Factors influencing job loss and early retirement in working men with prostate cancer—findings from the population-based Life After Prostate Cancer Diagnosis (LAPCD) study

Bennett, Damien; Kearney, Therese; Donnelly, David; Downing, Amy; Wright, Penny; Wilding, Sarah; Wagland, Richard; Watson, Eila; Glaser, Adam; Gavin, Anna

doi:10.1007/s11764-018-0704-x

Cited by 25 publications

(27 citation statements)

References 29 publications

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“…Survivors who have returned to work can experience a range of physical or psychological after-effects which adversely impact their work ability or functioning [60,61]. In addition, cancer-related symptoms, such as fatigue, pain, and depression, have been associated with leaving the workforce after cancer, albeit mainly in shorter-term survivors [62][63][64]. Alternatively, the decline may simply reflect ageing and people reaching retirement age or opting for early retirement.…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

et al. 2020

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Purpose Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. Methods We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. Results Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both crosssectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. Conclusion Almost three-quarters of long-term cancer survivors working at diagnosis retain work. Implications for Cancer Survivors These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.

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Section: Interpretation Of Resultsmentioning

confidence: 99%

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

et al. 2020

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“…In those studies, 91% of men treated with radiotherapy were back to work 1 year after diagnosis,11 and 88% of men treated with radical prostatectomy remained in the workforce 3 years after diagnosis 10. Although adverse events such as urinary leakage seem to have an impact on work in the first years following diagnosis,10 34 our study indicates that it is mainly men with cancer progression and secondary treatments that are on sick leave from 5 years after their prostate cancer diagnosis.…”

Section: Discussionmentioning

confidence: 61%

Duration of sick leave after active surveillance, surgery or radiotherapy for localised prostate cancer: a nationwide cohort study

et al. 2020

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ObjectivesTo compare the loss of working time due to sick leave by treatment strategy for localised prostate cancer.DesignNationwide cohort study.SettingSweden.ParticipantsA total of 15 902 working-aged men with localised low or intermediate-risk prostate cancer diagnosed during 2007–2016 from the Prostate Cancer Data Base Sweden, together with 63 464 prostate cancer-free men. Men were followed until 2016.Primary and secondary outcome measuresUsing multistate Markov models, we calculated the proportion of men on work, sick leave, disability pension and death, together with the amount of time spent in each state. All-cause and cause-specific estimates were calculated.ResultsDuring the first 5 years after diagnosis, men with active surveillance as their primary treatment strategy spent a mean of 17 days (95% CI 15 to 19) on prostate cancer-specific sick leave, as compared with 46 days (95% CI 44 to 48) after radical prostatectomy and 44 days (95% CI 38 to 50) after radiotherapy. The pattern was similar after adjustment for cancer and sociodemographic characteristics. There were no differences between the treatment strategies in terms of days spent on sick leave due to depression, anxiety or stress. Five years after diagnosis, over 90% of men in all treatment strategies were free from sick leave, disability pension receipt and death from any cause.ConclusionsMen on active surveillance experienced less impact on working life compared with men who received radical prostatectomy or radiotherapy. From a long-term perspective, there were no major differences between treatment strategies. Our findings can inform men diagnosed with localised prostate cancer on how different treatment strategies may affect their working lives.

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“…Studies on cancer-related symptoms, such as this one, are starting to suggest pathways by which financial hardship may lead to reduced QoL among survivors. In terms of explanations for our findings, experiencing cancer-related symptoms (including fatigue and pain) can hamper cancer survivors' ability to work, and increase their risk of unemployment and early retirement [48][49][50][51]. This suggests that the effects of CRF on work participation may, at least in part, explain our findings.…”

Section: Financial Hardship and Crfmentioning

confidence: 69%

“…In terms of explanations for our findings, experiencing cancer-related symptoms (including fatigue and pain) can hamper cancer survivors’ ability to work, and increase their risk of unemployment and early retirement [ 48 – 51 ]. This suggests that the effects of CRF on work participation may, at least in part, explain our findings.…”

Section: Discussionmentioning

confidence: 99%

Cumulative financial stress as a potential risk factor for cancer-related fatigue among prostate cancer survivors

Gavin²,

Drummond

et al. 2020

J Cancer Surviv

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Introduction Cancer-related fatigue (CRF) is the most commonly reported treatment-related side effect of prostate cancer (PCa). Recognition of financial hardship among cancer survivors is growing. We investigated, for the first time, associations between levels of financial stress and CRF among PCa survivors. Methods We used data from PCa survivors who had been identified through two population-based cancer registries covering the Republic of Ireland and Northern Ireland and had completed a postal questionnaire. CRF was measured by the fatigue subscale of the EORTC QLQ-C30. Financial stress was assessed as household ability to make ends meet (i) pre-diagnosis and (ii) at questionnaire completion (post-diagnosis). Multivariable logistic regression was used to relate financial stress to clinically important CRF (fatigue subscale score ≥ 39 of a possible 100). Results Two thousand four hundred fifty-eight PCa survivors were included. Of these, 268 (10.9%) reported pre-diagnosis financial stress only, 317 (12.9%) post-diagnosis stress only and 270 (11.0%) both pre-and post-diagnosis stress (cumulative stress); 470 (19.1%) reported clinically important CRF. After controlling for confounders, survivors with cumulative financial stress exposure were significantly more likely to have CRF (OR = 4.58, 95% CI 3.30-6.35, p < 0.001), compared with those without financial stress. There was a suggestion of a dose-response relationship (OR = 1.83, 95% CI 1.27-2.65, p = 0.001 for prediagnosis financial stress only; and OR = 4.11, 95% CI 3.01-5.61, p < 0.001 for post-diagnosis financial stress only). Conclusions Financial stress may be an independent risk factor for CRF. Implications for Cancer Survivors There may be benefits in targeting interventions for reducing CRF towards survivors with financial stress, or developing strategies to reduce financial stress.

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Factors influencing job loss and early retirement in working men with prostate cancer—findings from the population-based Life After Prostate Cancer Diagnosis (LAPCD) study

Cited by 25 publications

References 29 publications

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

Duration of sick leave after active surveillance, surgery or radiotherapy for localised prostate cancer: a nationwide cohort study

Cumulative financial stress as a potential risk factor for cancer-related fatigue among prostate cancer survivors

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