Sustained employability and health-related quality of life in cancer survivors up to four years after diagnosis

Abstract

Background: Most cancer survivors are able to return to work at some point after diagnosis. However, literature on sustained employability and health-related quality of life (HRQoL) is limited. Therefore, the aims of this study were to explore the influence of change in employment status on HRQoL in cancer survivors long term after diagnosis, and to identify predictors of work continuation in occupationally active survivors. Material and methods: We used prospective data (T0 ¼ two years after diagnosis, T1 ¼ one-year follow-up, and T2 ¼ two-year follow-up) from a cohort of cancer survivors that had an employment contract and were of working age at T0 (N ¼ 252, 69.8% female). Groups were formed on the basis of change in employment status: 'continuously not working' (19.8%), 'positive change in employment status' (5.6%), 'negative change in employment status' (14.7%), and 'continuously working' (59.9%). ANCOVA was used to explore the relationship between change in employment status and HRQoL at T1. Generalized estimating equations (GEE) were used to identify predictors of work continuation (at T1 and T2) in survivors that were occupationally active at T0 (N ¼ 212). Results: 'Continuously working' survivors scored significantly better on the EORTC QLQ-C30 scales: role functioning, fatigue, pain, constipation, global health/QoL and the Summary score, than 'continuously not working' survivors, and better on physical, role and emotional functioning, fatigue, financial impact, global health/QoL and the Summary score than survivors with a 'negative change in employment status' (effect size range ¼ 0.49-0.74). In occupationally active survivors, a high score on current work ability was associated with work continuation one year later [odds ratio (OR) 1.46; 95% CI 1.11-1.92]. Conclusion: Cancer survivors 'continuously working' function better and have a better health and QoL than those who are not able to work. However, in occupationally active cancer survivors, one should monitor those with low self-perceived work ability, because they have an increased risk to discontinue their work.

Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study

“…This study showed no association between cancer site and cancer treatment with any work functioning trajectory. Recently, Duijts et al . also found no differences in cancer site and treatment for cancer patients who are “continuously working” or “not‐continuously working” 4 years after diagnosis.…”

“…Several studies have addressed the employment consequences of cancer survivorship in terms of employment status . A recent study in occupationally active cancer patients up to four years after diagnosis showed that good work ability was associated with work continuation . An in‐depth review by Munir et al .…”

“…[6][7][8][9][10][11] A recent study in occupationally active cancer patients up to four years after diagnosis showed that good work ability was associated with work continuation. 12 An in-depth review by Munir et al 13 showed that cancer patients reported lower work ability, compared to healthy controls or those with other chronic conditions. Although variations in work ability were found across cancer types due to used study designs and used measures, [14][15][16] no clear conclusions could be drawn.…”

Managing work and cancer treatment: Experiences among survivors of hematological cancer

“…Indeed, survivors who had stopped working after the initiation of treatment cited these benefits as reasons for contemplating a return to work. Positive associations between employment, quality of life, self‐esteem, and satisfaction have been shown among cancer survivors . Swanberg et al found that survivors of breast cancer reported a sense of responsibility that included the need for normalcy as an influential reason for continued employment throughout cancer treatment.…”

The Quality of Working Life Questionnaire for Cancer Survivors: Sufficient responsiveness for use as a patient-reported outcome measurement

“…This led to a shift from merely focusing on survival to also focusing on short‐term effects, and long‐term effects as well as late effects of cancer and its treatment. For cancer survivors of working age, inability to return to work or continue working is one of these late effects that can negatively impact their quality of life (Duijts, Kieffer, van Muijen, & van der Beek, ). That is, because work gives them, for instance, a feeling of contributing to society (Tiedtke, de Rijk, Dierckx de Casterle, Christiaens, & Donceel, ), and as work provides them a much‐needed income (Yabroff et al, ).…”