Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period

AbstractDue to advances in medical science and technology, the number of cancer survivors continues to increase. The workplace needs and employment difficulties cancer survivors face after treatment need to be addressed to protect these individuals’ right to work and to maintain the overall labor force of the country. We conducted a retrospective cohort study with a follow-up period from 2004 to 2010. All data analyzed in the study were obtained from the Labor Insurance Database, the Taiwan Cancer Registry of the Ministry of Health and Welfare, and the National Health Insurance Research Database. The relationships between risk factors and the presence of returning to work were analyzed by a Cox proportional hazard model. The survival rates of patients with different cancer stages were evaluated using Kaplan–Meier survival analysis. Among the employees with an initial diagnosis of cancer, 70.4% remained employed through 1 year after the diagnosis, accounting for 83.4% of all cancer survivors; only 51.1% remained employed through 5 years after the diagnosis, accounting for 78.7% of all cancer survivors, a notable decrease. Age, gender, salary, treatment method, company size, and cancer stage were the factors that affected whether employees could return to work or not. The long-term survival of people diagnosed with cancer depends on their chances of returning to work. Strengthening existing return-to-work policies and assisting cancer survivors with returning to work after the treatment should be priorities for protecting these individuals’ right to work and for maintaining the overall labor force.

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The Fact of Return to Work in Cervical Cancer Survivors and the Impact of Survival Rate: An 11-Year Follow-Up Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010703 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10703

Author(s):

Yu-Shan Sun ◽

Wei-Liang Chen ◽

Wei-Te Wu ◽

Chung-Ching Wang

Keyword(s):

Cervical Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Research Database ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Cox Proportional Hazard Models ◽

Returning To Work ◽

The Impact

The aim of the current cohort study was to explore the relationship between return to work (RTW) after cervical cancer treatment and different medical and occupational covariates. We also investigated the effect of RTW on all-cause mortality and survival outcomes of cervical cancer survivors. Data were collected between 2004 and 2015 from the database of the Taiwan Cancer Registry, Labor Insurance Database, and National Health Insurance Research Database. The associations between independent variables and RTW were analyzed by Cox proportional hazard models. A total of 4945 workers (82.3%) who returned to work within 5 years after being diagnosed with cervical cancer. Patients who underwent surgical treatment were more likely to RTW by the 5th year compared to other groups, with a hazard ratio (HR) of 1.21 (95% CI: 1.01~1.44). Small company size and a monthly income greater than NT 38,200 were inversely associated with RTW (HR = 0.91, 95% CI: 0.84~0.98 and HR = 0.48, 95% CI: 0.44~0.53). Furthermore, RTW showed a statistically significant decrease in the risk of all-cause mortality in the fully adjusted HR, (HR = 0.42, p < 0.001). Some medical and occupational factors are associated with RTW in cervical cancer survivors. Returning to work may have a beneficial effect on the survival of patients with cervical cancer.

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Return to Work of Breast Cancer Survivors: Perspectives and Challenges for Occupational Physicians

Cancers ◽

10.3390/cancers12020355 ◽

2020 ◽

Vol 12 (2) ◽

pp. 355 ◽

Cited By ~ 2

Author(s):

Marcello Campagna ◽

Roberto Loscerbo ◽

Ilaria Pilia ◽

Federico Meloni

Keyword(s):

Breast Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Cancer Incidence ◽

Female Gender ◽

Individual Characteristics ◽

Occupational Physicians ◽

Returning To Work ◽

Therapeutic Tools

Breast cancer is one of the most common diseases worldwide, mainly affecting the female gender. Considering the increase of breast cancer incidence and the decrease of mortality due to news diagnostic and therapeutic tools, the return to work issue after treatment is going to be very common in the next years. Occupational physicians therefore need to face the return to work and the fitness for work of workers previously diagnosed with breast cancer with a sufficient cultural and technical background. In addition to individual characteristics preceding the diagnosis, clinical outcome, lifestyles and occupational variables are the most impactful factors on return to work that need to be taken into account. The aim of this work is to analyze these factors and discuss the central role of occupational physicians in the decision-making process of returning to work in breast cancer survivors.

