Predicting return to work among patients with colorectal cancer

Abstract

Background:The increase in prevalence of colorectal cancer among young patients coupled with an older retirement age in developed countries means that more patients are being diagnosed with colorectal cancer while still at work. The aim of this study was to develop prediction models for return to work by 1 and 2 years after the start of sick leave.Methods: This was a retrospective registry-based cohort study of data from a nationwide occupational health service in the Netherlands. Only employed patients with colonic or rectal cancer treated with curative intent were included. Two predictor variable models were developed using multivariable logistic regression with backward selection. Calibration, discrimination and explained variance were used to assess model performance, and internal validation by bootstrapping was performed. Results: Median time to return to work for 317 included patients was 423 (95 per cent c.i. 379 to 467) days. Two-thirds of patients had returned to work by 2 years after the start of the sick leave. Presence of metastases, adjuvant treatment, stoma, emotional distress and postoperative complications were predictors of not returning to work in the 1-year model. In the 2-year model, presence of metastases, emotional distress, postoperative complications, company size and the trajectory of the return-to-work process were predictors. Conclusion: Almost 70 per cent of patients with colorectal cancer in this population returned to work within 2 years after the start of sick leave. The models can be used to guide patients early in colorectal cancer treatment about the likelihood of returning to work, and to identify and modify barriers that could facilitate this.

Trajectories of sickness absence and disability pension before and after colorectal cancer: A Swedish longitudinal population-based matched cohort study

“…From the trajectory analyses, the majority of CRC survivors (80%) in our study had slightly higher numbers of SADP days compared to the general population over a 5-year span. The overall finding was in line with previous studies based on CRC survivors from the Netherlands [ 11 ] and rectal cancer survivors from Sweden [ 29 ]. Previous studies on work situations on CRC survivors were often limited in being only questionnaire-based [ 30 – 33 ] having small sample size [ 30 – 35 ], focusing not colon and rectal cancer together [ 29 , 31 , 36 ], with short follow-up (less than 2 years) [ 13 , 30 – 33 , 35 ], not quantifying its outcomes (with only binary outcome of return-to-work or not) [ 13 , 30 – 34 , 37 ], without information of DP [ 13 , 30 – 33 , 35 , 37 ].…”

Anastomotic leak after surgery for colon cancer and effect on long‐term survival

“…This topic poses methodological challenges that cannot be met by large national datasets but need appropriately designed prospective studies. Serious complications including anastomotic leak after surgery have recently been identified as a significant predictor for delayed return to work and this observation underlines the serious impact of anastomotic leak on the individual patient .…”

COVID-19 pandemic: perspectives on an unfolding crisis

“…In the dramatic scenario of intensive care bed scarcity, patients with cancer may need non‐invasive options as a compromise (for example, radiotherapy, chemotherapy, or both) yet there may be treatment delays due to the pandemic. The potential disease progression, which is associated with quality of life and costs of care implications, has a knock‐on effect that may happen with benign disorders too.…”