Return to Work in Survivors of Human Papillomavirus–Associated Oropharyngeal Cancer: An Australian Experience

Morales, Claudia Zecena; McDowell, Lachlan; Lisy, Karolina; Piper, Amanda J.; Jefford, Michael

doi:10.1016/j.ijrobp.2019.09.001

Cited by 14 publications

(18 citation statements)

References 48 publications

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“…There were only 10 studies that had an upper age limit as part of their exclusion criteria for study eligibility. Most studies included patients with varying head and neck cancer subsites, but two included patients with only oral cavity tumors, 14,15 while three studies including only oropharyngeal tumors 16–18 . There was one study by So et al 19 that included only patients with nasopharyngeal tumors.…”

Section: Resultsmentioning

confidence: 99%

“…There was high heterogeneity in the reported rate of RTW between studies, as evident by the I 2 value of 97.53%. There were five studies which reported data on number of people who returned to work but had reduced hours 5,17,19,24,25 . A meta‐analysis of these studies demonstrated that 44% of HNC survivors worked a reduced number of hours (95% CI 38%–51%, I 2 = 49.62%, Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…A meta‐analysis of these studies demonstrated that 44% of HNC survivors worked a reduced number of hours (95% CI 38%–51%, I 2 = 49.62%, Figure 3). There were also five studies that reported the number of people who returned to work but had changed occupations 14,17,22,25,26 . The meta‐analysis found that 30% of HNC survivors had to change work after completion of their treatment (95% CI 15%–45%, I 2 = 95.64%, Figure 4), although there was significant heterogeneity in this finding.…”

Section: Resultsmentioning

confidence: 99%

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Return to work in patients with head and neck cancer: Systematic review and meta‐analysis

Smith

Marwah

et al. 2022

Head & Neck

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Background: The aim of this review was to determine the prevalence of return to work (RTW) amongst head and neck cancer (HNC) survivors and to determine its impact on quality of life (QoL).Methods: A literature search was conducted in PubMed, Scopus, Embase and CINAHL in March 2021. Articles were included if they reported the number of patients with HNC receiving definitive treatment who were working at the time of diagnosis and returned to work. Results: There were 21 articles deemed eligible for inclusion. Meta-analysis suggested that 67% of patients with HNC who were employed at diagnosis RTW (95% CI 62%-73%, I 2 = 97.53%). Patients who RTW were demonstrated to have lower levels of anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale.Conclusions: Return to work is an important clinical outcome which must be considered in the survivorship care of patients with HNC. K E Y W O R D Shead and neck, head and neck cancer, otorhinolaryngology, Quality of life, return to work

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Return to work in patients with head and neck cancer: Systematic review and meta‐analysis

Smith

Marwah

et al. 2022

Head & Neck

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“…Although the underlying causal mechanisms for these differences in productivity by treatment arm are yet unknown, it is possible that differences in toxicities and symptom burdens seen on prior observational studies of patients with OPC who receive proton treatment could contribute to differences in recovery of function, recovery that may be effective enough to influence long-term disability. Recent observational studies of oropharyngeal or nasopharyngeal cancer, which included long-term survivors, identified the significance of fatigue, neurobehavioral dysfunction, and disability as contributing to work loss in these populations [ 30 , 31 ]. Therefore, the potential acute, subacute, and long-term toxicity profile benefits of IMPT could have a role in mitigating work outcomes.…”

Section: Discussionmentioning

confidence: 99%

Work Outcomes after Intensity-Modulated Proton Therapy (IMPT) versus Intensity-Modulated Photon Therapy (IMRT) for Oropharyngeal Cancer

