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Bennink C, Brink M, Duijts SFA, Scheurer H, Sonneveld P, Blommestein HM. Changes in income and employment after diagnosis among patients with multiple myeloma in The Netherlands. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024; 24:604-610. [PMID: 38724440 DOI: 10.1016/j.clml.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE Due to new treatment options, survival rates in multiple myeloma (MM) are improving. Consequently, maintaining work and income is becoming more important for patients and society. Therefore, we aimed to explore the change in income and employment in patients with MM. METHODS Data from the Netherlands Cancer Registry of MM patients diagnosed between 2012 and 2017 were merged with socioeconomic data from Statistics Netherlands. Descriptive statistics were used to analyse total income, income from employment, and accumulated income before and after diagnosis. RESULTS Income from employment decreased by 45% in MM patients, between 1 year before and 4 years after diagnosis Four years after diagnosis, 35% of the patients were still employed, with an accumulated 5-year productivity loss of €121 million. Higher income loss from employment and job loss was observed in female patients, patients with more extensive disease, or those not treated with autologous stem cell transplant. CONCLUSION Loss of (income from) employment among patients with MM was high, causing financial burden on the patient and society. With improving survival in MM, more research and awareness are needed to better assess the importance of income and work for MM patients and society.
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Affiliation(s)
- Christine Bennink
- Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Haematology, Amphia, Breda, The Netherlands.
| | - Mirian Brink
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands; Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands; Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
| | | | - Pieter Sonneveld
- Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hedwig M Blommestein
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands
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Maksten EF, Jørgensen RRK, Pedersen MS, Fonager K, Bech RS, Mølle I, Ørskov AD, Schöllkopf C, Overgaard UM, Thomsen GN, El-Galaly TC, Severinsen MT. Work Disability and Return to Work After Treatment for Acute Lymphoblastic Leukemia: A Danish Nationwide Cohort Study. Clin Epidemiol 2024; 16:191-202. [PMID: 38500516 PMCID: PMC10946445 DOI: 10.2147/clep.s444270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose Most adult patients diagnosed with acute lymphoblastic leukemia (ALL) are below retirement age. The overall survival of patients with ALL has improved with implementation of high intensity pediatric-inspired treatment protocols. However, this treatment comes with a risk of long-term complications, which could affect the ability to work. The aim of this study was to investigate the risk of disability pension (DP) and return to work (RTW) for patients with ALL. Patients and Methods Patients aged 18-60 years diagnosed with ALL between 2005 and 2019 were identified in the Danish National Acute Leukemia Registry. Each patient was matched with five comparators from the general population on birth year, sex, and Charlson Comorbidity Index. The Aalen-Johansen estimator was used to calculate the cumulative risk of DP for patients and comparators from index date (defined as 1 year after diagnosis) with competing events (transplantation or relapse, death, retirement pension, or early retirement pension). Differences in cumulative incidences were calculated using Gray's test. RTW was calculated as proportions one, three, and five years after the index date for patients holding a job before diagnosis. Results A total of 154 patients with ALL and 770 matched comparators were included. The 5-year cumulative risk of DP was increased fivefold for patients with ALL compared with the general population. RTW was 41.7%, 65.7%, and 60.7% one, three, and five years after the index date, respectively. Conclusion The risk of DP in patients with ALL increased significantly compared with the general population. Five years after the index date, RTW was 60.7% for patients with ALL.
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Affiliation(s)
- Eva Futtrup Maksten
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rasmus Rask Kragh Jørgensen
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mathilde Selmar Pedersen
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kirsten Fonager
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Rie Sander Bech
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ingolf Mølle
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Andreas Due Ørskov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Claudia Schöllkopf
- Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Tarec C El-Galaly
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Baum J, Lax H, Lehmann N, Merkel-Jens A, Beelen DW, Jöckel KH, Dührsen U. Impairment of vocational activities and financial problems are frequent among German blood cancer survivors. Sci Rep 2023; 13:22856. [PMID: 38129654 PMCID: PMC10739705 DOI: 10.1038/s41598-023-50289-9] [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: 08/28/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Little is known about changes in the personal living conditions of long-term blood cancer survivors in Germany. To gather information about social relationships, work life, overall well-being, and religion, we performed a questionnaire-based retrospective study on 1551 survivors who had been on follow-up for ≥ 3 years (median, 9 years). Most survivors reported that marital status and relationships with relatives and friends remained constant before and after blood cancer. Vocational activities were temporarily impaired for 47.5%, with a median time of 11 months to return to work. More than a third of the patients (35.6%) discontinued work permanently, with disability and retirement pension rates of 7.9% and 38.1%, respectively, at the time of the survey. Financial problems due to reduced income were reported by 26.2%, in particular after relapse or allogeneic transplantation. Patient reports addressing their quality of life showed large variations. It was best in acute leukemia survivors without a history of allogeneic transplantation and worst in patients with myeloproliferative disorders. Religion tended to become more important after blood cancer. In conclusion, vocational impairment and financial problems are frequent among German blood cancer survivors. Efforts should be made at an early stage to reestablish the patients' ability to work.
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Affiliation(s)
- Julia Baum
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Hildegard Lax
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Nils Lehmann
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Anja Merkel-Jens
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Dietrich W Beelen
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
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Svingel LS, Christensen SF, Kjærsgaard A, Stenling A, Paulsson B, Andersen CL, Christiansen CF, Stentoft J, Starklint J, Severinsen MT, Borg Clausen M, Hagemann Hilsøe M, Hasselbalch HC, Frederiksen H, Bak M, Mikkelsen EM. Labor market affiliation of patients with myeloproliferative neoplasms: a population-based matched cohort study. Acta Oncol 2023; 62:1286-1294. [PMID: 37656802 DOI: 10.1080/0284186x.2023.2251670] [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: 03/01/2023] [Accepted: 08/19/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Patients with myeloproliferative neoplasms (MPNs) suffer from substantial symptoms and risk of debilitating complications, yet observational data on their labor market affiliation are scarce. MATERIAL AND METHODS We conducted a descriptive cohort study using data from Danish nationwide registries, including patients diagnosed with MPN in 2010-2016. Each patient was matched with up to ten comparators without MPN on age, sex, level of education, and region of residence. We assessed pre- and post-diagnosis labor market affiliation, defined as working, unemployed, or receiving sickness benefit, disability pension, retirement pension, or other health-related benefits. Labor market affiliation was assessed weekly from two years pre-diagnosis until death, emigration, or 31 December 2018. For patients and comparators, we reported percentage point (pp) changes in labor market affiliation cross-sectionally from week -104 pre-diagnosis to week 104 post-diagnosis. RESULTS The study included 3,342 patients with MPN and 32,737 comparators. From two years pre-diagnosis until two years post-diagnosis, a larger reduction in the proportion working was observed among patients than comparators (essential thrombocythemia: 10.2 [95% CI: 6.3-14.1] vs. 6.8 [95% CI: 5.5-8.0] pp; polycythemia vera: 9.6 [95% CI: 5.9-13.2] vs. 7.4 [95% CI: 6.2-8.7] pp; myelofibrosis: 8.1 [95% CI: 3.0-13.2] vs. 5.8 [95% CI: 4.2-7.5] pp; and unclassifiable MPN: 8.0 [95% CI: 3.0-13.0] vs. 7.4 [95% CI: 5.7-9.1] pp). Correspondingly, an increase in the proportion of patients receiving sickness benefits including other health-related benefits was evident around the time of diagnosis. CONCLUSION Overall, we found that Danish patients with essential thrombocythemia, polycythemia vera, myelofibrosis, and unclassifiable MPN had slightly impaired labor market affiliation compared with a population of the same age and sex. From two years pre-diagnosis to two years post-diagnosis, we observed a larger reduction in the proportion of patients with MPN working and a greater proportion receiving sickness benefits compared with matched individuals.
