title: Long-term cancer survivors experience work changes after diagnosis: results of a population-based study.
abstract: BACKGROUND
  Although cancer survivorship is increasing with improved diagnosis and treatments, few studies have explored employment changes and the factors related to this change among cancer survivors. Therefore, we aim to explore the prevalence of employment problems in long-term cancer survivors. In addition, we explored what patient or tumour characteristics predicted employment changes.
  
  
  METHODS
  All 1893 long-term survivors of prostate cancer, endometrial cancer, non-Hodgkin's lymphoma, and Hodgkin's lymphoma diagnosed between 1989 and 1998 in the area of the Comprehensive Cancer Centre South, The Netherlands were included in a population-based cross-sectional survey.
  
  
  RESULTS
  Response rate was 80% (n=1511). After excluding survivors without a job before diagnosis, 403 survivors remained; 197 (49%) experienced no changes in their work situation following cancer diagnosis, 69 (17%) were working fewer hours, and 137 (34%) stopped working or retired. A medium educational level was significant in reducing the risk of work changes. Being older, having more than one comorbid condition, being treated with chemotherapy, and disease progression were significant independent predictors of work changes after cancer. Experiencing work changes was associated with lower physical functioning but positively associated with social well-being.
  
  
  CONCLUSIONS
  Long-term cancer survivors experience work changes after diagnosis and treatment, and clinical factors significantly predicted work change after cancer. As such, our study underscores the importance of rehabilitation programs in improving the return to work after cancer.
authors.affiliation: CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, 5000 LE Tilburg, The Netherlands. F.Mols@uvt.nl
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.forename: Melissa S Y
authors.initials: MS
authors.lastname: Thong
authors.forename: Gerard
authors.initials: G
authors.lastname: Vreugdenhil
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004522:Educational Status; D016889:Endometrial Neoplasms / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006306:Health Surveys; D006689:Hodgkin Disease / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D009426:Netherlands; D011471:Prostatic Neoplasms / Q000523:psychology / Q000534:rehabilitation; D011788:Quality of Life / Q000523:psychology; D012050:Rehabilitation, Vocational; D012179:Retirement; D012307:Risk Factors; D017741:Survivors / Q000523:psychology*; D014940:Work Schedule Tolerance
chemical_list: D000970:Antineoplastic Agents