiter Tower, 9 Jupiter Street, North Point, Hong Kong, China
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Banegas MP, Guy GP, de Moor JS, Ekwueme DU, Virgo KS, Kent EE, Nutt S, Zheng Z, Rechis R, Yabroff KR. For Working-Age Cancer Survivors, Medical Debt And Bankruptcy Create Financial Hardships. Health Aff (Millwood) 2017; 35:54-61. [PMID: 26733701 DOI: 10.1377/hlthaff.2015.0830] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The rising medical costs associated with cancer have led to considerable financial hardship for patients and their families in the United States. Using data from the LIVESTRONG 2012 survey of 4,719 cancer survivors ages 18-64, we examined the proportions of survivors who reported going into debt or filing for bankruptcy as a result of cancer, as well as the amount of debt incurred. Approximately one-third of the survivors had gone into debt, and 3 percent had filed for bankruptcy. Of those who had gone into debt, 55 percent incurred obligations of $10,000 or more. Cancer survivors who were younger, had lower incomes, and had public health insurance were more likely to go into debt or file for bankruptcy, compared to those who were older, had higher incomes, and had private insurance, respectively. Future longitudinal population-based studies are needed to improve understanding of financial hardship among US working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer.
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Affiliation(s)
- Matthew P Banegas
- Matthew P. Banegas is an investigator at the Kaiser Permanente Center for Health Research, in Portland, Oregon
| | - Gery P Guy
- Gery P. Guy Jr. is a health economist at the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia
| | - Janet S de Moor
- Janet S. de Moor is a program director in the Division of Cancer Control and Population Sciences, at the National Cancer Institute (NCI), in Bethesda, Maryland
| | | | - Katherine S Virgo
- Katherine S. Virgo is an adjunct professor in the Department of Health Policy and Management at Emory University, in Atlanta
| | - Erin E Kent
- Erin E. Kent is an epidemiologist and program director in the Outcomes Research Branch, Applied Research Program, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, at the NCI
| | - Stephanie Nutt
- Stephanie Nutt is a program manager at the LIVESTRONG Foundation, in Austin, Texas
| | - Zhiyuan Zheng
- Zhiyuan Zheng is a senior epidemiologist at the American Cancer Society in Atlanta, Georgia
| | - Ruth Rechis
- Ruth Rechis is vice president of programs and strategy at the LIVESTRONG Foundation
| | - K Robin Yabroff
- K. Robin Yabroff is an epidemiologist in the Division of Cancer Control and Population Sciences at the NCI
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Lost Labor Productivity Costs of Prostate Cancer to Patients and Their Spouses: Evidence From US National Survey Data. J Occup Environ Med 2017; 58:351-8. [PMID: 27058474 DOI: 10.1097/jom.0000000000000621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study is to estimate lost labor productivity costs of prostate cancer (PC) to patients and their spouses. METHODS This study used a nationally representative database from the United States, the Medical Expenditure Panel Survey, to estimate lost productivity costs attributable to PC for patients and their spouses. We used multivariate methods that controlled for sociodemographic factors and comorbid diseases. Sensitivity analyses were used to mitigate the tendency for prevalence rates to be underreported in surveys. RESULTS PC patients had an aggregate national annual lost productivity cost of $5.4 billion ($3601 per individual), whereas their spouses had an aggregate annual lost productivity cost of $3.0 billion ($4013 per individual). CONCLUSIONS These results enhance our knowledge of lost labor productivity costs of PC morbidity and may inform the management and treatment of PC from an employer's perspective.