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Affiliation(s)
- Lise Skovgaard Svingel
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | | | - Anders Kjærsgaard
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | | | | | | | - Christian Fynbo Christiansen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
| | - Jesper Stentoft
- Department of Hematology, Aarhus University Hospital, Denmark
| | | | | | - Mette Borg Clausen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | | | | | - Marie Bak
- Department of Hematology, Zealand University Hospital, Denmark
| | - Ellen Margrethe Mikkelsen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
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Dahl AA, Smeland KB, Eikeland S, Fagerli UM, Bersvendsen HS, Fosså A, Kiserud CE. Work ability and work status changes in long-term Hodgkin lymphoma survivors with focus on late adverse effects. J Cancer Surviv 2023:10.1007/s11764-023-01432-y. [PMID: 37526861 DOI: 10.1007/s11764-023-01432-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE We studied work-related issues in long-term survivors of Hodgkin lymphoma [HLSs] who had undergone treatment according to contemporary stage risk-adapted approaches. At survey, work changes and problems since diagnosis, comparisons of HLSs with low/moderate versus high work ability, associations between work issues, and late adverse effects [LAEs] were examined. METHODS This cross-sectional questionnaire-based study included HLSs treated from 1997 to 2006 and alive at the end of 2016. They completed a mailed questionnaire including work and health-related issues. RESULTS Among 518 invited HLSs, 297 (58%) completed the work-related issues, and 48% of them were females. Mean age at survey was 45.9 years, and mean time was 16.7 years since diagnosis. At follow-up, 71% of the HLSs held paid work and 19% were on disability pension. Only 3% of HLSs did not hold paid work at any time after diagnosis. In total, 43% HLSs had low/moderate and 57% high work ability at follow-up. Low/moderate work ability was significantly associated with older age, female sex, more LAEs, disability pension, lower household income, distressed personality, obesity, fatigue, and mental disorders. More LAEs were significantly associated with more work problems. CONCLUSIONS Many HLSs manage to stay in the work force. Several health problems and LAEs amenable for interventions are significantly associated with low/moderate work ability and emphasize the importance of focus on these issues in long-term follow-up. IMPLICATIONS FOR CANCER SURVIVORS HLSs in paid work at diagnosis can be optimistic as to their future participation in work life. Screening and treatment for health problems such as LAEs may improve work ability.
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Affiliation(s)
- Alv A Dahl
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway.
- Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | - Knut B Smeland
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Siri Eikeland
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Hanne S Bersvendsen
- Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Alexander Fosså
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- KG Jebsen Center for B-Cell Malignancies, University of Oslo, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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Diaz-delCastillo M, Gundesen MT, Andersen CW, Nielsen AL, Møller HEH, Vinholt PJ, Asmussen JT, Kristensen IB, Nyvold CG, Abildgaard N, Levin Andersen T, Lund T. Increased Bone Volume by Ixazomib in Multiple Myeloma: 3-Month Results from an Open Label Phase 2 Study. J Bone Miner Res 2023; 38:639-649. [PMID: 36970780 DOI: 10.1002/jbmr.4807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
Multiple myeloma (MM) is an incurable bone marrow cancer characterized by the development of osteolytic lesions due to the myeloma-induced increase in osteoclastogenesis and decrease in osteoblastic activity. The standard treatment of MM often involves proteasome inhibitors (PIs), which can also have a beneficial off-target bone anabolic effect. However, long-term treatment with PIs is unadvised due to their high side-effect burden and inconvenient route of administration. Ixazomib is a new-generation, oral PI that is generally well tolerated; however, its bone effect remains unknown. Here, we describe the 3-month results of a single-center phase II clinical trial investigating the effect of ixazomib treatment on bone formation and bone microstructure. Thirty patients with MM in stable disease not receiving antimyeloma treatment for ≥3 months and presenting ≥2 osteolytic lesions received monthly ixazomib treatment cycles. Serum and plasma samples were collected at baseline and monthly thereafter. Sodium 18 F-Fluoride positron emission tomography (NaF-PET) whole-body scans and trephine iliac crest bone biopsies were collected before and after three treatment cycles. The serum levels of bone remodeling biomarkers suggested an early ixazomib-induced decrease in bone resorption. NaF-PET scans indicated unchanged bone formation ratios; however, histological analyses of bone biopsies revealed a significant increase in bone volume per total volume after treatment. Further analyses of bone biopsies showed unchanged osteoclast number and COLL1A1High -expressing osteoblasts on bone surfaces. Next, we analyzed the superficial bone structural units (BSUs), which represent each recent microscopic bone remodeling event. Osteopontin staining revealed that following treatment, significantly more BSUs were enlarged (>200,000 μm2 ), and the distribution frequency of their shape was significantly different from baseline. Overall, our data suggest that ixazomib induces overflow remodeling-based bone formation by decreasing the level of bone resorption and promoting longer bone formation events, making it a potentially valuable candidate for future maintenance treatment. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Michael Tveden Gundesen
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | | | | | - Jon Thor Asmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Ida Bruun Kristensen
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Hematology-Pathology Research Laboratory, Research Unit for Hematology & Research Unit for Pathology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Charlotte Guldborg Nyvold
- Hematology-Pathology Research Laboratory, Research Unit for Hematology & Research Unit for Pathology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Niels Abildgaard
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Levin Andersen
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Thomas Lund
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Maksten EF, Jakobsen LH, Kragholm KH, Baech J, Andersen MP, Madsen J, Jørgensen JM, Clausen MR, Pedersen RS, Dessau-Arp A, Larsen TS, Poulsen CB, Gang AO, Brown P, Fonager K, El-Galaly TC, Severinsen MT. Work Disability and Return to Work After Lymphoma: A Danish Nationwide Cohort Study. Clin Epidemiol 2023; 15:337-348. [PMID: 36941977 PMCID: PMC10024509 DOI: 10.2147/clep.s399488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
Purpose Many patients diagnosed with lymphoma are of working age. Cancer patients are known to have a higher risk of sick leave and disability pension, but this has only been delineated for certain subtypes of lymphoma. Therefore, this study aimed at investigating the overall risk of disability pension for all lymphoma subtypes and at quantifying return to work for patients with lymphoma in work before diagnosis. Patients and Methods Patients aged 18-60 years with lymphoma in complete remission (CR) diagnosed between 2000 and 2019 were included in the study. Using national registers, each patient was matched with five comparators from the general population with same sex, birth year, and level of Charlson Comorbidity Index. Risk of disability pension was calculated from 90 days after CR or end of treatment with competing events (death, retirement pension, early retirement pension, relapse for patients, or lymphoma diagnosis for comparators). Return to work for patients was calculated annually until 5 years after diagnosis for patients employed before diagnosis. Results In total, 4072 patients and 20,360 comparators were included. There was a significant increased risk of disability pension for patients with all types of lymphoma compared to the general population (5-year risk difference: 5.3 (95% confidence interval (CI): 4.4;6.2)). Patients with non-Hodgkin lymphoma were more likely to get disability pension than patients with Hodgkin lymphoma (sex- and age-adjusted 10-year risk difference: 2.9 (95% CI: 0.3;5.5)). One year after diagnosis, 24.5% of the relapse-free patients were on sick leave. Return to work was highest 2 years after diagnosis (82.1%). Conclusion Patients with lymphoma across all subtypes have a significantly higher risk of disability pension. Return to work peaks at 2 years after diagnosis.
