Employment pathways in a large cohort of adult cancer survivors

Authors

  • Pamela Farley Short Ph.D.,

    Corresponding author
    1. Department of Health Policy and Administration, Center for Health Care and Policy Research, The Pennsylvania State University, University Park, Pennsylvania
    • Department of Health Policy and Administration, Pennsylvania State University, 116 Henderson Building, University Park, PA 16802
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    • Fax: (814) 863-0846

  • Joseph J. Vasey Ph.D.,

    1. Department of Health Policy and Administration, Center for Health Care and Policy Research, The Pennsylvania State University, University Park, Pennsylvania
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  • Kaan Tunceli Ph.D.

    1. Center for Health Services Research, Henry Ford Health System, Detroit, Michigan
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  • This research was supported by the National Cancer Institute under grant RO1 CA82619. The contents are solely the responsibility of the authors and do not necessarily represent the official views of National Cancer Institute.

Abstract

BACKGROUND

Employment and work-related disability were investigated in a cohort of adult cancer survivors who were working when they were diagnosed from 1997 to 1999 with a variety of cancers. Employment from the time of diagnosis through the early years of survivorship was studied, self-reported effects of cancer survival on disability and employment were quantified, and risk factors associated with cancer-related disability and withdrawal from employment were identified.

METHODS

One thousand four hundred thirty-three cancer survivors were interviewed by telephone from 1 year to nearly 5 years after diagnosis. They were asked retrospectively about employment from the time of diagnosis to follow-up and about work-related disability at follow-up. They also were asked whether disabilities or reasons for quitting work were cancer-related. Return to work and quitting work were projected over time in a life-table analysis. Risk factors were identified from logit analyses.

RESULTS

One of five survivors reported cancer-related disabilities at follow-up. Half of those with disabilities were working. A projected 13% of all survivors had quit working for cancer-related reasons within 4 years of diagnosis. More than half of survivors quit working after the first year, when three-quarters of those who stopped for treatment returned to work. Survivors of central nervous system, head and neck, and Stage IV blood and lymph malignancies had the highest adjusted risk of disability or quitting work.

CONCLUSIONS

Cancer survival sometimes has long-term effects on employment and the ability to work. Employment outcomes can be improved with innovations in treatment and with clinical and supportive services aimed at better management of symptoms, rehabilitation, and accommodation of disabilities. Cancer 2005. © 2005 American Cancer Society.

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