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Tevaarwerk A, Denlinger CS, Sanft T, Ansbaugh SM, Armenian S, Baker KS, Broderick G, Day A, Demark-Wahnefried W, Dickinson K, Friedman DL, Ganz P, Goldman M, Henry NL, Hill-Kayser C, Hudson M, Khakpour N, Koura D, McDonough AL, Melisko M, Mooney K, Moore HCF, Moryl N, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Patel C, Peterson L, Pirl W, Rodriguez MA, Ruddy KJ, Schapira L, Shockney L, Smith S, Syrjala KL, Zee P, McMillian NR, Freedman-Cass DA. Survivorship, Version 1.2021. J Natl Compr Canc Netw 2021; 19:676-685. [PMID: 34214969 DOI: 10.6004/jnccn.2021.0028] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor's complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.
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Affiliation(s)
| | | | - Tara Sanft
- 3Yale Cancer Center/Smilow Cancer Hospital
| | | | | | - K Scott Baker
- 6Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | - Andrew Day
- 8UT Southwestern Simmons Comprehensive Cancer Center
| | | | | | | | | | - Mindy Goldman
- 13UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | - Melissa Hudson
- 16St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | | | - Kathi Mooney
- 20Huntsman Cancer Institute at the University of Utah
| | - Halle C F Moore
- 21Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | | | | | - Electra D Paskett
- 25The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Lindsay Peterson
- 26Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | - Lillie Shockney
- 30The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | - Karen L Syrjala
- 6Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Phyllis Zee
- 32Robert H. Lurie Comprehensive Cancer Center of Northwestern University; and
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Gao N, Ryan M, Krucien N, Robinson S, Norman R. Paid work, household work, or leisure? Time allocation pathways among women following a cancer diagnosis. Soc Sci Med 2020; 246:112776. [PMID: 31918348 DOI: 10.1016/j.socscimed.2019.112776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is extensive evidence on the relationship between receiving a cancer diagnosis and labour market outcomes. However, there is limited evidence on the relationship between a cancer diagnosis and non-labour market outcomes such as household work, passive leisure and physical leisure. Furthermore, most current research focuses on time allocation at a given time point, ignoring both the life course perspective and long term effects. METHODS Using data from the Australian Longitudinal Study on Women's Health (ALSWH), we observe time allocation for 91 women diagnosed with breast cancer and 486 women diagnosed with skin cancer, and 2711 women living without cancer. Our analysis is unique in combining sequence analysis and multivariate multinomial logit modelling. Using sequence analysis, we first analyse life-courses post a cancer diagnosis for paid work, household work, passive leisure and physical leisure from 2004 to 2016. Using multivariate multinomial logit modelling, we test whether a cancer diagnosis influences such life-courses. We consider the robustness of results to cancer severity and change in time allocation before and after a cancer diagnosis. RESULTS We identify three clusters for paid work and two clusters for household work, passive leisure and physical leisure. Neither a breast cancer nor skin cancer diagnosis has a significant effect on the pathways of time allocation. Such results are robust to severity of diagnosis with 'cured' and 'non-cured' breast cancer, and skin cancer treated with and without 'chemotherapy or radiotherapy'. Women post a breast cancer diagnosis are less likely to maintain their pre-cancer's time use on paid work, household work and passive leisure; however, such effects are not significant. CONCLUSION Being diagnosed with breast cancer or skin cancer has no significant long-term effect on the pathways of time allocation. Future work should explore the relationship between time allocation and wellbeing and the preference for time allocation.
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Affiliation(s)
- Ni Gao
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK.
| | - Mandy Ryan
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK
| | - Nicolas Krucien
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK
| | - Suzanne Robinson
- Health Systems and Health Economics, School of Public Health, Curtin University, Perth, Australia
| | - Richard Norman
- Health Systems and Health Economics, School of Public Health, Curtin University, Perth, Australia
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Kent EE, Davidoff A, de Moor JS, McNeel TS, Virgo KS, Coughlan D, Han X, Ekwueme DU, Guy GP, Banegas MP, Alfano CM, Dowling EC, Yabroff KR. Impact of sociodemographic characteristics on underemployment in a longitudinal, nationally representative study of cancer survivors: Evidence for the importance of gender and marital status. J Psychosoc Oncol 2018; 36:287-303. [PMID: 29634413 DOI: 10.1080/07347332.2018.1440274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND We examined the longitudinal association between sociodemographic factors and an expanded definition of underemployment among those with and without cancer history in the United States. METHODS Medical Expenditure Panel Survey data (2007-2013) were used in multivariable regression analyses to compare employment status between baseline and two-year follow-up among adults aged 25-62 years at baseline (n = 1,614 with and n = 39,324 without cancer). Underemployment was defined as becoming/staying unemployed, changing from full to part-time, or reducing part-time work significantly. Interaction effects between cancer history/time since diagnosis and predictors known to be associated with employment patterns, including age, gender/marital status, education, and health insurance status at baseline were modeled. RESULTS Approximately 25% of cancer survivors and 21% of individuals without cancer reported underemployment at follow-up (p = 0.002). Multivariable analyses indicated that those with a cancer history report underemployment more frequently (24.7%) than those without cancer (21.4%, p = 0.002) with underemployment rates increasing with time since cancer diagnosis. A significant interaction between gender/marital status and cancer history and underemployment was found (p = 0.0004). There were no other significant interactions. Married female survivors diagnosed >10 years ago reported underemployment most commonly (38.7%), and married men without cancer reported underemployment most infrequently (14.0%). A wider absolute difference in underemployment reports for married versus unmarried women as compared to married versus unmarried men was evident, with the widest difference apparent for unmarried versus married women diagnosed >10 years ago (18.1% vs. 38.7%). CONCLUSION Cancer survivors are more likely to experience underemployment than those without cancer. Longer time since cancer diagnosis and gender/marital status are critical factors in predicting those at greatest risk of underemployment. The impact of cancer on work should be systematically studied across sociodemographic groups and recognized as a component of comprehensive survivorship care.