Smith

Ning

et al. 2021

International Journal of Particle Therapy

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Purpose We compared work outcomes in patients with oropharyngeal cancer (OPC), randomized to intensity-modulated proton (IMPT) versus intensity-modulated photon therapy (IMRT) for chemoradiation therapy (CRT). Patients and Methods In 147 patients with stage II-IVB squamous cell OPC participating in patient-reported outcomes assessments, a prespecified secondary aim of a randomized phase II/III trial of IMPT (n = 69) versus IMRT (n = 78), we compared absenteeism, presenteeism (i.e., the extent to which an employee is not fully functional at work), and work productivity losses. We used the work productivity and activity impairment questionnaire at baseline (pre-CRT), at the end of CRT, and at 6 months, 1 year, and 2 years. A one-sided Cochran-Armitage test was used to analyze within-arm temporal trends, and a χ2 test was used to compare between-arm differences. Among working patients, at each follow-up point, a 1-sided Wilcoxon rank-sum test was used to compare work-productivity scores. Results Patient characteristics in IMPT versus IMRT arms were similar. In the IMPT arm, within-arm analysis demonstrated that an increasing proportion of patients resumed working after IMPT, from 60% (40 of 67) pre-CRT and 71% (30 of 42) at 1 year to 78% (18 of 23) at 2 years (P = 0.025). In the IMRT arm, the proportion remained stable, with 57% (43 of 76) pre-CRT, 54% (21 of 39) at 1 year, and 52% (13 of 25) working at 2 years (P = 0.47). By 2 years after CRT, the between-arm difference between patients who had IMPT and those who had IMRT trended toward significance (P = 0.06). Regardless of treatment arm, among working patients, the most severe work impairments occurred from treatment initiation to the end of CRT, with significant recovery from absenteeism, presenteeism, and productivity impairments by the 2-year follow-up (P < 0.001 for all). Higher magnitudes of recovery from absenteeism (at 1 year, P = 0.05; and at 2 years, P = 0.04) and composite work impairment scores (at 1 year, P = 0.04; and at 2 years, P = 0.04) were seen in patients treated with IMPT versus those treated with IMRT. Conclusion In patients with OPC receiving curative CRT, patients randomized to IMPT demonstrated increasing work and productivity recovery trends. Studies are needed to identify mechanisms underlying head and neck CRT treatment causing work disability and impairment.

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“…The rapidly increasing incidence of HPV‐associated oropharyngeal cancer (OPC) a subgroup of HNC, among younger patients with excellent prognosis, is contributing to a growing population of OPC survivors 11 . In a cross‐sectional study, treatment‐related fatigue was reported as an impediment to resuming work among HPV‐associated OPC patients after radiotherapy 12 . In addition, in a cross‐sectional study, mean fatigue score, even though quite modest, was one of the five most prevalent and severely rated symptoms reported by OPC survivors at an average follow‐up time of 7 years after diagnosis 13 …”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with patient‐reported fatigue among long‐term oropharyngeal carcinoma survivors

et al. 2022

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Background The study objective is to identify risk factors associated with fatigue among long‐term OPC survivors. Methods This cross‐sectional study included disease‐free OPC survivors treated curatively between 2000 and 2013 who were surveyed from September 2015 to July 2016. The outcome variable was patient‐reported fatigue. Multivariable logistic regression was used to identify factors associated with moderate to severe fatigue. Results Among 863 OPC survivors, 17.4% reported moderate to severe fatigue. Self‐reported thyroid problems (OR: 2.01; p = 0.003), current cigarette smoking at time of survey (OR: 3.85; p = 0.001), late lower cranial neuropathy (OR: 3.44; p = 0.002), and female sex (OR: 1.91; p = 0.010) were concurrent risk factors of reporting moderate to severe fatigue. Ipsilateral intensity‐modulated radiotherapy (OR: 0.18; p = 0.014) was associated with lower risk of reporting moderate to severe fatigue. Conclusions Our study identified thyroid problems, smoking, and late lower cranial neuropathy as associated with moderate to severe fatigue. These findings should be further validated in prospective studies to address fatigue among OPC survivors.

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Return to Work in Survivors of Human Papillomavirus–Associated Oropharyngeal Cancer: An Australian Experience

Cited by 14 publications

References 48 publications

Return to work in patients with head and neck cancer: Systematic review and meta‐analysis

Return to work in patients with head and neck cancer: Systematic review and meta‐analysis

Work Outcomes after Intensity-Modulated Proton Therapy (IMPT) versus Intensity-Modulated Photon Therapy (IMRT) for Oropharyngeal Cancer

Risk factors associated with patient‐reported fatigue among long‐term oropharyngeal carcinoma survivors

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