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den Bakker CM, Anema JR, Zaman AGNM, de Vet HCW, Sharp L, Angenete E, Allaix ME, Otten RHJ, Huirne JAF, Bonjer HJ, de Boer AGEM, Schaafsma FG. Prognostic factors for return to work and work disability among colorectal cancer survivors; A systematic review. PLoS One 2018; 13:e0200720. [PMID: 30110333 PMCID: PMC6093640 DOI: 10.1371/journal.pone.0200720] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 07/02/2018] [Indexed: 12/22/2022] Open
Abstract
Background Colorectal cancer is diagnosed progressively in employed patients due to screening programs and increasing retirement age. The objective of this study was to identify prognostic factors for return to work and work disability in patients with colorectal cancer. Methods The research protocol was published at PROSPERO with registration number CRD42017049757. A systematic review of cohort and case-control studies in colorectal cancer patients above 18 years, who were employed when diagnosed, and who had a surgical resection with curative intent were included. The primary outcome was return to work or work disability. Potentially prognostic factors were included in the analysis if they were measured in at least three studies. Risk of bias was assessed according to the QUality In Prognosis Studies tool. A qualitative synthesis analysis was performed due to heterogeneity between studies. Quality of evidence was evaluated according to Grading of Recommendation Assessment, Development and Evaluation. Results Eight studies were included with a follow-up period of 26 up to 520 weeks. (Neo)adjuvant therapy, higher age, and more comorbidities had a significant negative influence on return to work. A previous period of unemployment, extensive surgical resection and postoperative complications significantly increased the risk of work disability. The quality of evidence for these prognostic factors was considered very low to moderate. Conclusion Health care professionals need to be aware of these prognostic factors to select patients eligible for timely intensified rehabilitation in order to optimize the return to work process and prevent work disability.
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Affiliation(s)
- Chantal M. den Bakker
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
- * E-mail:
| | - Johannes R. Anema
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - AnneClaire G. N. M. Zaman
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrika C. W. de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University medical center, Amsterdam, The Netherlands
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle, United Kingdom
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Göteburg, Sweden
| | - Marco E. Allaix
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | | | - Judith A. F. Huirne
- Department of Gynaecology, VU University medical center, Amsterdam, The Netherlands
| | - Hendrik J. Bonjer
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
| | - Angela G. E. M. de Boer
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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