title: Employment and insurance outcomes and factors associated with employment among long-term thyroid cancer survivors: a population-based study from the PROFILES registry.
abstract: OBJECTIVE
  To obtain insight into employment and insurance outcomes of thyroid cancer survivors and to examine the association between not having employment and other factors including quality of life.
  
  
  METHODS
  In this cross-sectional population-based study, long-term thyroid cancer survivors from the Netherlands participated. Clinical data were collected from the cancer registry. Information on employment, insurance, socio-demographic characteristics, long-term side effects, and quality of life was collected with questionnaires.
  
  
  RESULTS
  Of the 223 cancer survivors (response rate 87 %), 71 % were employed. Of the cancer survivors who tried to obtain insurance, 6 % reported problems with obtaining health care insurance, 62 % with life insurance, and 16 % with a mortgage. In a multivariate logistic regression analysis, higher age (OR 1.07, CI 1.02-1.11), higher level of fatigue (OR 1.07, CI 1.01-1.14), and lower educational level (OR 3.22, CI 1.46-7.09) were associated with not having employment. Employment was associated with higher quality of life.
  
  
  CONCLUSIONS
  Many thyroid cancer survivors face problems when obtaining a life insurance, and older, fatigued, and lower educated thyroid cancer survivors may be at risk for not having employment.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S J
authors.initials: SJ
authors.lastname: Tamminga
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: U
authors.initials: U
authors.lastname: Bültmann
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands. Olga.Husson@radboudumc.nl.|Comprehensive Cancer Center Netherlands South, Eindhoven Cancer Registry, Eindhoven, The Netherlands. Olga.Husson@radboudumc.nl.
authors.forename: O
authors.initials: O
authors.lastname: Husson
authors.affiliation: VGZ Health Insurance Company, Eindhoven, The Netherlands.
authors.forename: J L P
authors.initials: JL
authors.lastname: Kuijpens
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M H W
authors.initials: MH
authors.lastname: Frings-Dresen
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: A G E M
authors.initials: AG
authors.lastname: de Boer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005221:Fatigue; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007352:Insurance, Life / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012042:Registries; D012107:Research Design; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D013964:Thyroid Neoplasms / Q000628:therapy*; D014478:Unemployment / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cancer survivorship; Employment; Population-based study; Thyroid cancer; Work