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Affiliation(s)
- Eva Futtrup Maksten
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Correspondence: Eva Futtrup Maksten, Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, Aalborg, 9000, Denmark, Tel +45 97663872, Fax + 45 97666323, Email
| | - Lasse Hjort Jakobsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Kristian Hay Kragholm
- Department of Cardiology & Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Joachim Baech
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Jakob Madsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | | | - Robert Schou Pedersen
- Department of Medicine, Section of Haematology, Regionshospital Goedstrup, Goedstrup, Denmark
| | | | | | | | - Anne Ortved Gang
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Brown
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Fonager
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Tarec C El-Galaly
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Haematology, Clinical Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Impact of the treatment of chronic myeloid leukaemia by tyrosine-kinase inhibitors on sick leaves refund: a nationwide cohort study. Support Care Cancer 2022; 30:5431-5440. [PMID: 35304631 DOI: 10.1007/s00520-022-06968-w] [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: 07/31/2021] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The advent of chronic myeloid leukaemia (CML) tyrosine-kinase inhibitors (TKI) has led to new paradigms including occupational rehabilitation. OBJECTIVES This study aimed to characterize the impact of CML treatment on sick leaves within the 2 years following diagnosis in working-age patients. METHODS A cohort of all 18-60-year-old newly diagnosed CML patients initiating a TKI between January 1st 2011 and December 31st 2014 in France was identified in the French National Healthcare database (Système National des Données de Santé [SNDS]). Patients with a sick leave identified in the 24 months after TKI initiation were compared with sex and initiation date matched controls in a nested case-control design. Factors associated with sick leaves were identified through a conditional logistic regression model, providing adjusted odds-ratio (OR) with their 95% confidence interval (CI). RESULTS Among 646 18-60-year-old patients, 268 were prescribed at least one sick leave in the study period, with 176 (27.2%) having their first sick leave prescribed after TKI initiation. The median number of sick days over the 2-years period was 115 per patient (interquartile range 25.5-384.5). In the nested case-control study (176 cases and 176 matched controls), sick leaves were more likely observed with second generation TKI (OR 4.11 [1.80-9.38]), whereas they were less likely observed in case if social deprivation (OR 0.07 [0.02-0.28]. CONCLUSION More than 25% of working-age CML patients had at least one sick leave within 2 years of TKI initiation, with a higher impact of second generation TKI, and with a median duration of 115 days.
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Nielsen LK, Larsen RF, Jarlbaek L, Möller S, Jespersen E. Health-related quality of life in patients with multiple myeloma participating in a multidisciplinary rehabilitation program. Ann Hematol 2021; 100:2311-2323. [PMID: 33409622 DOI: 10.1007/s00277-020-04356-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
Patients with multiple myeloma (MM) report high symptom burden and functional disabilities resulting in impaired health-related quality of life (HRQoL). Effective evidence-based rehabilitation guidelines are needed for patients with MM to improve HRQoL. The primary aim of this study was to investigate HRQoL in patients with rehabilitation needs living their everyday life. Patients with MM in remission attended a 12-week multidisciplinary rehabilitation program including a 5-day residential course, home-based exercise and a 2-day follow-up course. The patients were referred by the treating haematologist and completed a booklet of validated HRQoL questionnaires at baseline and before arriving for the 2-day follow-up course. The proportion of participants with moderate to severe symptoms and functional problems were assessed at the two time points and multivariate logistic regression was used to investigate explaining factors of impaired HRQoL at baseline. Ninety-two patients participated with a follow-up compliance rate of 90%. Median age was 67 years and median time since diagnosis was 26 months (ranged 5 months to 15.6 years). The most frequently reported symptoms were global quality of life, role functioning, fatigue, pain, peripheral neuropathy and physical functioning. Pain and fatigue were both highly coherent with impairment in physical functioning and those two symptoms explained most HRQoL impairments. Overall, the participants reported no change in HRQoL after the 12-week rehabilitation program. The study supports the need for an evidence-based guideline for rehabilitation and palliative care to patients with MM in remission living their everyday life.
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Affiliation(s)
- Lene Kongsgaard Nielsen
- Quality of Life Research Center, Department of Haematology, Odense University Hospital, Kløvervænget 10, 12. floor, 5000, Odense C, Denmark.
- Department of Internal Medicine and Cardiology, Regional Hospital Viborg, Viborg, Denmark.
| | - Rikke Faebo Larsen
- Department of Occupational Therapy and Physiotherapy, Zealand University Hospital, Koge, Denmark
- Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Lene Jarlbaek
- REHPA - The Danish Knowlegde Centre for Rehabilitation and Palliative Care, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- OPEN - Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Eva Jespersen
- REHPA - The Danish Knowlegde Centre for Rehabilitation and Palliative Care, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Rehabilitation, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Bennink C, van der Klift M, Scheurer H, Sonneveld P, Duijts SFA. Perspectives on returning to work of multiple myeloma patients: A qualitative interview study. Eur J Cancer Care (Engl) 2021; 30:e13481. [PMID: 34152665 PMCID: PMC9285059 DOI: 10.1111/ecc.13481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/08/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
Objective Multiple myeloma (MM) is a rare and incurable disease. Because new treatments improved survival rates, return to work (RTW) became more relevant to MM patients of working age. Also, (health care) experts may be confronted with specific obstacles in guiding MM patients' RTW. Therefore, we aimed to qualitatively explore perspectives and experiences of MM patients and (health care) experts regarding RTW and participation at work. Methods Semi‐structured interviews were conducted with patients (N = 9) and (health care) experts (N = 15). Interviews were transcribed verbatim and analysed using thematic analysis. Results Four themes resulted from the interviews with patients and (health care) experts: (1) severity of diagnosis and treatment impact RTW, (2) step‐by‐step reintegration facilitates RTW, (3) meaning of work differs between MM patients and experts and (4) lack of tailored counselling by experts. Conclusion Although MM patients' work ability may be limited due to the severity of diagnosis and side effects from treatment, most patients consider RTW important. Both patients and (health care) experts emphasise the benefits from early work ability assessment (in the hospital setting) and specialised RTW counselling, especially in those with physically demanding jobs.
