Employment pathways in a large cohort of adult cancer survivors.
BACKGROUND
Employment and work-related disability were investigated in a cohort of adult cancer survivors who were working when they were diagnosed from 1997 to 1999 with a variety of cancers. Employment from the time of diagnosis through the early years of survivorship was studied, self-reported effects of cancer survival on disability and employment were quantified, and risk factors associated with cancer-related disability and withdrawal from employment were identified.


METHODS
One thousand four hundred thirty-three cancer survivors were interviewed by telephone from 1 year to nearly 5 years after diagnosis. They were asked retrospectively about employment from the time of diagnosis to follow-up and about work-related disability at follow-up. They also were asked whether disabilities or reasons for quitting work were cancer-related. Return to work and quitting work were projected over time in a life-table analysis. Risk factors were identified from logit analyses.


RESULTS
One of five survivors reported cancer-related disabilities at follow-up. Half of those with disabilities were working. A projected 13% of all survivors had quit working for cancer-related reasons within 4 years of diagnosis. More than half of survivors quit working after the first year, when three-quarters of those who stopped for treatment returned to work. Survivors of central nervous system, head and neck, and Stage IV blood and lymph malignancies had the highest adjusted risk of disability or quitting work.


CONCLUSIONS
Cancer survival sometimes has long-term effects on employment and the ability to work. Employment outcomes can be improved with innovations in treatment and with clinical and supportive services aimed at better management of symptoms, rehabilitation, and accommodation of disabilities.
Short
Pamela Farley
PF
Department of Health Policy and Administration, Center for Health Care and Policy Research, The Pennsylvania State University, University Park, Pennsylvania 16802, USA. pamshort@psu.edu
Vasey
Joseph J
JJ
Tunceli
Kaan
K
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000534:rehabilitation*; D011788:Quality of Life; D012050:Rehabilitation, Vocational / Q000592:standards* / Q000639:trends; D012189:Retrospective Studies; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D017741:Survivors