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Successful Return to Work for Cancer Survivors

AAOHN Journal ◽

10.1177/216507990705500705 ◽

2007 ◽

Vol 55 (7) ◽

pp. 290-295 ◽

Cited By ~ 55

Author(s):

Nancy M. Nachreiner ◽

Rada K. Dagher ◽

Patricia M. McGovern ◽

Beth A. Baker ◽

Bruce H. Alexander ◽

...

Keyword(s):

Return To Work ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Critical Role ◽

Recovery Process ◽

Population Based ◽

Related Factors ◽

Returning To Work ◽

Female Cancer Survivors

This study investigated factors associated with successful return to work for cancer survivors in accordance with the Americans with Disabilities Act. A focus group was held with seven female cancer survivors. Participants discussed return-to-work issues following a cancer diagnosis. Factors such as coworker support and job flexibility improved their experiences, whereas coworker and supervisor ignorance about cancer and lack of support made returning to work more stressful. Participants discussed personal, environmental, and cancer-related factors that influenced their experiences with returning to work following a cancer diagnosis. Knowledge of factors that support employees helps occupational health nurses ease their transition, and may improve quality of life for employees. Physicians and health care provider teams may play a critical role in the employees' positive evaluation of their recovery process. This pilot study serves as a basis for a larger, population-based study.

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Epidemiological Study of Return to Work and Mortality in Lung Cancer Survivors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010309 ◽

2021 ◽

Vol 19 (1) ◽

pp. 309

Author(s):

Zhe-Yu Yang ◽

Ching-Huang Lai ◽

Ching-Liang Ho ◽

Chung-Ching Wang

Keyword(s):

Lung Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Cancer Patients ◽

Lower Risk ◽

Research Database ◽

Related Factors ◽

Lung Cancer Patients ◽

Work Related ◽

All Cause Mortality

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths worldwide. Return to work (RTW) plays an important role for lung cancer survivors. Few studies focus solely on the relationship among possible variables and the RTW of lung cancer patients. The aim of our study was to examine sociodemographic, disease-related and work-related factors associated with RTW among lung cancer survivors in Taiwan. A total of 2206 employees who had been diagnosed with lung cancer at the Labor Insurance Database (LID), Taiwan Cancer Registry (TCR) and the National Health Insurance Research Database (NHIRD) during the period 2004–2015, were included in the study. We used the Cox proportional hazards model to investigate the associations between sociodemographic, disease-related and work-related factors on one hand and RTW on the other hand. The Kaplan–Meier method was used for analyzing the survival probability. Patients with an early cancer stage and those who underwent surgery had a higher likelihood of RTW. Factors including older age, male, higher monthly income and receipt of radiotherapy were inversely correlated with RTW. For lung cancer patients, RTW was a predictor of a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. A better survival rate was found in stage III and IV lung cancer patients who had RTW. Sociodemographic and clinical-related variables had an impact on RTW among employees with lung cancer. RTW was correlated with a lower risk of all-cause mortality and better lung cancer survival. Our study showed the influence of RTW and independent confounding factors in lung cancer survivorship.

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Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain

Behavioral Sciences ◽

10.3390/bs11100135 ◽

2021 ◽

Vol 11 (10) ◽

pp. 135

Author(s):

Francisco Aguiar-Fernández ◽

Yolanda Rodríguez-Castro ◽

Mercedes Botija ◽

Rosana Martínez-Román

Keyword(s):

Breast Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Female Breast Cancer ◽