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Affiliation(s)
- Christine Bennink
- Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | | | - Hans Scheurer
- Myeloma Patients Europe (MPE), Brussels, Belgium.,Hematon, Utrecht, The Netherlands
| | - Pieter Sonneveld
- Department of Haematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University Amsterdam, Amsterdam, The Netherlands
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11
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Hernæs KH, Smeland KB, Fagerli UM, Kiserud CE. Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation. BMC Cancer 2021; 21:143. [PMID: 33557789 PMCID: PMC7871541 DOI: 10.1186/s12885-021-07836-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/26/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT. METHODS All survivors treated with HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged ≥18 years at HDT-ASCT and alive at survey in 2012-2013 were eligible. We divide survivors by current employment status (full-time, part-time and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients employed when diagnosed but not before HDT-ASCT. RESULTS Of the 274 who completed the survey, 82% (N = 225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 70% of the average annual wage in Norway in 2012. CONCLUSIONS For a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors' probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.
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Affiliation(s)
- Kjersti Helene Hernæs
- Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway. .,Previous affiliation: Research Support Services, Oslo University Hospital, Sogn Arena, Klaus Torgårds vei 3, 3. Floor, 0372, Oslo, Norway.
| | - Knut B Smeland
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
| | - Unn-Merete Fagerli
- Department of Oncology, St. Olavs hospital HF, Postboks 3250 Torgarden, 7006, Trondheim, Norway.,Institute for Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Olav kyrres gate 9, 7006, Trondheim, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
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12
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Rosbjerg R, Hansen DG, Zachariae R, Hoejris I, Lund T, Labriola M. The Predictive Value of Return to Work Self-efficacy for Return to Work Among Employees with Cancer Undergoing Chemotherapy. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:665-678. [PMID: 32114672 PMCID: PMC7716905 DOI: 10.1007/s10926-020-09882-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose The aim of the present study was to examine the predictive value of Return to Work Self-efficacy (RTWSE) on Return to Work (RTW) among employees undergoing chemotherapy for cancer and to examine the relative contribution of RTWSE as predictor variable compared to personal, health-related, illness- and treatment-related and work-related factors. Methods A sample of 114 sickness absent employees with various cancers (age 18-62) included in the study on average 33 days after initiating chemotherapy were followed for 15 months. Data sources included patient questionnaires (RTWSE, depression, fatigue, performance status), sociodemographic factors (age, sex, job type, and perceived support from the workplace), patient records (type of cancer, treatment intention, number of treatment modalities, time since diagnosis and time since initiation of chemotherapy), and Danish national registries (RTW and education). Associations between RTWSE at baseline and weeks until full RTW during 15-months follow-up were analyzed using Cox proportional hazards regression. Results In the univariate analysis, high RTWSE was associated with shorter time to RTW (Hazard Ratio (HR) 1.84, 95% confidence interval (CI) 1.12-3.03). In the multivariate model, RTWSE failed to reach statistical significance (HR 1.12, 95% CI 0.62-2.02), whereas female sex (HR 0.30, 95% CI 0.15-0.60) and receiving palliative treatment (HR 0.15, 95% CI 0.05-0.44) were significantly associated with later RTW. Conclusion Compared to other factors of significance, RTWSE was not the strongest predictor of RTW when examined among employees undergoing chemotherapy for cancer. Before using the RTWSE questionnaire to identify employees with cancer at risk of late RTW, it is important to recognize that the predictive value of RTWSE may be different for employees on sick leave due to cancer than for other sickness absence populations.
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Affiliation(s)
- Rikke Rosbjerg
- Department of Public Health, Aarhus University, Aarhus, Denmark.
- DEFACTUM, Central Denmark Region, P.P. Ørums Gade 11, 1.B, 8000, Aarhus C, Denmark.
| | - Dorte Gilså Hansen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Department of Psychology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Inger Hoejris
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Lund
- Centre for Social Medicin, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Merete Labriola
- Centre for Social Medicin, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- NORCE Norwegian Research Centre AS, Bergen, Norway
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13
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Hutchings M, Dahl‐Sørensen RB, Frederiksen H, Stoltenberg D, Bøgsted M, Østgård LSG, Severinsen MT, El‐Galaly TC. Depression and anxiety in Hodgkin lymphoma patients: A Danish nationwide cohort study of 945 patients. Cancer Med 2020; 9:4395-4404. [PMID: 32301251 PMCID: PMC7300408 DOI: 10.1002/cam4.2981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/15/2022] Open
Abstract
Cancer-related psychological distress may lead to depression and anxiety among survivors. The vast majority of patients with Hodgkin lymphoma (HL) become long-term survivors, but the risk of mental health problems after HL is not well-characterized. Using national population-based registries, we investigated the cumulative incidence of psychotropic drug (antidepressants, antipsychotics, and anxiolytics) use (proxies for depression and anxiety) in HL patients as well as if an increased risk would normalize over time for patients in remission. The study included 945 HL patients aged 18-92 years and 4725 matched persons. In total, 215 HL patients (22.8%) received a prescription of any psychotropic drug (PD) at some point after date of diagnosis compared to 545 persons (11.5%) in the matched cohort. Cumulative incidences with death/relapse as competing risk confirmed that HL patients were at higher risk of receiving psychotropic drug prescriptions, but the increased risk was transient and normalized to the matched population 5 years into survivorship. Increased age, Eastern Cooperative Oncology Group performance status, and disease stage were associated with higher risk of psychotropic drug prescriptions. Given the increased rate of psychotropic drug prescriptions after HL diagnosis, screening for symptoms of depression and anxiety is warranted after HL diagnosis and first years into survivorship.
