title: Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study.
abstract: BACKGROUND
  Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed.
  
  
  METHODS
  We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined.
  
  
  RESULTS
  The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2-15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8-5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1-4.7), distress (OR = 3.9, 95 % CI, 1.7-9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1-6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group.
  
  
  CONCLUSIONS
  Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors.
  
  
  CONCLUSIONS
  This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.
authors: University of Wisconsin Carbone Comprehensive Cancer Center, 1111 Highland Avenue, Madison, WI 53705-2275, USA. at4@medicine.wisc.edu
authors: A J
authors: AJ
authors: Tevaarwerk
authors: J W
authors: JW
authors: Lee
authors: M E
authors: ME
authors: Sesto
authors: K A
authors: KA
authors: Buhr
authors: C S
authors: CS
authors: Cleeland
authors: J
authors: J
authors: Manola
authors: L I
authors: LI
authors: Wagner
authors: V T S
authors: VT
authors: Chang
authors: M J
authors: MJ
authors: Fisch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D016208:Databases, Factual; D004651:Employment / Q000706:statistics & numerical data*; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D017741:Survivors / Q000706:statistics & numerical data*; D063189:Symptom Assessment; D014478:Unemployment / Q000706:statistics & numerical data; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
references: Biometrics. 1986 Mar;42(1):121-30
references: 3719049
references: Cancer Invest. 2007 Feb;25(1):47-54
references: 17364557
references: Acta Oncol. 2007;46(1):90-6
references: 17438710
references: Eur J Cancer. 2007 Mar;43(5):914-20
references: 17314041
references: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references: 22237781
references: CMAJ. 2005 Sep 27;173(7):765-71
references: 16186583
references: J Occup Rehabil. 2012 Jun;22(2):220-9
references: 22081271
references: Disabil Rehabil. 2004 Jan 21;26(2):78-84
references: 14668143
references: Eur J Cancer. 2003 Jul;39(11):1562-7
references: 12855263
references: Cochrane Database Syst Rev. 2011 Feb 16;(2):CD007569
references: 21328297
references: J Occup Rehabil. 2012 Dec;22(4):447-55
references: 22527875
references: MMWR Morb Mortal Wkly Rep. 2004 Jun 25;53(24):526-9
references: 15215740
references: Psychooncology. 1999 Nov-Dec;8(6):467-73
references: 10607979
references: J Pain. 2006 Jan;7(1):49-56
references: 16414555
references: Psychooncology. 2009 Dec;18(12):1252-60
references: 19156675
references: Head Neck. 2004 Sep;26(9):796-807
references: 15350026
references: J Natl Cancer Inst Monogr. 2004;(32):76-8
references: 15263044
references: Cancer. 2000 Oct 1;89(7):1634-46
references: 11013380
references: J Cancer Surviv. 2010 Dec;4(4):415-37
references: 20945110
references: Work. 2006;26(2):179-90
references: 16477110
references: JAMA. 2009 Feb 18;301(7):753-62
references: 19224752
references: Clin Adv Hematol Oncol. 2006 Nov;4(11):828-9
references: 17143252
references: Palliat Support Care. 2012 Sep;10(3):197-204
references: 22613011
references: Cancer. 2011 Jun 15;117(12):2779-90
references: 21495026
references: Cancer. 2009 Jun 15;115(12):2775-82
references: 19365847
references: Semin Oncol Nurs. 2007 May;23(2):121-6
references: 17512439
references: J Clin Oncol. 2009 Jan 20;27(3):390-7
references: 19064976
references: Psychooncology. 2002 May-Jun;11(3):188-98
references: 12112479
references: Eur J Cancer. 2008 Sep;44(13):1866-74
references: 18640029
references: J Clin Oncol. 2006 Jan 20;24(3):345-53
references: 16421415
references: J Occup Environ Med. 2010 Feb;52(2):219-27
references: 20134340
references: Crit Rev Oncol Hematol. 2011 Feb;77(2):109-30
references: 20117019
references: Breast Cancer Res Treat. 2007;105 Suppl 1:75-89
references: 17912638
references: J Health Econ. 2005 Jan;24(1):137-60
references: 15617792
references: J Natl Cancer Inst. 2005 Jul 6;97(13):958-65
references: 15998948
references: J Cancer Surviv. 2009 Dec;3(4):223-32
references: 19760150
references: Acta Oncol. 2009;48(1):93-8
references: 18937082
references: Occup Environ Med. 2003 May;60(5):352-7
references: 12709521
references: Psychooncology. 2002 Mar-Apr;11(2):124-31
references: 11921328
references: Int J Psychiatry Med. 2010;40(2):163-81
references: 20848873
references: J Am Dent Assoc. 2008 Mar;139(3):291-9; quiz 358-9
references: 18310733
references: Cancer Epidemiol Biomarkers Prev. 2011 Oct;20(10):1996-2005
references: 21980007
references: J Cancer Surviv. 2010 Jun;4(2):179-86
references: 20373043
references: Oncol Nurs Forum. 2009 May;36(3):E133-43
references: 19403441
references: Cancer Nurs. 2007 Sep-Oct;30(5):354-61
references: 17876181
references: J Clin Oncol. 2005 Nov 20;23(33):8280-2
references: 16219929
references: J Pain Symptom Manage. 2010 Feb;39(2):241-9
references: 19963335
references: AAOHN J. 2004 Dec;52(12):500-10
references: 15635931
references: J Occup Environ Med. 2008 Jul;50(7):777-84
references: 18617833
references: Pain. 1995 May;61(2):277-284
references: 7659438
references: JAMA. 2001 Feb 21;285(7):885-92
references: 11180731
references: Work. 2011;38(4):337-46
references: 21508523
references: Br J Cancer. 2008 Apr 22;98(8):1342-7
references: 18349834
references: J Clin Nurs. 2010 May;19(9-10):1362-70
references: 20500346
references: Cancer Pract. 1999 Sep-Oct;7(5):240-7
references: 10687593
references: J Rehabil Med. 2003 Jul;35(4):153-62
references: 12892240
references: Occup Med (Lond). 2009 Sep;59(6):378-80
references: 19692523
references: J Clin Oncol. 2012 Jun 1;30(16):1980-8
references: 22508819
references: Breast Cancer Res Treat. 2005 Oct;93(3):217-26
references: 16136270
references: Cancer. 2005 Mar 15;103(6):1292-301
references: 15700265
references: J Cancer Surviv. 2010 Dec;4(4):322-30
references: 20549572
references: J Pain Symptom Manage. 2009 Feb;37(2):220-32
references: 18619769
references: Psychooncology. 2010 Jul;19(7):677-83
references: 19823971
references: Breast Cancer Res Treat. 2009 Aug;116(3):609-16
references: 18855135