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Nakamura K, Masuyama H, Nishida T, Haraga J, Ida N, Saijo M, Haruma T, Kusumoto T, Seki N, Hiramatsu Y. Return to work after cancer treatment of gynecologic cancer in Japan. BMC Cancer 2016; 16:558. [PMID: 27473230 PMCID: PMC4966766 DOI: 10.1186/s12885-016-2627-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/26/2016] [Indexed: 11/28/2022] Open
Abstract
Background Gynecologic cancer is one of the most common malignant diseases in working-age women. This study investigated whether several characteristics influence return to work after treatment of gynecologic cancer. Methods We investigated the correlations between return to work and several other characteristics in 199 gynecologic cancer survivors. Questionnaires were distributed to patients with cancer (≥1 year after treatment and age of <65 years) who visited Okayama University. Logistic regression analysis and receiver operating characteristic curves were used to determine whether each characteristic influenced return to work (no return to work or job change) in these gynecologic cancer survivors. Results For all patients, the mean age at the time of diagnosis was 47.0 years, and the average number of years after treatment was 4.5. Forty-four patients (53.7 %) who were non-regular employees continued to be employed at the same workplace. Non-regular employment had a significantly higher area under the curve (AUC) (0.726) than other characteristics in terms of negatively affecting return to work. Additionally, non-regular employment tended to have a higher AUC (0.618) than other characteristics in terms of job changes. Conclusions Non-regular employment was the variable most likely to negatively affect return to work and job changes in employed patients who underwent treatment for gynecologic cancer.
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Affiliation(s)
- Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takeshi Nishida
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Junko Haraga
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Naoyuki Ida
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masayuki Saijo
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tomoko Haruma
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tomoyuki Kusumoto
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Noriko Seki
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yuji Hiramatsu
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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The association between pre-treatment occupational skill level and mood and symptom burden in early-stage, postmenopausal breast cancer survivors during the first year of anastrozole therapy. Support Care Cancer 2016; 24:3401-9. [PMID: 26984246 DOI: 10.1007/s00520-016-3161-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Previous research has explored occupational activity of breast cancer survivors but has not examined the influence of occupational level on symptoms prospectively. The purpose of this study was to examine the relationship between occupational classification and changes in mood and symptom burden for postmenopausal breast cancer survivors during the first year of anastrozole therapy. METHODS This was an exploratory secondary analysis in 49 postmenopausal women receiving anastrozole therapy for early-stage breast cancer. Participants reported their occupation at baseline and completed self-report questionnaires measuring mood and symptom burden at baseline, 6 months, and 12 months. Occupation was classified according to four major skill levels delineated by the International Standard Classification of Occupations (ISCO). RESULTS Breast cancer survivors employed at occupational skill levels 1 through 3 reported significantly higher depressive symptoms, fatigue, and total symptoms on average than those employed at ISCO skill level 4. After adjusting for multiple comparisons, this pattern remained for the musculoskeletal, vasomotor, and gastrointestinal symptom subscales. CONCLUSIONS Breast cancer survivors employed at lower skill levels (i.e., ISCO 1-3) reported poorer mood and greater symptom burden than breast cancer survivors employed at a higher skill level (i.e., ISCO 4). Assessing baseline occupation of occupationally active breast cancer survivors may improve understanding of the association between types of occupations and mood and symptom trajectories and may inform development of interventions to mitigate symptom severity in order to help breast cancer survivors maintain optimal occupational function and adherence to therapy.
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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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Radical Hysterectomy Plus Concurrent Chemoradiation/Radiation Therapy Is Negatively Associated With Return to Work in Patients With Cervical Cancer. Int J Gynecol Cancer 2016; 27:117-122. [DOI: 10.1097/igc.0000000000000840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ObjectiveCervical cancer is one of the most common malignant diseases in working-age women. This study investigated the influence of adverse effects of various treatment modalities on return to work in women with cervical cancer.MethodsQuestionnaires and clinical data from medical records of 97 patients with early stage (stages I and II) cervical cancer were collected and assessed by treatment received. The following treatment groups were analyzed for correlations between time to return to work and various adverse effects: radical hysterectomy (RH) alone, RH group (n = 29); concurrent chemoradiation therapy (CCRT)/radiation therapy (RT) alone, CCRT/RT group (n = 21); and RH + CCRT/RT group (n = 47). Theχ2test was used to determine the significance of the correlations.ResultsThe mean age at the time of diagnosis was 43.0 years and the average interval since treatment was 4.5 years. The RH + CCRT/RT group was the most strongly negatively associated with return to work in employed patients who had undergone CCRT/RT group of cervical cancer (P= 0.012). There was a significant association between failure to return to work and lower extremity lymphedema (P= 0.049). A more than–6-month interval between treatment and return to work and reduced personal income occurred in a significantly higher percentage of patients in the RH + CCRT group than in the CCRT/RT group (P= 0.034 andP= 0.034).ConclusionsOf the treatments assessed, RH + CCRT/RT has the greatest negative effect on return to work in women with cervical cancer.
