Employment Among Survivors of Lung Cancer and Colorectal Cancer

Institute for Clinical Evaluative Sciences and University of Toronto, Toronto, Ontario, Canada.
Journal of Clinical Oncology (Impact Factor: 18.43). 03/2010; 28(10):1700-5. DOI: 10.1200/JCO.2009.24.7411
Source: PubMed


To identify the frequency of and factors associated with changes in employment among cancer survivors.
This prospective cohort study took place in the context of the population-based Cancer Care Outcomes Research and Surveillance Consortium. Patients with nonmetastatic lung or colorectal cancer who survived approximately 15 months after diagnosis without cancer recurrence provided their self-reported employment status, employment experiences, and changes in insurance coverage at 4 and 15 months after diagnosis. Multiple logistic regression was used to relate sociodemographic and disease factors to the probability of labor force departure.
Among 2,422 eligible patients, employment declined from 3% to 31% over the 15 months after cancer was diagnosed. Labor force departures attributable to cancer occurred in 17% of those employed at baseline. Factors associated with significantly higher rates of labor force departure were lung versus colon cancer, stage III versus I or II disease, lower educational and income levels, and, among colorectal patients, older age. Married women were significantly more likely than unmarried women to leave the workforce. Only 2% of patients lacked health insurance during the study period.
Most employed patients with nonmetastatic lung or colorectal cancer return to work, but approximately one sixth of patients leave the workforce, particularly those with worse prognoses or lower socioeconomic status. Potential economic effects must be considered in management decisions about cancer.

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    • "Cancer-related sequelae, such as depression, cognitive impairment, fatigue, and mobility problems , can interfere with work (Duijts et al., 2014). Predictors of lower likelihood of returning to work and limitations at work include having more invasive treatments, older age, lower socioeconomic status, and a physically demanding job (Earle et al., 2010; van Muijen et al., 2013). Because the majority of Americans derive medical benefits from the workplace, unemployment and underemployment diminishes vital coverage for health care. "
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    ABSTRACT: The number of individuals living with a history of cancer is estimated at 13.7 million in the United States and is expected to rise with the aging of the population. With expanding attention to the psychosocial and physical consequences of surviving illness, psychological science and evidence-based practice are making important contributions to addressing the pressing needs of cancer survivors. Research is demonstrating that adults diagnosed with cancer evidence generally positive psychosocial adjustment over time; however, a subset is at risk for compromised psychological and physical health stemming from long-term or late effects of cancer and its treatment. In this article, we characterize survivorship after medical treatment completion during the periods of reentry, early survivorship, and long-term survivorship. We describe the major psychosocial and physical sequelae facing adults during those periods, highlight promising posttreatment psychosocial and behavioral interventions, and offer recommendations for future research and evidence-based practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    American Psychologist 02/2015; 70(2):159-174. DOI:10.1037/a0037875 · 6.87 Impact Factor
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    • "Coping with uncertainty about the future and the presence of other health conditions were found by Steginga et al. (2009) to relate to increased distress and a reduction in functional adjustment. The return to prior levels of social functioning can be delayed for colorectal cancer survivors as a result of poor health, leading to loss of employment and consequently lower socioeconomic status (Sanchez et al., 2004; Earle et al., 2010). Individuals may also experience discrimination in the workplace (Jenkins, 2006). "
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    ABSTRACT: Purpose of the research: This paper is a report of a study of the experiences of individuals with colorectal cancer in the period following their cancer treatment and the physical, psychological and social aspects associated with adjusting to everyday life. Methods and sample: Qualitative interviews using a phenomenological approach were conducted with a purposive sample of 13 individuals who had completed active curative treatment for colorectal cancer. Results: Study findings suggest that colorectal cancer survivors employ a broad range of techniques and approaches to manage adjustment to everyday life such as goal-setting, managing informal networks and adopting strategies for physical and emotional recovery. Personal interests were used to create a sense of meaning and through the cultivation of altruistic and utilitarian outlooks on life, positive emotional gains were obtained. Conclusions: Colorectal cancer survivors employ personal strategies for managing life in the survivorship period following cancer treatment. The study findings demonstrate additional areas for exploration such as the effect of altruism on adjustment and the relationship to other groups of cancer survivors.
    European journal of oncology nursing: the official journal of European Oncology Nursing Society 02/2013; 17(5). DOI:10.1016/j.ejon.2013.01.002 · 1.43 Impact Factor
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    ABSTRACT: In this chapter, we briefly describe the epidemiological and clinical factors that have led to the growing interest in cancer survivorship. We then describe the development of the term “cancer survivor”, reviewing definitions that have been applied to the term. Finally, we highlight the challenges that cancer survivorship poses to both patients and the health care systems.
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