Long-term employment status and quality of life after cancer: A longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis

Abstract

BACKGROUND: Accumulating evidence suggests that cancer survivors are able to return to work. However, little is known about their work situation 5 years after diagnosis. OBJECTIVE: To explore fluctuations in employment status and its association with quality of life 2, 3, and 5 years after cancer diagnosis of 65 cancer survivors employed at diagnosis. METHODS: In association with a randomised controlled trial (RCT), questionnaires were administrated to eligible cancer survivors at diagnosis, 2, 3, and 5 years thereafter comprising of validated questionnaires related to work (i.e. Work Ability Index (WAI), cancer, and quality of life (QOL) (i.e. SF-36, VAS QOL). The RCT studied a hospital-based work support intervention in female breast and gynaecological cancer survivors who were treated with curative intent and had paid work at diagnosis. Descriptive statistics and longitudinal multi-level analysis were employed. RESULTS: Sixty-five of the 102 eligible cancer survivors participated, who were primarily diagnosed with breast cancer (63%). Two and 5 years after cancer diagnosis respectively 63 (97%) and 48 (81%) participants were employed. Reasons for not being employed after 5 years included receiving unemployment benefits (7%), voluntary unemployment (3%), receiving disability benefits (3%), and early retirement (3%). Longitudinal multi-level analysis showed that employed cancer survivors reported in general statistically significant better quality of life outcomes at 5 years follow-up compared to those not being employed. CONCLUSIONS: We found high employment rates and few fluctuations in employment status. The steepest decline in employment rate occurs after the first two years of diagnosis. Employed participants reported better quality of life outcomes. Survivorship care should therefore focus on the population at risk possibly within the first two years after diagnosis.

Exploring the Relationship between Physical Activities and Health-Related Factors in the Health-Related Quality of Life among People with Disability in Korea

“…The workplace activities of disabled people in Korea were found to have a positive effect on HRQoL. This is supported by research on work status and QoL in patients with a disease (e.g., cancer, kidney transplant) and adolescents [23][24][25]. Disabled people have several socio-economic and physical limitations to engaging in stable regular jobs [3].…”

“…According to previous studies, HRQoL is known to be affected by factors such as health behavior (drinking and smoking) [18,19], exercise [20][21][22], job status [23][24][25], independent living [26][27][28], and chronic disease [29][30][31][32]. These studies emphasized quality of life (QoL) or well-being that encompasses the body and mind.…”

Survivorship, Version 1.2021

“…When employment is disrupted, these advantages can be lost. In fact, several studies have shown that cancer survivors who are unemployed or have greater work impairments experience greater long-term psychologic distress and worse HRQoL outcomes compared with other cancer survivors, 32,39,40 although caution should be applied to this interpretation given likely confounding. In addition, employment issues (and presumably subsequent income and insurance issues) may affect receipt of cancer treatment, leading to treatment delays, suboptimal treatment adherence, or treatment discontinuation.…”

A social-healthcare pathway to facilitate return to work of cancer survivors in Italy: The UNAMANO project

“…Thus, RTW is a major goal in order to promote cancer survivors' (CSs) social participation, which corresponds to fully carrying out activities of daily living and social roles [5]. Employment is key to determining an individual's social participation [6][7][8] since it is an essential element of self-identity and self-esteem, it provides financial support to the individual and his/her family, it allows one to express his/her abilities and talents, it gives normalcy to daily structure and, finally, it results in better health [9,10]. Moreover, RTW provides the opportunity to engage socially with colleagues and other individuals [11].…”