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Dorland HF, Abma FI, Roelen CAM, Smink A, Feuerstein M, Amick BC, Ranchor AV, Bültmann U. The Cognitive Symptom Checklist-Work in cancer patients is related with work functioning, fatigue and depressive symptoms: a validation study. J Cancer Surviv 2015; 10:545-52. [PMID: 26620817 PMCID: PMC4863029 DOI: 10.1007/s11764-015-0500-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/17/2015] [Indexed: 12/31/2022]
Abstract
Purpose The study objectives are to translate the 21-item Cognitive Symptom Checklist-Work (CSC-W21) to Dutch (CSC-W DV) and to validate the CSC-W DV in working cancer patients. Methods The CSC-W21 was cross-culturally translated and adapted to a Dutch version. In this 19-item version, the dichotomous response option was changed to an ordinal five-point scale. A validation study of the CSC-W DV was conducted among cancer patients who had returned to work during or following cancer treatment. Internal consistency (Cronbach’s α), structural validity (exploratory factor analysis) and construct validity (hypothesis testing) were evaluated. Results In a cohort of 364 cancer patients, 341 (94 %) completed the CSC-W DV (aged 50.6 ± 8.6 years, 60 % women). Exploratory factor analysis revealed two subscales ‘working memory’ and ‘executive function’. The internal consistency of the total scale and subscales was high (Cronbach’s α = 0.93–0.95). Hypothesis testing showed that self-reported cognitive limitations at work were related to work functioning (P < 0.001), fatigue (P = 0.001) and depressive symptoms (P < 0.001), but not to self-rated health (P = 0.14). Conclusions The CSC-W DV showed high internal consistency and reasonable construct validity for measuring work-specific cognitive symptoms in cancer patients. The CSC-W DV was associated in expected ways with work functioning, fatigue and depressive symptoms. Implications for Cancer Survivors It is important to enhance knowledge about cognitive symptoms at work in cancer patients, to guide and support cancer patients as good as possible when they are back at work and to improve their work functioning over time.
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Affiliation(s)
- H F Dorland
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, Room 616, 9713 AV, Groningen, The Netherlands.
| | - F I Abma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, Room 616, 9713 AV, Groningen, The Netherlands
| | - C A M Roelen
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, Room 616, 9713 AV, Groningen, The Netherlands.,ArboNed Occupational Health Services, Utrecht, The Netherlands
| | - A Smink
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Feuerstein
- Department of Medical and Clinical Psychology and Preventive Medicine and Biometrics, The Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - B C Amick
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.,Institute for Work & Health, Toronto, ON, Canada
| | - A V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, Room 616, 9713 AV, Groningen, The Netherlands
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Zajacova A, Dowd JB, Schoeni RF, Wallace RB. Employment and income losses among cancer survivors: Estimates from a national longitudinal survey of American families. Cancer 2015; 121:4425-32. [PMID: 26501494 DOI: 10.1002/cncr.29510] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 12/15/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer presents a substantial hardship for patients and their families in multiple domains beyond health and survival. Relatively little is known about the economic impact of cancer. The authors present estimates of the aggregate effects of a cancer diagnosis on employment and income in a prospective, nationally representative sample of US adults. METHODS The authors used data from the 1990 through 2009 waves of the Panel Study of Income Dynamics, a nationally representative, prospective, population-based observational study with high-quality individual and family-level economic information. Age-adjusted, sex-stratified, individual fixed-effects regression models were used to derive estimates of the impact of cancer on employment, hours worked, individual income, and total family income. RESULTS Significant effects of cancer on all 4 outcomes were observed. The probability of a cancer patient being employed dropped by almost 10 percentage points, and hours worked declined by up to 200 hours in the first year after diagnosis. Annual labor-market earnings dropped almost 40% within 2 years after diagnosis and remained low, whereas total family income declined by 20%, although it recovered within 4 years after the diagnosis. These economic impacts on survivors were driven by effects among men; the effects among women largely were not statistically significant. CONCLUSIONS A cancer diagnosis has substantial effects on the economic well-being of affected adults and their families. With the increasing number of cancer survivors in the US population, there is a growing need for examining the long-term implications for economic well-being and ways to mitigate the economic hardship associated with cancer.
