Return to Work in the Gastric Cancer Survivors

Abstract

Returning to work (RTW) is an often used outcome in work research to describe employee fully recovering from disease. Several factors are suggested as barriers for workers returning to work. The goal of this study was to investigate the role of RTW in workers with gastric cancer and identify its impact on their survival outcomes during 11 years of follow-up. A total of 4467 workers who with newly diagnosis of gastric cancer were included in this retrospective cohort study with a follow-up period ranging from 2004 to 2015. Relationships between work, treatment, and disease-related variables and RTW were analyzed by Cox regression. The impact of RTW on survival outcomes was analyzed by Kaplan-Meier survival curves. Old age, males, comorbidities, chemotherapy, radiotherapy, and manual jobs were inversely associated with RTW. Operation and early stage of gastric cancer were associated with increased likelihood of RTW. After adjusting for variables, workers with stage 1 gastric cancer were more likely return to work than other stages with HR of 4.67 (95%CI: 2.99~7.31) and 7.44 (95%CI: 4.12~13.43) in the 2nd and 5th year. In terms of effect of RTW on survival rate, reemployed workers had better survival than those without employment in all gastric cancer survivors. Furthermore, RTW had significant association with reduced risk of all-cause mortality (HR: 0.49, 95%CI: 0.38~0.65). Improving these identified barriers and strengthening facilitators of RTW can provide employers and government to conduct comprehensive employment plans for increasing the percentage of RTW in the gastric cancer survivors.