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Affiliation(s)
- Andreas K. Øvlisen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | - Lasse H. Jakobsen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | - Kristian H. Kragholm
- Department of CardiologyUnit of Epidemiology and BiostatisticsAalborg University HospitalAalborgDenmark
| | - René E. Nielsen
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Department of PsychiatryAalborg University HospitalAalborgDenmark
| | - Martin Hutchings
- Department of HaematologyRigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | | | | | - Danny Stoltenberg
- Department of HaematologyCopenhagen University HospitalHerlevDenmark
| | - Martin Bøgsted
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | | | - Marianne T. Severinsen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Clinical Cancer Research UnitAalborg University HospitalAalborgDenmark
| | - Tarec C. El‐Galaly
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Clinical Cancer Research UnitAalborg University HospitalAalborgDenmark
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14
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Endo M, Muto G, Imai Y, Mitsui K, Nishimura K, Hayashi K. Predictors of post-cancer diagnosis resignation among Japanese cancer survivors. J Cancer Surviv 2020; 14:106-113. [PMID: 31721037 DOI: 10.1007/s11764-019-00827-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE In Japan, due to the increased incidence of cancer among the working population, it has become more important to support employees to achieve a balance between cancer treatment and work. This study aimed to clarify the predictors of resigning from employment after being diagnosed with cancer (post-cancer diagnosis [PCD] resignation) among Japanese employees. METHODS As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2017. The investigators analyzed the risk factors for PCD resignation using a logistic regression model, including age at diagnosis, sex, cancer type, cancer stage, year of diagnosis, whether the patient held a managerial role, type of employment, and company size. RESULTS Of 750 employed Japanese CSs, 93 (12.4%) resigned from their jobs. The non-managers resigned more often (14.6%) than the managers (7.6%) (p = 0.007). The temporary workers exhibited the highest PCD resignation rates (22.2%), while the PCD resignation rates of the self-employed workers and permanent workers were 15.2% and 7.6%, respectively (p < 0.001). As the result of multivariate analysis, being female (odds ratio [OR], 3.67; 95%CI, 1.71-7.87), having hematological cancer (OR, 4.23; 95%CI, 1.37-13.04), having advanced cancer (OR, 2.48; 95%CI, 1.52-4.03), and being a temporary worker (OR, 2.51; 95%CI, 1.40-4.50) were identified as predictors of PCD resignation. CONCLUSIONS In total, 12.4% of Japanese employees quit their jobs after being diagnosed with cancer. Being female or a temporary worker and having advanced cancer were identified as predictors of PCD resignation. Regarding cancer type, hematological cancer was most strongly associated with PCD resignation. IMPLICATION OF CANCER SURVIVORS CSs who are females and temporary workers and have advanced cancer should be followed-up more carefully after cancer diagnosis for their work sustainability, by medical professionals, companies, and society.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Go Muto
- Department of Hygiene, Kitasato University School of Medicine, Tokyo, Japan
| | - Yuya Imai
- Department of Public Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kiyomi Mitsui
- Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Tokyo, Japan
| | - Katsuji Nishimura
- Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Kazuhiko Hayashi
- Department of Chemotherapy and Palliative Care, Tokyo Women's Medical University Hospital, Tokyo, Japan
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15
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Stapelfeldt CM, Duijts SFA, Horsboel TA, Momsen AMH, Andersen NT, Larsen FB, Friis K, Nielsen CV. Educational attainment and work disability in cancer survivors: Do diagnosis and comorbidity affect this association? Eur J Cancer Care (Engl) 2020; 29:e13228. [PMID: 31999396 DOI: 10.1111/ecc.13228] [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: 06/24/2019] [Revised: 12/13/2019] [Accepted: 01/07/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To study whether educational attainment had less impact on work disability in cancer survivors than in individuals without cancer. To study whether comorbidity had a higher impact on work disability in low-educated cancer survivors than in high-educated and whether this impact differed when compared with individuals without cancer. METHODS Linkage of population-based public health survey data and the Danish Cancer Registry formed two groups: cancer survivors (n = 3,514) and cancer-free individuals (n = 171,262). In logistic regression models, the risk of experiencing an 8-week sick leave spell and the granting of disability pension within a 3-year follow-up period was studied in three educational levels and whether these associations were modified by history of cancer and comorbidity. Odds ratios (OR) with 95% confidence intervals (CI) are reported. RESULTS Non-stratified adjusted risk of experiencing an 8-week sick leave spell (OR: 1.41, 95% CI (1.33-1.49)) or being granted a disability pension (OR: 1.61, 95% CI (1.31-1.97)) was significantly higher in low-educated than in high-educated respondents. Cancer or comorbidity did not significantly interact with education on the risk of work disability. CONCLUSIONS A moderate impact of low education on future work disability was found for all respondents, neither history of cancer nor comorbidity modified this association.
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Affiliation(s)
- Christina M Stapelfeldt
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus C, Denmark.,DEFACTUM Social & Health Services and Labour Market, Aarhus C, Denmark
| | - Saskia F A Duijts
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Trine A Horsboel
- Survivorship and Inequality in Cancer, Danish Cancer Society, Copenhagen, Denmark
| | | | - Niels T Andersen
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Finn B Larsen
- DEFACTUM Social & Health Services and Labour Market, Aarhus N, Denmark
| | - Karina Friis
- DEFACTUM Social & Health Services and Labour Market, Aarhus N, Denmark
| | - Claus V Nielsen
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus C, Denmark.,DEFACTUM Social & Health Services and Labour Market, Aarhus C, Denmark.,Regional Hospital West Jutland, Herning, Denmark
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16
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Understanding survivors' needs and outcomes: the role of routinely collected data. Curr Opin Support Palliat Care 2019; 12:254-260. [PMID: 29916842 DOI: 10.1097/spc.0000000000000352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW The number of cancer survivors is growing due to population ageing, earlier detection and more effective therapies. Routinely collected data (RCD), generally cancer registry data, has been used to investigate survivors' needs and outcomes. We reviewed uses of RCD since 2017, identifying novel findings and research directions. RECENT FINDINGS Survival is improving internationally but continues to vary between subgroups. Longitudinal survivor surveys suggest malignancy-specific temporal patterns in unmet needs and health-related quality-of-life (HRQoL). Unmet needs are a risk factor for future depression and depression predicts poorer HRQoL in all domains. Emerging evidence suggests links between posttraumatic stress and poor HRQoL and posttraumatic growth and improved HRQoL. Evidence for a link between cancer-related financial hardship and poor HRQoL is accumulating. Surveys and linkage studies continue to show poorer work outcomes in survivors. Among survivors of childhood and young adult cancers, large linkage studies demonstrate significant risk of late effects, including hospitalization, pregnancy and labour complications, and cardiac death. SUMMARY RCD plays a significant role in understanding survivors' needs and outcomes. New approaches which overlay different types of data - including detailed clinical and treatment data, biomarker data and nonhealth administrative data - have the potential to generate considerable new knowledge.