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Affiliation(s)
- Anna Zajacova
- Department of Sociology, University of Wyoming, Laramie, Wyoming
| | - Jennifer B Dowd
- CUNY School of Public Health, Hunter College, City University of New York, New York, New York
| | - Robert F Schoeni
- Institute for Social Research, School of Public Policy, and Department of Economics, University of Michigan, Ann Arbor, Michigan
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Bradley CJ. Economic recovery: A measure of the quality of cancer treatment and survivorship? Cancer 2015; 121:4282-5. [DOI: 10.1002/cncr.29511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Cathy J. Bradley
- Department of Healthcare Policy and Research; Virginia Commonwealth University; Richmond Virginia
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Candon D. The effects of cancer on older workers in the English labour market. ECONOMICS AND HUMAN BIOLOGY 2015; 18:74-84. [PMID: 25965970 DOI: 10.1016/j.ehb.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/04/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
The continued rise in overall cancer survival rates has ignited a field of research which examines the effect that cancer has on survivors' employment. Previous estimates of the effect of cancer on labour market outcomes, using U.S. data, show significant reductions in employment in the first 6 months after diagnosis. However, this impact has been found to dissipate after 12 and 18 months. I use data from the English Longitudinal Study of Ageing and find that, in England, where there is a more generous welfare support system, not only does cancer have a negative impact in the first 6-month period following diagnosis, but also in the second 6-month period. I estimate that, in the second 6-month period after diagnosis, respondents with cancer are 12.2% points less likely to work and work 4.2 fewer hours a week when compared to matched, healthy controls. This suggests that the negative effects from cancer can persist for longer than the six months identified previously. These results have implications for government policy and employers, because it increases the length of time that survivors may be on government supported sick pay, and the expected time that workers will be absent from work due to illness.
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Affiliation(s)
- David Candon
- School of Economics and Geary Institute, University College Dublin, Ireland.
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Shim HY, Shin JY, Kim JH, Kim SY, Yang HK, Park JH. Negative Public Attitudes Towards Cancer Survivors Returning to Work: A Nationwide Survey in Korea. Cancer Res Treat 2015; 48:815-24. [PMID: 26044157 PMCID: PMC4843714 DOI: 10.4143/crt.2015.094] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/22/2015] [Indexed: 11/26/2022] Open
Abstract
Purpose Early diagnosis and an improved survival rate have emerged as important issues for cancer survivors returning to work during the prime of their working life. This study investigated the attitudes of the general public towards cancer survivors returning to work in Korea and attempted to identify the factors influencing this negative attitude. Materials and Methods A general public perception survey regarding cancer survivors returning to work, targeting 2,000 individuals between 40-70 years of age, was conducted as face-to-face home visit. Results The public expressed a negative attitude towards cancer survivors returning to work, in terms of both perception and acceptance. Negative perception was higher among those in metropolitan areas compared with urban/rural areas (odds ratio [OR], 1.71), with monthly incomes < $2,000 compared with > $4,000 (OR, 1.54), and with patient care experience compared with those without (OR, 1.41). Negative acceptance was higher among those with monthly incomes < $2,000 compared with > $4,000 (OR, 1.71) and those with patient care experience compared with those without (OR, 1.54). The common factors between acceptance and perception that influenced negative attitude included area of residence, patient care experience, and monthly income. Conclusion This study identified negative attitudes towards cancer survivors returning to work in South Korea and the factors influencing the reintegration of cancer survivors into society. It is necessary to promote community awareness and intervention activities to enable access to community, social, and individual units for the social reintegration of cancer survivors.
