Assessing the impact of cancer on work outcomes

Abstract

C ancer survivorship research seeks to improve the physical, psychosocial, and economic outcomes of individuals who have a history of cancer. 1 For working-age adults with cancer, work impairment may be one of the most burdensome consequences of cancer. Inability to return to work after cancer treatment, frequent or prolonged work absenteeism, or problems with work performance may have substantial economic impact on the survivor and her or his family. [2][3][4][5] Changes in work also may have substantial impact on self-esteem, quality of life, and social or family roles. 6 -10 Finally, work performance after cancer treatment may be a measure of recovery in its own right.Despite its importance, the impact of cancer and its treatment on work has been studied infrequently. Spelten and colleagues reviewed the literature through 1999 and concluded that critical questions, such as the impact of different cancer sites on work and the extent of racial or socioeconomic disparities in work function after cancer, have rarely been addressed. 11 Furthermore, the existing literature rarely has identified remediable targets for intervention and has lacked rigorously tested intervention strategies to increase return to work or work function.More and better research on the work impact of cancer is necessary to inform the decisions of cancer survivors and their treatment providers. In this commentary, we examine the characteristics of research studies that may advance our understanding of this important clinical and social issue. To achieve this objective, we identify six methodologic attributes that provide the solid scientific knowledge necessary to inform interventions, evaluate existing studies in the light of these criteria, and propose a conceptual model to guide future research.

The impact of cancer on spouses' labor earnings

“…[25][26][27] We have previously found similar percentage declines in earnings for Norwegian men and women after cancer, 16 in line with those observed after breast cancer. 24,28 Earnings are, however, in general lower among women than men in most developed countries, 10,16 and fairly similar percentage effects may have a different impact on the total economic situation for households.…”

“…Selection and information bias is thus minimal, which is an important asset in studying cancer and earnings. 26,39,40 A disadvantage with the use of registry data is, however, that the causal mechanisms that cancer operates through in affecting earnings, such as wages, working hours, or changing perceptions of the value of work, cannot be identified, and neither can the perceived impact of the lower earnings on the persons' well-being more generally.…”

Occupational status among adult survivors following allo-SCT

“…2 Paid work is essential for an individual's identity and health, enables the person to regain a sense of normality [3][4][5] and is highly desirable from a social and economic perspective. 6 A substantial number of SCT long-term survivors report disease-and treatmentrelated problems that may last for a considerable time, with a possible negative influence on general well-being, quality of life [7][8][9][10][11][12] and participation in paid work. 13 Moreover, being in work is associated with better well being among survivors previously treated with SCT.…”

Work disability associated with cancer survivorship and other chronic conditions

“…Long-term disability threatens the economic well-being of survivors and their families, as it may mean a loss of earnings and job-related health insurance. Additionally, the quality of life of survivors who are limited in ability to work may be affected by the loss of identity and purpose, life satisfaction, and social relationships that work often provides (Steiner et al, 2004).…”