title: Return to work among self-employed cancer survivors.
abstract: The aim of this study is to investigate whether salaried and self-employed workers differ regarding factors relevant for return to work after being diagnosed with cancer. The possible mediators of an effect of self-employment on work ability were also investigated.
  
  
  
  A total of 1115 cancer survivors (1027 salaried and 88 self-employed) of common invasive cancer types who were in work at the time of diagnosis completed a mailed questionnaire 15-39 months after diagnosis.
  
  
  
  Twenty-four percent of self-employed cancer survivors reported that they had not returned to work at the time of the survey, and 18 % of those who were salaried had not. While 9 % of the self-employed had received disability or early retirement pension, only 5 % had received such a pension among salaried employees. Compared with the salaried workers, the self-employed people reported significantly more often reduced work hours (P < 0.001), negative cancer-related financial (P < 0.001), and occupational changes (P = 0.005) and low overall health (P = 0.02), quality of life (P = 0.04), and total work ability (P = 0.02). The negative effect of self-employment on total work ability seems to be mediated by reduced work hours and a negative cancer-related financial change.
  
  
  
  Compared with salaried, self-employed workers in Norway, they seem to struggle with work after cancer. This may be because the two groups have different work tasks and because self-employed people have lower social support at work and less legal support from the Working Environment Act and public health insurance.
  
  
  
  Self-employed people with cancer should be informed about the work-related challenges they may encounter and be advised to seek practical help from social workers who know about the legal rights of self-employed people.
authors.affiliation: Department of Health Promotion, University College of Southeast Norway, PO Box 4, 3199, Borre, Norway. steffen.torp@hbv.no.
authors.forename: Steffen
authors.initials: S
authors.lastname: Torp
authors.affiliation: Department of Health Promotion, University College of Southeast Norway, PO Box 4, 3199, Borre, Norway.
authors.forename: Jonn
authors.initials: J
authors.lastname: Syse
authors.affiliation: Aix-Marseille School of Economics (Aix-Marseille University, GREQAM) & Southeastern Health Observatory (ORS PACA), Aix-Marseille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Paraponaris
authors.affiliation: Department of Health Promotion, University College of Southeast Norway, PO Box 4, 3199, Borre, Norway.
authors.forename: Sævar
authors.initials: S
authors.lastname: Gudbergsson
mesh_terms: D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000534:rehabilitation*; D011788:Quality of Life; D062707:Return to Work / Q000639:trends*; D017741:Survivors / Q000706:statistics & numerical data*
keywords: Cancer survivor; Employment; Health promotion; Self-employment; Sick leave; Work ability