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17
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Pálmarsdóttir R, Kiesbye Øvlisen A, Severinsen MT, Glimelius I, Smedby KE, El-Galaly T. Socioeconomic impact of Hodgkin lymphoma in adult patients: a systematic literature review. Leuk Lymphoma 2019; 60:3116-3131. [PMID: 31167589 DOI: 10.1080/10428194.2019.1613538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hodgkin lymphoma is a highly curable disease with a peak incidence in young adulthood at times where education, family, and social relations are established. We performed a systematic literature review to assess the impact of Hodgkin lymphoma on the socioeconomic status of adolescent and adult survivors (including educational achievements, occupational aspects, marriage, and parenthood). In total, 39 articles were included. Overall, 26-36% of survivors perceived Hodgkin lymphoma as negatively affecting their socioeconomic status. Studies consistently found educational achievements in line with general population. Employment rates for survivors were comparable to the general population, but lower than before Hodgkin lymphoma diagnosis, with a post-diagnosis increase in disability pension and early retirement. Employed survivors encountered problems related to physical restrictions and recruitment. Marriage and parenthood were not substantially affected. In conclusion, current studies suggest acceptable socioeconomic outcomes following a Hodgkin lymphoma diagnosis but the use of standardized reporting methods hampers comparability across studies.
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Affiliation(s)
| | - Andreas Kiesbye Øvlisen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ingrid Glimelius
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Solna, Sweden.,Department of Immunology, Genetics and Pathology, Clinical and Experimental Oncology, Uppsala University and Uppsala Akademiska Hospital, Uppsala, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Solna, Sweden.,Hematology Center, Karolinska University Hospital, Solna, Sweden
| | - Tarec El-Galaly
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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19
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Yang B, Yu R, Cai L, Bin Guo, Chen H, Zhang H, He P, Lu X. Haploidentical versus matched donor stem cell transplantation for patients with hematological malignancies: a systemic review and meta-analysis. Bone Marrow Transplant 2018; 54:99-122. [PMID: 29988061 DOI: 10.1038/s41409-018-0239-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/27/2018] [Accepted: 04/29/2018] [Indexed: 12/13/2022]
Abstract
We compared the safety and efficacy of haploidentical stem cell transplantation (haplo-SCT) to matched donor SCT (matched-SCT) in treating hematological malignancies. The Medline, Cochrane, EMBASE, and Google Scholar databases were searched through 21 June 2017 using the search term "(hematological disease) AND matched AND (haploidentical OR haplo-identical OR haplo identical OR haplo transplantation OR haplo transplant OR haplo-SCT OR haplo-HSCT OR haplo-HCT)." Twenty-five studies enrolling 11,359 patients (haplo-SCT: 2677; matched-SCT: 8682) were included. The primary outcomes were acute and chronic graft-versus-host disease (GVHD), non-relapse mortality, and 1-year cumulative incidence of relapse. Haplo-SCT was associated with similar risks as matched-SCT for all primary endpoints. Subgroup analysis of patients who received a matched-SCT from a related donor revealed that patients who received haplo-SCT had a lower risk of acute GVHD. Among patients who received reduced-intensity conditioning (RIC), those who received haplo-SCT had a higher risk of acute grade II-IV GVHD and non-relapse mortality than did patients who received a matched-SCT from a related or unrelated donor. Haplo-SCT should continue to be considered as a safe and effective transplant option when a matched donor is unavailable, but it may not be suitable for patients who receive RIC.
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Affiliation(s)
- Bo Yang
- Department of Hematology, Nanlou Division & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Ruili Yu
- Department of Allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, 100038, China
| | - Lili Cai
- Department of Laboratory Medicine, Nanlou Division & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Bin Guo
- Department of Library and Information Science, Shanxi Medical University School of Management, Taiyuan, 30001, China
| | - Hongfei Chen
- Department of Hematology, Nanlou Division & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Respiratory Disease, Nanlou Division & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Haomin Zhang
- Department of Social Medicine and Health Service Management, Shanxi Medical University School of Management, Taiyuan, 30001, China
| | - Peifeng He
- Department of Social Medicine and Health Service Management, Shanxi Medical University School of Management, Taiyuan, 30001, China.
| | - Xuechun Lu
- Department of Hematology, Nanlou Division & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
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20
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When a policy decision meets practice realities: The case of cancer survivorship care and rehabilitation needs assessment. Eur J Oncol Nurs 2018; 33:70-77. [DOI: 10.1016/j.ejon.2018.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/13/2017] [Accepted: 01/25/2018] [Indexed: 11/22/2022]
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21
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Magyari F, Kósa K, Berecz R, Illés A, Miltényi Z, Simon Z, Illés Á. Employment status and health related quality of life among Hodgkin-lymphoma survivors'- results based on data from a major treatment center in Hungary. Health Qual Life Outcomes 2017; 15:180. [PMID: 28927453 PMCID: PMC5605984 DOI: 10.1186/s12955-017-0758-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 09/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to risk and response adapted treatment strategies, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured, and become long-term survivors. However, a high proportion of survivors suffer from treatment-related long-term side effects such as secondary malignancy, organ failure, persistent fatigue and psychological distress. The aim of this study was to evaluate psychological distress and its risk factors among our HL survivors. METHODS One hundred sixty-three (50% female) adult HL survivors were contacted between January 1, 2012 and march 31, 2015 in our outpatient centre. The patients were asked to complete a standardized, validated, self-administered Hungarian questionnaire with demographic questions and the following scales: Hospital anxiety and depression scale (HADS14), general health questionnaire (GHQ12), sense of coherence (SOC13) perceived stress scale (PSS4), dysfunctional attitude scale (DAS17). Disease and treatment data were acquired from hospital records. RESULTS Majority of HL survivors are in early adulthood, our most important goal should be to return them to normal life after their lymphoma is cured. The employment status at the time of survey seemed to be crucial so patients were divided into either active (n = 93) or inactive (n = 47) group. Retired survivors (n = 19) were excluded from the subgroup analysis. Psychological distress was significantly lower in active patients. Multiple logistic regression analysis showed significant differences between the inactive and active subgroups, such as age at diagnosis (≥30 years or below, p = 0.001), education level (below college vs. college, p = 0.032) and treatment related long-term side effects (yes vs. no, p < 0.001). Predictors for treatment-related long-term side effects are female gender (p = 0.011), chemotherapy protocol (ABVD vs. other, p < 0.001). CONCLUSIONS Our data suggest that employment status and treatment-related long-term side effects play a critical role in the health related quality of life outcome among Hungarian HL survivors.