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Affiliation(s)
- Erin E Kent
- a Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute , Rockville , Maryland , USA.,b ICF International , Fairfax , VA
| | - Amy Davidoff
- c Department of Health Policy & Management , School of Public Health, Yale University , New Haven , Connecticut , USA
| | - Janet S de Moor
- a Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute , Rockville , Maryland , USA
| | - Timothy S McNeel
- d Information Management Services, Inc. , Rockville , Maryland , USA
| | - Katherine S Virgo
- e Department of Health Policy and Management , Rollins School of Public Health, Emory University , Atlanta , Georgia , USA
| | - Diarmuid Coughlan
- f Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute , Rockville , Maryland , USA
| | - Xuesong Han
- g American Cancer Society , Atlanta , Georgia , USA
| | - Donatus U Ekwueme
- h Centers for Disease Control and Prevention, Division of Cancer Prevention and Control , Atlanta , Georgia , USA
| | - Gery P Guy
- h Centers for Disease Control and Prevention, Division of Cancer Prevention and Control , Atlanta , Georgia , USA
| | - Matthew P Banegas
- i Kaiser Permanente Center for Health Research , Portland , Oregon , USA
| | | | - Emily C Dowling
- j Massachusetts General Hospital , Boston , Massachusetts , USA
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Heinesen E, Imai S, Maruyama S. Employment, job skills and occupational mobility of cancer survivors. JOURNAL OF HEALTH ECONOMICS 2018; 58:151-175. [PMID: 29486331 DOI: 10.1016/j.jhealeco.2018.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 06/08/2023]
Abstract
Previous studies find significant negative effects of cancer on employment, with stronger effects for less-educated workers. We investigate whether the effect of cancer varies by skill requirement in the pre-cancer occupation, whether such heterogeneity can explain educational gradients, and whether cancer is associated with changes in job characteristics for cancer survivors who remain employed four years after the diagnosis. We combine Danish administrative registers with detailed skill requirement data and use individuals without cancer as a control group. Our main findings are the following: the negative effect of cancer on employment is stronger if the pre-cancer occupation requires high levels of manual skills or low levels of cognitive skills; the educational gradient diminishes substantially if we allow the effects of cancer to also depend on pre-cancer skill requirements; and cancer is not associated with occupational mobility, indicating potential for policies that reduce labour market frictions for cancer survivors.
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Affiliation(s)
- Eskil Heinesen
- Rockwool Foundation Research Unit, Sølvgade 10, 1307 Copenhagen K, Denmark.
| | - Susumu Imai
- Hokkaido University, Kita 9 Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0809, Japan; University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Shiko Maruyama
- University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
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Hornbrook MC, Grant M, Wendel C, Bulkley JE, Mcmullen CK, Altschuler A, Temple LK, Herrinton LJ, Krouse RS. Rectal Cancer Survivors' Participation in Productive Activities. Perm J 2017; 22:17-022. [PMID: 29236653 DOI: 10.7812/tpp/17-022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Rectal cancer and its treatment impair survivors' productivity. OBJECTIVE To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. DESIGN We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. MAIN OUTCOME MEASURES Productive activities, functional health status, and bowel management at the time of the survey. RESULTS Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. CONCLUSION Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.
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Affiliation(s)
- Mark C Hornbrook
- Senior Investigator Emeritus at the Center for Health Research in Portland, OR.
| | - Marcia Grant
- Distinguished Professor in the Department of Nursing Research and Education at the City of Hope National Medical Center in Duarte, CA.
| | - Christopher Wendel
- Instructor at the University of Arizona College of Medicine and Arizona Center on Aging in Tucson.
| | - Joanna E Bulkley
- Research Associate at the Center for Health Research in Portland, OR.
| | - Carmit K Mcmullen
- Medical Anthropologist and Investigator in the Science Programs Department at the Center for Health Research in Portland, OR.
| | - Andrea Altschuler
- Research Project Manager for the Division of Research in Oakland, CA.
| | - Larissa Kf Temple
- Chief of the Division of Colorectal Surgery at the University of Rochester Medical Center in NY.
| | | | - Robert S Krouse
- Instructor of Surgery at the University of Pennslvania School of Medicine and Chief of Surgery for the CMC Veterans Affairs Medical Center in Philadelphia.
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