Psychological Consequences ◽

Adaptation Measures ◽

Female Breast ◽

Returning To Work ◽

Age Range

The objective of this study was to analyze the experiences of returning to work of women who had overcome breast cancer, identifying its physical and psychological consequences, the process they underwent, their motivations, and difficulties. A total of 19 female breast cancer survivors, with an age range of 30 to 57 years, participated in two focus groups. A semi-structured script was prepared about their experiences of returning to work. The results indicated that survivors’ self-perception was weakened by the physical and psychological consequences of the treatment of the disease; economic difficulties were one of the main reasons for going back to work; lastly, returning to work was a difficult process, mainly because of their physical/psychological limitations, the scarcity of job adaptation measures, and the limited support of the various public administrations. In addition, most of the women had to cope with seeking a new job without any guidance or job training. Significant difficulties related to the maintenance and return to work of female breast cancer survivors have been revealed. Findings highlighted the need to provide more and better information and guidance to cancer patients concerning their return to work or the search for a new job.

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“To have and then lose the safety net” –Female cancer survivors’ experiences of the process of becoming ready to return to work

Work ◽

10.3233/wor-213623 ◽

2021 ◽

pp. 1-10

Author(s):

K.S. Petersen ◽

L.S. Anth Madsen ◽

C.V. Nielsen ◽

M. Labriola ◽

C.M. Stapelfeldt

Keyword(s):

Return To Work ◽

Cancer Survivors ◽

Safety Net ◽

Occupational Rehabilitation ◽

Data Driven ◽

Data Generation ◽

Structured Interviews ◽

Qualitative Research Design ◽

Returning To Work ◽

Female Cancer Survivors

BACKGROUND: Validation studies have not been able to confirm the stage-specific understanding as operationalised in the readiness for return to work (RRTW) questionnaire. OBJECTIVE: To explore retrospectively how working female cancer survivors experienced the process of becoming ready to RTW during and beyond participation in an occupational rehabilitation intervention and thereby expand the understanding of the RRTW construct. METHODS: A qualitative research design was employed. Thirteen female cancer survivors were included for semi-structured interviews one to two years after they had completed active treatment and returned to work. The RRTW construct guided data generation and analysis. Content analysis was performed in four analytical steps that combined a concept-driven and a data-driven analytic strategy. RESULTS: Three themes were identified; “To have and then lose the safety net”, “Realise a changed life situation”, “Strive to balance work and everyday life”. In a time span of approximately one to two years (from receiving treatment, being enrolled in an intervention and to gradually returning to work); the identified themes were interdependent of each other as one theme gradually evolved to the next theme in the process of engaging in sustained work participation. CONCLUSIONS: The present study points towards continuous development of the RRTW construct and whether the addition of a preparedness dimension would improve validity.

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Possible Mechanisms of Subsequent Neoplasia Development in Childhood Cancer Survivors: A Review

Cancers ◽

10.3390/cancers13205064 ◽

2021 ◽

Vol 13 (20) ◽

pp. 5064

Author(s):

Jarmila Kruseova ◽

Ales Vicha ◽

Barbara Feriancikova ◽

Tomas Eckschlager

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Survival Rates ◽

Childhood Cancer Survivors ◽

Good Prognosis ◽

Malignant Neoplasms ◽

Term Survival ◽

Improved Outcomes ◽

Prediction And Prevention ◽

Life Threatening

Advances in medicine have improved outcomes in children diagnosed with cancer, with overall 5-year survival rates for these children now exceeding 80%. Two-thirds of childhood cancer survivors have at least one late effect of cancer therapy, with one-third having serious or even life-threatening effects. One of the most serious late effects is a development of subsequent malignant neoplasms (histologically different cancers, which appear after the treatment for primary cancer), which occur in about 3–10% of survivors and are associated with high mortality. In cancers with a very good prognosis, subsequent malignant neoplasms significantly affect long-term survival. Therefore, there is an effort to reduce particularly hazardous treatments. This review discusses the importance of individual factors (gender, genetic factors, cytostatic drugs, radiotherapy) in the development of subsequent malignant neoplasms and the possibilities of their prediction and prevention in the future.