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Affiliation(s)
- Ferenc Magyari
- Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Karolina Kósa
- Department of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Roland Berecz
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anna Illés
- Department of Anaesthesiology and Intensive Care Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsófia Miltényi
- Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsófia Simon
- Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Árpád Illés
- Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Handberg C, Jensen CM, Maribo T. Lack of Needs Assessment in Cancer Survivorship Care and Rehabilitation in Hospitals and Primary Care Settings. J Clin Med Res 2017; 9:864-871. [PMID: 28912923 PMCID: PMC5593434 DOI: 10.14740/jocmr3160w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/25/2017] [Indexed: 11/21/2022] Open
Abstract
Background Formalized and systematic assessment of survivorship care and rehabilitation needs is prerequisite for ensuring cancer patients sufficient help and support through their cancer trajectory. Patients are often uncertain as to how to express and address their survivorship care and rehabilitation needs, and little is known about specific, unmet needs and the plans necessary to meet them. There is a call for both ensuring survivorship care and rehabilitation for cancer patients in need and further for documenting the specific needs related to the cancer disease and its treatment. Thus the aim of this study was to describe specific survivorship care and rehabilitation needs and plans as stated by patients with cancer at hospitals when diagnosed and when primary care survivorship care and rehabilitation begins. Methods Needs assessment forms from cancer patients at two hospitals and two primary care settings were analyzed. The forms included stated needs and survivorship care and rehabilitation plans. All data were categorized using the International Classification of Functioning, Disability and Health (ICF). Results Eighty-nine patients at hospitals and 99 in primary care, stated their needs. Around 50% of the patients completed a survivorship care and rehabilitation plan. In total, 666 (mean 7.5) needs were stated by hospital patients and 836 (mean 8.0) by those in primary care. The needs stated were primarily within the ICF component “body functions and structure”, and the most frequent needs were (hospitals/primary care) fatigue (57%/67%), reduced muscle strength (55%/67%) and being worried (37%/36%). Conclusions The results underpin an urgent need for a systematic procedure to assess needs in clinical practice where cancer patients are being left without survivorship care and rehabilitation needs assessment. Gaining knowledge on needs assessment and the detailed description of needs and plans can facilitate targeted interventions. The findings indicate an urgent need to change the practice culture to be systematic in addressing and identifying survivorship care needs among patients with cancer. Further the findings call for considering the development of a new needs assessment form with involvement of both patients and healthcare professionals.
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Affiliation(s)
- Charlotte Handberg
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
| | - Charlotte Maria Jensen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
| | - Thomas Maribo
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
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23
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Arboe B, Olsen MH, Goerloev JS, Duun-Henriksen AK, Johansen C, Dalton SO, Brown PDN. Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation. Clin Epidemiol 2017; 9:321-329. [PMID: 28652814 PMCID: PMC5476433 DOI: 10.2147/clep.s134603] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Autologous stem cell transplantation (ASCT) is the standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL) or transformed indolent lymphoma (TIL). The treatment is mainly considered for younger patients still available for the work market. In this study, social outcomes after ASCT in terms of return to work (RTW) are described. Patients and methods Information from national administrative registers was combined with clinical information on patients, who received ASCT for relapse of DLBCL or TIL between 2000 and 2012. A total of 164 patients were followed until RTW, disability or old-age pension, death, or December 31, 2015, whichever came first. A total of 205 patients were followed with disability pension as the event of interest. Cox models were used to determine cause-specific hazards. Results During follow-up, 82 (50%) patients returned to work. The rate of returning to work in the first year following ASCT was decreased for patients being on sick leave at the time of relapse (hazard ratio [HR] 0.3 [0.2;0.5]) and increased for patients aged ≥55 years (HR 1.9 [1.1;3.3]). In all, 56 (27%) patients were granted disability pension. Being on sick leave at the time of relapse was positively associated with receiving a disability pension in the first 2 years after ASCT (HR 3.7 [1.8;7.7]). Conclusion Patients on sick leave at the time of relapse have a poorer prognosis regarding RTW and have a higher rate of disability pension. Furthermore, patients >55 are more likely to RTW compared to younger patients. These results indicate an unmet need for focused social rehabilitation.
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Affiliation(s)
- Bente Arboe
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet.,Unit of Survivorship Research, The Danish Cancer Society Research Center
| | - Maja Halgren Olsen
- Unit of Survivorship Research, The Danish Cancer Society Research Center
| | | | | | - Christoffer Johansen
- Unit of Survivorship Research, The Danish Cancer Society Research Center.,Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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24
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Duijts S, Dalton SO, Lundh MH, Horsboel TA, Johansen C. Cancer survivors and return to work: current knowledge and future research. Psychooncology 2016; 26:715-717. [PMID: 27478074 DOI: 10.1002/pon.4235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Saskia Duijts
- VU University Medical Center, Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands
| | | | - Marie Høyer Lundh
- Metropolitan University College, Department of Nursing, Copenhagen, Denmark.,Uppsala University, Department of Public Health and Caring Sciences, Uppsala, Sweden
| | | | - Christoffer Johansen
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark.,Rigshospitalet, Department of Oncology, Copenhagen, Denmark
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25
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Kiserud CE, Fagerli UM, Smeland KB, Fluge Ø, Bersvendsen H, Kvaløy S, Holte H, Dahl AA. Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation. Acta Oncol 2016; 55:547-53. [PMID: 27123741 DOI: 10.3109/0284186x.2015.1125015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background This study examined employment patterns and associated factors in lymphoma survivors treated with high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) from diagnosis to a follow-up survey at a mean of 10 years after HDT-ASCT. Patients and methods All lymphoma survivors aged ≥18 years at HDT-ASCT in Norway from 1987 to 2008, and alive at the end of 2011 were eligible for this cross-sectional study performed in 2012/2013. Participants completed a mailed questionnaire. Job status was dichotomized as either employed (paid work) or not-employed (disability and retirement pension, on economic support, home-makers, or students). Results The response rate was 78%, and the sample (N = 312) contained 60% men. Mean age at HDT-ASCT was 44.3 and at survey 54.0 years. At diagnosis 85% of survivors were employed, 77% before and 77% after HDT-ASCT, and 58% at follow-up. Forty seven percent of the survivors were employed at all time points. The not-employed group at survey was significantly older and included significantly more females than the employed group. No significant between-group differences were observed for lymphoma-related variables. Fatigue, mental distress and type D personality were significantly higher among those not-employed, while quality of life was significantly lower compared to the employed group. Older age at survey, being female, work ability and presence of type D personality remained significantly related to being not-employed at survey in the multivariable analysis. Conclusions Our findings show that not-employed long-term survivors after HDT-ASCT for lymphoma have more comorbidity, cognitive problems and higher levels of anxiety/depression than employed survivors. These factors should be checked and eventually treated in order to improve work ability.