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Affiliation(s)
- Hye-Young Shim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Ji-Yeon Shin
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Jong Heun Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Young Kim
- College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea
| | - Hyung-Kook Yang
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jong-Hyock Park
- College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea
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Ghasempour M, Rahmani A, Davoodi A, Sheikhalipour Z, Ziaeei JE, Abri F. Return to work and its relation to financial distress among Iranian cancer survivors. Asian Pac J Cancer Prev 2015; 16:2257-61. [PMID: 25824747 DOI: 10.7314/apjcp.2015.16.6.2257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Return to work after treatment completion is important for both cancer survivors and society. Financial distress is one of the factors that may influence the return to work in cancer survivors. However, this relationship has not been well investigated. This study aimed to determine the rate of return to work and its relation to financial distress among Iranian cancer survivors. MATERIALS AND METHODS This descriptive-correlational study was undertaken among 165 cancer survivors who completed their initial treatments and had no signs of active cancer. The Return to Work questionnaire and Financial Distress/Financial Well-Being Scale were used for data collection. Data were analyzed using SPSS statistical software. RESULTS After initial treatments, 120 cancer survivors (72%) had returned to work, of which 50 patients (42%) had returned to full-time work and 70 (58%) reduced their work hours and returned to part-time work. Cancer survivors also reported high levels of financial distress. In addition, the financial distress was lower among patients who had returned completely to work, in comparison to patients who had quit working for cancer-related reasons (p=0.001) or returned to work as part-time workers (p=0.001). CONCLUSIONS The findings showed that a high percent of Iranian cancer survivors had not returned to their jobs or considerably reduced working hours after treatment completion. Accordingly, due to high levels of financial distress experienced by participants and its relation to return to work, designing rehabilitation programs to facilitate cancer survivor return to work should be considered.
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Affiliation(s)
- Mostafa Ghasempour
- Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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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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Gordon LG, Beesley VL, Lynch BM, Mihala G, McGrath C, Graves N, Webb PM. The return to work experiences of middle-aged Australian workers diagnosed with colorectal cancer: a matched cohort study. BMC Public Health 2014; 14:963. [PMID: 25230842 PMCID: PMC4190428 DOI: 10.1186/1471-2458-14-963] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/18/2014] [Indexed: 11/21/2022] Open
Abstract
Background Few studies have been undertaken to understand the employment impact in patients with colorectal cancer and none in middle-aged individuals with cancer. This study described transitions in, and key factors influencing, work participation during the 12 months following a diagnosis of colorectal cancer. Methods We enrolled 239 adults during 2010 and 2011who were employed at the time of their colorectal cancer diagnosis and were prospectively followed over 12 months. They were compared to an age- and gender-matched general population group of 717 adults from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Data were collected using telephone and postal surveys. Primary outcomes included work participation at 12 months, changes in hours worked and time to work re-entry. Multivariable logistic and Cox proportional hazards models were undertaken. Results A significantly higher proportion of participants with colorectal cancer (27%) had stopped working at 12 months than participants from the comparison group (8%) (p < 0.001). Participants with cancer who returned to work took a median of 91 days off work (25–75 percentiles: 14–183 days). For participants with cancer, predictors of not working at 12 months included: being older, lower BMI and lower physical well-being. Factors related to delayed work re-entry included not being university-educated, working for an employer with more than 20 employees in a non-professional or managerial role, longer hospital stay, poorer perceived financial status and having or had chemotherapy. Conclusions In middle-adulthood, those working and diagnosed with colorectal cancer can expect to take around three months off work. Individuals treated with chemotherapy, without a university degree and from large employers could be targeted for specific assistance for a more timely work entry. Trial registration ACTRN12611000530921 Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-963) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louisa G Gordon
- Griffith Health Institute, Centre for Applied Health Economics, Griffith University, University Drive, Meadowbrook QLD, 4131 Brisbane, Australia.
