Work outcomes of breast cancer survivors who returned to work after treatment: CANTO cohort

Background

As survival rates among breast cancer patients improve there is an increasing need to address breast cancer survivors’ (BCS) issues, professional life being a key aspect. Return to work (RTW) of BCS has been largely studied, but studies on job maintenance and its determinants are scarce. We aim to study job maintenance after RTW and the associated factors among BCS.

Methods

We used data from the CANTO cohort, a French prospective cohort of BCS. We included 1643 BCS aged <57 at diagnosis (dx) who returned to work two years after dx. We excluded self-employed BCS. Using multinomial logistic models, we assessed the association between activity status one year after they return to work. (i.e. active, sick leave, or unemployed, retired or invalidity) and sociodemographic, clinical, health status and work-related factors.

Results

Overall, 87% of BCS were active, 10% were on sick leave and 3% were on unemployment, retirement or invalidity one year after they return to work. In the fully adjusted model being on sick leave was associated with stage III at dx (OR: 1.89, 95% CI: 1.11-3.22), being severely fatigued at the moment of returning to work (OR: 1.53, 1.04-2.27), and having workplace accommodations (OR: 1.79, 1.14-2.81). The unemployed, retired, invalidity status was negatively associated with professional life being more than or as important as one’s personal life (OR: 0.51, 0.26-0.98) and being <50 years old (OR: 0.51, 0.27-0.96), and positively associated with having a fixed-term contract (OR: 2.69, 1.39-5.18) and working for a small company (OR: 2.73, 1.24-6.02).

Conclusions

A non-negligible proportion of BCS are non-active one year after they return to work. While clinical factors are associated with sick leave, work related factors are associated with the unemployed, retired, and invalidity status. RTW should not be regarded as the ultimate goal and future policies should focus on ensuring people are ready to return to work and maintain their jobs.

Key messages

• A non-negligible proportion of breast cancer survivors are non-active one year after they return to work.

• Future policies should ensure job maintenance along with return to work.

Employment two years after breast cancer diagnosis: role of household characteristics, CANTO cohort

Background

Breast cancer is associated with a high 5-year survival rate and more than half women are still of working age at diagnosis. Many studies evaluated the clinical determinants of return to work (RTW) but few investigated RTW in relation to family factors. Our objective was to study the role of household characteristics in non-RTW two years after breast cancerdiagnosis.

Methods

We used data of a French prospective cohort of women diagnosed with stage I-III, primary breast cancer (CANTO, NCT01993498). Patients had to be under 57 and have a job at diagnosis. We performed logistic regressions to model non-RTW two years after diagnosis in relation to household characteristics at diagnosis (marital status, children, support from partner), adjusting for tumor characteristics, health status at baseline and one year after diagnosis, and household income at diagnosis. In a second step, we conducted analyses stratified for household income at diagnosis.

Results

In total, 1874 women were eligible. Being in a relationship did not impact non-RTW (OR = 1.43 [95% CI 0.95-2.16]). Among the 1566 women in a relationship, being married was associated with elevated odds of non-RTW(OR = 1.37 [0.96-1.94]). Having children(OR = 1.17 [0.81-1.69]) or receiving support from their partner (OR = 1.17 [0.77-1.78]) was not associated with non-RTW. However, the situation differed in low-income households(&lt;2500€) among whom being married was associated with more elevated odds of non-RTW(OR = 1.94 [0.97-3.88]). No clear association was observed between having children (OR = 1.85 [0.85-4.03]) and non-RTW, but living with at least two children (OR = 2.76 [1.14-6.70]) and receiving support from their partner (OR = 2.28 [1.01-5.17]) was associated with increased odds of non-RTW.

Conclusions

The family environment is associated with non-RTW among the poorest women but not the others.

Key messages

Among the poorest women, the family environment is associated with non-RTW. Among all women, the family environment is not associated with non-RTW.