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Affiliation(s)
- C. E. Kiserud
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - U-M. Fagerli
- Department of Oncology, St. Olav’s Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - K. B. Smeland
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ø. Fluge
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - H. Bersvendsen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - S. Kvaløy
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - H. Holte
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - A. A. Dahl
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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26
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Endo M, Haruyama Y, Takahashi M, Nishiura C, Kojimahara N, Yamaguchi N. Returning to work after sick leave due to cancer: a 365-day cohort study of Japanese cancer survivors. J Cancer Surviv 2015; 10:320-9. [PMID: 26318185 PMCID: PMC4801999 DOI: 10.1007/s11764-015-0478-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Abstract
Purpose More employees are experiencing a cancer diagnosis during their working-age years, yet there have been no large-scale Japanese studies investigating sick leave due to cancer. We clarified differences in the cumulative partial and full return to work (RTW) rates between different cancer types among Japanese cancer survivors. Methods Data on Japanese employees who experienced an episode of sick leave due to clinically certified cancer diagnosed between 1 January 2000 and 31 December 2011 were obtained from an occupational health register. Subject outcomes within the 365-day period following their initial day of sick leave were utilized for this study. We investigated the cumulative partial/full and full RTW rates by using survival analysis with competing risks and predictors of time to RTW by a Fine-Gray proportional hazard regression model. Results One thousand two hundred seventy-eight subjects (1033 males and 245 females) experienced their first episode of sick leave due to cancer during the 12-year follow-up period. Of the subjects, 47.1 % returned to work full time within 6 months of their initial day of sick leave absence, and 62.3 % by 12 months. The cumulative RTW rate varied significantly by cancer type. There were considerable differences in the range of cumulative full RTW rates between the two categories (“lower full RTW rate” groups (“lung,” “hepatic, pancreatic,” “esophageal,” and “blood” cancer groups) vs. “higher full RTW rate” groups (“gastric,” “intestinal,” “breast,” “female genital,” “male genital,” “urinary”): 6.3 to 14.3 % vs. 11.4 to 28.3 % at 60 days, 10.6 to 22.4 % vs. 27.0 to 50.0 % at 120 days, 21.3 to 34.7 % vs. 38.5 to 65.4 % at 180 days, 34.3 to 42.9 % vs. 66.0 to 79.5 % at 365 days). Additionally, older age may be associated with a longer time to full RTW. Conclusions More than half of the subjects returned to work full-time within the 365-day period following their initial day of sick leave, with cumulative RTW rates varying by cancer type. Older employees may require a longer time to full RTW. Implications of Cancer Survivors It is very important for companies (especially small- and medium-sized companies) to establish and improve their RTW support system for cancer survivors, with knowledge that the median time to RTW is expected to be at least a few months.
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Affiliation(s)
- Motoki Endo
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666.
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Miyako Takahashi
- Division of Cancer Survivorship Research, National Cancer Center, Tokyo, Japan
| | - Chihiro Nishiura
- Department of Safety and Health, Tokyo Gas Co. Ltd., Tokyo, Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666
| | - Naohito Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666
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27
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Horsboel TA, Nielsen CV, Nielsen B, Andersen NT, De Thurah A. Wage-subsidised employment as a result of permanently reduced work capacity in a nationwide cohort of patients diagnosed with haematological malignancies. Acta Oncol 2015; 54:743-9. [PMID: 25752974 DOI: 10.3109/0284186x.2014.999871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients with haematological malignancies have a poorer labour market prognosis than the general population. We have previously found that they have low rates of return to work, and a higher risk of being granted disability pension, than individuals without a history of these diseases. The aim of this study was to further investigate the labour market prognosis for these patients, by comparing the risk of being granted wage-subsidised (WS) employment as a result of permanently reduced work capacity among patients diagnosed with haematological malignancies to a reference cohort, and to determine if relative risks differ between subtypes of haematological malignancies. MATERIAL AND METHODS We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until they were granted WS employment, disability pension, anticipatory pension, old age pension, emigration, death or until 26 February 2012, whichever came first. RESULTS A total of 310 (10%) patients and 795 (3%) reference individuals had their work capacity permanently reduced to an extent that they were granted WS employment during the follow-up period. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies, and four years after diagnosis they ranged from 2.47 (95% CI 1.46-4.16) for patients with Hodgkin lymphoma to 10.83 (95% CI 7.15-16.40) for patients with chronic myeloid leukaemia. CONCLUSION All eight subtypes of haematological malignancies were associated with an increased risk of being granted WS employment due to permanently reduced work capacity compared to the reference cohort. The relative risks differed according to haematological malignancy subtype, and the highest was found for patients with chronic myeloid leukaemia.
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MESH Headings
- Adult
- Age Factors
- Cohort Studies
- Denmark/epidemiology
- Employment, Supported/statistics & numerical data
- Female
- Hematologic Neoplasms/classification
- Hematologic Neoplasms/complications
- Hematologic Neoplasms/epidemiology
- Hodgkin Disease/complications
- Hodgkin Disease/economics
- Hodgkin Disease/epidemiology
- Humans
- Insurance, Disability
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/economics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/epidemiology
- Male
- Middle Aged
- Multiple Myeloma/complications
- Multiple Myeloma/economics
- Multiple Myeloma/epidemiology
- Pensions/statistics & numerical data
- Retirement/statistics & numerical data
- Return to Work/statistics & numerical data
- Risk
- Sex Factors
- Survivors
- Work Capacity Evaluation
- Young Adult
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Affiliation(s)
- Trine A Horsboel
- Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University , Denmark
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28
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Glimelius I, Ekberg S, Linderoth J, Jerkeman M, Chang ET, Neovius M, Smedby KE. Sick leave and disability pension in Hodgkin lymphoma survivors by stage, treatment, and follow-up time—a population-based comparative study. J Cancer Surviv 2015; 9:599-609. [DOI: 10.1007/s11764-015-0436-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
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29
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Horsboel TA, Bültmann U, Nielsen CV, Nielsen B, Andersen NT, de Thurah A. Are fatigue, depression and anxiety associated with labour market participation among patients diagnosed with haematological malignancies? A prospective study. Psychooncology 2014; 24:408-15. [PMID: 25174733 DOI: 10.1002/pon.3658] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/22/2014] [Accepted: 08/01/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The objectives of this study are to examine levels of fatigue, depression and anxiety following diagnosis of a haematological malignancy, to determine the incidence of return to work (RTW) and long-term sickness absence (LTSA) during 1-year follow-up and to examine whether fatigue, depression and anxiety are associated with RTW and LTSA in this group of cancer patients. METHODS Questionnaire-based data on fatigue, depression and anxiety were obtained at baseline. In all, 196 patients returned the questionnaire. Of these, 106 patients were on sick leave and 90 patients were working. They were all followed prospectively for 1 year using register-based data on labour market participation. RESULTS At baseline, high levels of fatigue, depression and anxiety were more prevalent among sickness absent patients than in those working. Half of the sickness absent patients returned to work during follow-up, and only 10 (11%) working patients experienced LTSA. Sickness absent patients with highest scores of physical fatigue were less likely to RTW than those with lowest scores (RRadj 0.43, 95% CI 0.23-0.78). Similar, we found an association between symptoms of anxiety and RTW (p = 0.048). This association was though non-significant in multivariable analyses (p = 0.068). No significant association was found between depression and RTW. CONCLUSION Half of sickness absent patients returned to work, and only a few of working patients experienced LTSA during follow-up. Patients reporting high levels of physical fatigue were less likely to RTW. There was a similar tendency for anxiety, whereas we found no association between depression and RTW. Larger prospective studies are needed.
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Affiliation(s)
- Trine A Horsboel
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark; Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark
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30
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Affiliation(s)
- Karin E Smedby
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden and Center for Hematology, Karolinska University Hospital , Stockholm , Sweden
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