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Dahl S, Loge JH, Berge V, Dahl AA, Cvancarova M, Fosså SD. Influence of radical prostatectomy for prostate cancer on work status and working life 3 years after surgery. J Cancer Surviv 2014; 9:172-9. [DOI: 10.1007/s11764-014-0399-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/01/2014] [Indexed: 11/28/2022]
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Dahl S, Steinsvik EAS, Dahl AA, Loge JH, Cvancarova M, Fosså SD. Return to work and sick leave after radical prostatectomy: a prospective clinical study. Acta Oncol 2014; 53:744-51. [PMID: 24195691 DOI: 10.3109/0284186x.2013.844357] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To evaluate work status at three months after radical prostatectomy (RP) in patients with prostate cancer (PCa) in relation to socio-demographics, urinary incontinence and bother, medical complications health-related quality of life (HRQOL) and surgical methods. To identify pre-RP available factors that can predict the duration of immediate post-RP sick leave. MATERIAL AND METHODS This prospective questionnaire-based study included 264 men with PCa<65 years, who were active in the work force before RP. Urinary incontinence and bother were assessed using the Expanded Prostate Cancer Index Composite-50 (EPIC-50). HRQOL was measured using SF-12. Medical complications comprised self- reported new morbidities and re-hospitalizations within three months after RP. Patients' work status was defined as either "stable/improved" or "declined" at three months compared to work status at baseline. Duration of immediate post-RP sick leave was considered as prolonged when lasting >6 weeks. Associations were analyzed using logistic regression analyses. RESULTS Almost 30% of the patients had declined work status three months after RP. Change of physical HRQOL was the only factor remaining significantly associated with declined work status in the multivariate analysis. Half of the patients had prolonged immediate sick leave. Having physically strenuous work was the strongest predictor for this outcome. CONCLUSIONS Long periods of sick leave and reduced workforce participation after RP should be considered potential adverse effects of this treatment.
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Affiliation(s)
- Sigrun Dahl
- National Resource Center for Late Effects after Cancer, Oslo University Hospital, The Norwegian Radium Hospital , Oslo , Norway
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Geraerts I, Van Poppel H, Devoogdt N, Laenen A, De Groef A, Van Kampen M. Progression and predictors of physical activity levels after radical prostatectomy. BJU Int 2014; 114:185-92. [PMID: 24112623 DOI: 10.1111/bju.12465] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the progression of all aspects (total, occupational, sports, household) of physical activity (PA) over time after radical prostatectomy (RP) and to find predictive factors for a decrease in PA. PATIENTS AND METHODS In all, 240 men planned for open or robot-assisted RP were analysed. All patients completed the Flemish Physical Activity Computerised Questionnaire before RP concerning PA over the past year and at 6 weeks, 3, 6 and 12 months after RP for the PA of the past month. A linear model for repeated measures was used to evaluate the progression of continuous variables over time and the effect of various predictors for the progression of patients over time. A logistic regression model for repeated measures was used to evaluate binary measures. RESULTS Total, occupational, sports and household PA levels were significantly decreased at 6 weeks after RP, but recovered quickly to approximately baseline levels from that time. Predictive factors for decreased PA levels at 6 weeks after RP were a younger age (total PA level), being unskilled/semi-skilled (occupational PA level) and being unemployed/retired (household PA level). RP type (open vs robot-assisted) did not influence the different PA levels at 6 weeks, 3, 6 or 12 months after RP. The severity of first day incontinence and urine loss measured at 6 weeks and 3, 6 and 12 months after RP significantly affected total and/or household PA level at all time-points. CONCLUSIONS This is the first study to investigate the progression of all aspects of PA (total, occupational, sports and household) after RP and to find predictive factors for a decrease in PA. All PA levels were significantly decreased at 6 weeks after RP and recovered quickly to approximately baseline levels from that time. Patients that had robot-assisted RP did not have a faster recovery of PA than those that had open RP. Severity of first day incontinence and urine loss measured at 6 weeks and 3, 6 and 12 months after RP were significantly related to total and/or household PA level at all time-points.