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Life Expectancy after Curative-intent Treatment of Breast Cancer: Impact on Long-term Follow-up Care

The American Surgeon ◽

10.1177/000313481408000626 ◽

2014 ◽

Vol 80 (6) ◽

pp. 604-609 ◽

Cited By ~ 8

Author(s):

Amanda K. Arrington ◽

Leanne Goldstein ◽

Laura Kruper ◽

Courtney Vito ◽

John Yim ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

General Population ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Survival Curve ◽

Survival Rates ◽

Stage I ◽

Term Survival

Long-term survival rates after treatment for breast cancer are directly influenced by early deaths resulting from disease. For longer-term breast cancer survivors, survival rates appear deceptively low. We hypothesize that the actual survival curve for long-term survivors approaches the overall survival of the general population. The Surveillance, Epidemiology, and End Results database (1988 to 2002) was used to identify patients with nonmetastatic breast cancer who underwent definitive surgical treatment. The survival of the general population was constructed by using national life tables with an age-matched population. Comparisons of survivals were made for 3-, 5-, and 7-year breast cancer survivor cohorts. Of 237,180 patients, 92.4 per cent survived three years, 82.1 per cent five years, and 58.1 per cent seven years. Stage I patients have equivalent or better survivals compared with the age-matched general population in all three cohorts. Stage II patients reached equivalent conditional survival between eight and nine years after diagnosis regardless of cohort. Stage III patients required achieving nine to 10 years after diagnosis to achieve equivalent survival probability, except in 7-year survivors, in whom 10 to 11 years was required. In all stages, once equivalence was reached, survival exceeded the general population over the remaining years. Initial cancer stage influences overall survival for many years after diagnosis. Patients with Stage I cancer return to the general population risk as early as three years after diagnosis, whereas higher stages can require up to nine years to achieve parity with a more generalized population. These findings should be factored into general health screening issues for long-term breast cancer survivors.

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Return to Work in the Gastric Cancer Survivors

10.21203/rs.3.rs-144594/v1 ◽

2021 ◽

Author(s):

Yuan-Yuei Chen ◽

Wei-Liang Chen ◽

Wei-Te Wu ◽

Ching-Liang Ho ◽

Chung-Ching Wang

Keyword(s):

Gastric Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Cox Regression ◽

Early Stage ◽

Survival Outcomes ◽

Kaplan Meier ◽

Returning To Work ◽

The Impact

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.

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Functionality and factors associated with work behaviour among Brazilian breast cancer survivors: A cross-sectional study

Work ◽

10.3233/wor-203342 ◽

2020 ◽

Vol 67 (4) ◽

pp. 917-925

Author(s):

Kamilla Zomkowski ◽

Anke Bergmann ◽

Cinara Sacomori ◽

Mirella Dias ◽

Fabiana Flores Sperandio

Keyword(s):

Breast Cancer ◽

Return To Work ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Upper Limbs ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Returning To Work

BACKGROUND: Breast cancer treatments lead to several comorbidities in the upper limbs, such as pain and stiffness, hindering physical functions and the return to work. OBJECTIVE: To explore the functionality and factors associated with work behaviour among manual and non-manual Brazilian workers who have recovered from breast cancer. METHODS: This is an observational cross-sectional study involving Brazilian breast cancer survivors. The sociodemographic, work, and clinical aspects were assessed through clinical records, upper limb disability, and human functionality obtained from 62 women. Multiple and univariate logistic regressions were used to identify the association of variables on return to work, p < 0.05. RESULTS: 56.5% of women did not return to work, the mean time for returning to work was 16 months (±15.21), absenteeism from work lasted 41 months (±34.58). Modified radical mastectomy (OR = 5.13, 95% CI = 1.35 to 18.66) and moderate-to-severe disability levels in the upper limbs (OR = 6.77, 95% CI = 1.86 to 24.92) were associated with not returning to work. The loss of productivity was higher among non-manual workers (21.5%) (p = 0.040). CONCLUSIONS: The rates of not returning to work after breast cancer treatment are high. Women who did not return to work presented higher levels of disability.

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