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Affiliation(s)
- Inge Geraerts
- Department of Rehabilitation Science, KU Leuven, Leuven, Belgium
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Moran JR, Short PF. Does cancer reduce labor market entry? Evidence for prime-age females. Med Care Res Rev 2013; 71:224-42. [PMID: 24243912 DOI: 10.1177/1077558713510359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Existing studies of the labor market status of cancer survivors have focused on the extent to which cancer disrupts the employment of individuals who were working when diagnosed with cancer. We examine how surviving cancer affects labor market entry and usual hours of work among females aged 28 to 54 years who were not working when first diagnosed. We find that prime-age females have employment rates 2 to 6 years after diagnosis that are 12 percentage points lower than otherwise similar women who were initially out of the labor force, full-time employment rates that are 10 percentage points lower, and usual hours of work that are 5 hours per week lower. These estimates are somewhat larger than estimates for prime-age women employed at the time of diagnosis and highlight the importance of considering nonworking females when assessing the economic and psychosocial burden of cancer.
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Affiliation(s)
- John R Moran
- 1Penn State University, University Park, PA, USA
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Luker K, Campbell M, Amir Z, Davies L. A UK survey of the impact of cancer on employment. Occup Med (Lond) 2013; 63:494-500. [DOI: 10.1093/occmed/kqt104] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Li C, Zeliadt SB, Hall IJ, Smith JL, Ekwueme DU, Moinpour CM, Penson DF, Thompson IM, Keane TE, Ramsey SD. Burden among partner caregivers of patients diagnosed with localized prostate cancer within 1 year after diagnosis: an economic perspective. Support Care Cancer 2013; 21:3461-9. [PMID: 23955026 DOI: 10.1007/s00520-013-1931-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Informal care plays an important role in the overall care for people with cancer. This study estimates lost productivity and informal caregiving and associated costs among partner caregivers of localized prostate cancer patients within 1 year after diagnosis. METHODS We applied data from the Family and Cancer Therapy Selection study, a three-wave self-administered survey among patients diagnosed with localized prostate cancer and their partner caregivers in multiple clinics in the USA. Time spent was measured by the sum of working hours lost, informal caregiving hours performed, and hours spent on household chores. The national median income for women 55 years or older was used to calculate costs associated with the time spent using the opportunity cost method. Descriptive and bivariate analyses were conducted. RESULTS The average working hours decreased from 14.0 h/week (SD = 17.6) to 10.9 h/week (SD = 15.9), without a significant change in responsibility/intensity at work. The mean annual time spent on informal caregiving and household chores was 65.9 h/year (SD = 172.4) and 76.2 h/year (SD = 193.3), respectively. The mean annual economic burden among partner caregivers was US$6,063 (range US$571-US$47,105) in 2009 dollars accounted for by a mean of 276.2 h (range 26-2,146) in the study sample. The time spent on informal caregiving and household chores varied by patient and caregiver characteristics. CONCLUSIONS Pilot estimates on non-medical economic burden among partner caregivers (spouses) during the initial phase of the treatment provide important information for comprehensive estimation of disease burden and can be used in cost-effectiveness analyses of prostate cancer interventions.
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Affiliation(s)
- Chunyu Li
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control & Prevention, 4770 Buford Highway NE, MS F-76, Atlanta, GA, 30341-3724, USA,
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Marino P, Luis Sagaon T, Laetitia M, Anne-Gaelle LCS. Sex Differences in the Return-to-Work Process of Cancer Survivors 2 Years After Diagnosis: Results From a Large French Population-Based Sample. J Clin Oncol 2013; 31:1277-84. [DOI: 10.1200/jco.2011.38.5401] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the effects of clinical, sociodemographic, and occupational factors on time to return to work (RTW) during the 2 years after cancer diagnosis and to analyze whether sex differences exist. Patients and Methods This study was based on a French national cross-sectional survey involving 4,270 cancer survivors. Time to RTW was estimated through the duration of sick leave of 801 cancer survivors younger than 58 years who were employed during the 2-year survey. Multivariate analysis of the RTW after sick leave was performed using a Weibull accelerated failure time model. Results We found some sex differences in the RTW process. Older men returned to work more slowly than older women (P = .013), whereas married men returned to work much faster than married women (P = .019). Duration dependence was also sex-specific. In men, the time spent on sick leave was independent of the probability of returning to work, whereas in women, this duration dependence was positive (P < .001). For both men and women, clinical factors including chemotherapy, adverse effects, and cancer severity were found to delay RTW (P = .035, P = .001, and P < .001, respectively). Survivors investing most strongly in their personal lives also delayed their RTW (P = .006), as did those with a permanent work contract (P = .042). The factor found to accelerate RTW was a higher educational level (P = .014). Conclusion The RTW process 2 years after cancer diagnosis differed between men and women. A better knowledge of this process should help the national implementation of more cost-effective strategies for managing the RTW of cancer survivors.
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Affiliation(s)
- Patricia Marino
- Patricia Marino, Institut Paoli-Calmettes; Patricia Marino, Luis Sagaon Teyssier, Laetitia Malavolti, and Anne-Gaelle Le Corroller-Soriano, L'Institut National de la Santé et de la Recherche Médicale INSERM, Unité Mixte de Recherche (UMR) 912; Patricia Marino, Luis Sagaon Teyssier, and Anne-Gaelle Le Corroller-Soriano, Aix Marseille Université, INSERM UMR S912; Institut de la Recherche pour le développement; and Luis Sagaon Teyssier, Observatoir Régional de la Santé Provence-Alpes-Cote d'Azur Marseilles,
| | - Teyssier Luis Sagaon
- Patricia Marino, Institut Paoli-Calmettes; Patricia Marino, Luis Sagaon Teyssier, Laetitia Malavolti, and Anne-Gaelle Le Corroller-Soriano, L'Institut National de la Santé et de la Recherche Médicale INSERM, Unité Mixte de Recherche (UMR) 912; Patricia Marino, Luis Sagaon Teyssier, and Anne-Gaelle Le Corroller-Soriano, Aix Marseille Université, INSERM UMR S912; Institut de la Recherche pour le développement; and Luis Sagaon Teyssier, Observatoir Régional de la Santé Provence-Alpes-Cote d'Azur Marseilles,
| | - Malavolti Laetitia
- Patricia Marino, Institut Paoli-Calmettes; Patricia Marino, Luis Sagaon Teyssier, Laetitia Malavolti, and Anne-Gaelle Le Corroller-Soriano, L'Institut National de la Santé et de la Recherche Médicale INSERM, Unité Mixte de Recherche (UMR) 912; Patricia Marino, Luis Sagaon Teyssier, and Anne-Gaelle Le Corroller-Soriano, Aix Marseille Université, INSERM UMR S912; Institut de la Recherche pour le développement; and Luis Sagaon Teyssier, Observatoir Régional de la Santé Provence-Alpes-Cote d'Azur Marseilles,
| | - Le Corroller-Soriano Anne-Gaelle
- Patricia Marino, Institut Paoli-Calmettes; Patricia Marino, Luis Sagaon Teyssier, Laetitia Malavolti, and Anne-Gaelle Le Corroller-Soriano, L'Institut National de la Santé et de la Recherche Médicale INSERM, Unité Mixte de Recherche (UMR) 912; Patricia Marino, Luis Sagaon Teyssier, and Anne-Gaelle Le Corroller-Soriano, Aix Marseille Université, INSERM UMR S912; Institut de la Recherche pour le développement; and Luis Sagaon Teyssier, Observatoir Régional de la Santé Provence-Alpes-Cote d'Azur Marseilles,
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Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study. J Cancer Surviv 2013; 7:191-202. [PMID: 23378060 DOI: 10.1007/s11764-012-0258-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/28/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed. METHODS We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined. RESULTS The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2-15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8-5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1-4.7), distress (OR = 3.9, 95 % CI, 1.7-9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1-6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group. CONCLUSIONS Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.
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