Correlates of Return to Work for Breast Cancer Survivors

Department of Medicine, Michigan State University, East Lansing, MI 48824, USA.
Journal of Clinical Oncology (Impact Factor: 18.43). 02/2006; 24(3):345-53. DOI: 10.1200/JCO.2004.00.4929
Source: PubMed


To identify correlates of return to work for employed breast cancer survivors.
Patients included 416 employed women with newly diagnosed breast cancer identified from the Metropolitan Detroit Cancer Surveillance System. Patients were interviewed by telephone 12 and 18 months after diagnosis. Correlates of return to work at 12 and 18 months were identified using multivariate logistic regression.
More than 80% of patients returned to work during the study period, and 87% reported that their employer was accommodating to their cancer illness and treatment. After adjusting for demographic characteristics, health status, cancer stage, treatment, and job type, heavy lifting on the job (odds ratio = 0.42; 95% CI, 0.18 to 0.99), perceived employer accommodation for cancer illness and treatment (odds ratio = 2.2; 95% CI, 1.03 to 4.8), and perceived employer discrimination because of a cancer diagnosis (odds ratio = 0.27; 95% CI, 0.10 to 0.71) were independently associated with return to work at 12 months after breast cancer diagnosis, and perceived employer accommodation (odds ratio = 2.3; 95% CI, 1.06 to 5.1) was independently associated with return to work at 18 months after breast cancer diagnosis.
A high percentage of employed breast cancer patients returned to work after treatment, and workplace accommodations played an important role in their return. In addition, perceived employer discrimination because of cancer was negatively associated with return to work for breast cancer survivors. Employers seem to have a pivotal role in breast cancer patients' successful return to work.

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Available from: Reynard Ronald Bouknight
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    • "Even in early stage BC, the ability to work was negatively influenced at least up to 5 years after diagnosis (Eaker et al, 2011). Studies have shown that BC treatment is an important risk factor for impaired work-ability (Bouknight et al, 2006; Balak et al, 2008; de Boer et al, 2008; Lavigne et al, 2008; Yoon et al, 2008; Ahn et al, 2009; Fantoni et al, 2010; Hedayati et al, 2012). Chemoor hormonal therapy and mastectomy have been associated with higher risks of unemployment and lower ability to work within the first years after diagnosis, whereas no such effects were found for radiotherapy (Drolet et al, 2005a; Balak et al, 2008; Eaker et al, 2011; Lindbohm et al, 2011). "
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    ABSTRACT: Background: Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment. Methods: Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000-2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events. Results: BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4-1.8) or any work-related event up to 5-7 years (HR 1.5, 95% CI 1.3-1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6-2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4-1.7) or losing paid employment (HR 1.3, 95% CI 1.2-1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1-1.3) and after chemotherapy (HR 1.7; 95% CI 1.5-1.9) during the first 5 years after diagnosis. Conclusions: BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC.
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    • "To predict those who may lose jobs and plan intervention for those groups accordingly, several studies have attempted to identify the correlates of unemployment. As a result, disease-related factors such as cancer site [6], stage [7], type of treatment [5] , as well as socio-demographic factors such as age [5], marital status [8], and income [9] were reported to be associated with unemployment as much as work-related factors such as workplace atmosphere [6] or type of work [6,7]. "
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    ABSTRACT: Little is known regarding cervical cancer survivors' employment status, which represents social integration of cancer survivors as a pivotal domain of long-term quality of life. The goal of this study was to assess the correlates of unemployment and evaluate the impact on the comprehensive quality of life in cervical cancer survivors. We enrolled 858 cervical cancer survivors from the gynecologic oncology departments of multi-centers in Korea. Factors associated with unemployment were identified using multivariate logistic regression analyses. We assessed different health-related quality of life domains with multivariate-adjusted least-square means between cervical cancer survivors who currently work and do not. After diagnosis and treatment, the percentage of unemployed survivors increased from 50.6% to 72.8%. Lower income (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.38 to 2.81), medical aid (aOR, 1.58; 95% CI, 1.05 to 2.38), two or more comorbidities (aOR, 1.80; 95% CI, 1.12 to 2.90), current alcohol drinkers (aOR, 2.33; 95% CI, 1.54 to 3.52), and employed at the time of diagnosis (aOR, 10.72; 95% CI, 7.10 to 16.16) were significantly associated with unemployment. Non-working groups showed significant differences with respect to physical functioning, role functioning, depression, and existential well-being. The proportion of unemployed cervical cancer survivors seems to increase, with low-income status and the presence of medical aid negatively being associated with employment, in addition to other comorbidities and previous working status. Effort should be made to secure the financial status of cervical cancer survivors.
    Full-text · Article · Oct 2013 · Journal of Gynecologic Oncology
    • "The perceived motivation of employers in accommodating breast cancer survivors' illness and treatment is an important element affecting RTW (Bouknight et al., 2006). Breast cancer survivors have reported a high proportion of employers are accommodating, which suggests that the majority of employers are receptive to the needs of employees who have been diagnosed with breast cancer (Bouknight et al., 2006). Employers need to understand that it is important for survivors to maintain a connection with their work, especially while on sick leave (Fantoni et al., 2010). "
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    ABSTRACT: Breast cancer and return to work (RTW) is a global issue affected by many factors. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) can be used to address disease/treatment, person and work related factors that can impact the RTW process for breast cancer survivors. The work environment, treatment and sociodemographic factors can affect the timeliness of RTW. While conventional treatment methods are critical for survival, there are other strategies that may provide comfort and relief that can improve functioning in the workplace. Although the number of studies addressing this is increasing, certain issues such as differences in RTW rates, RTW needs and accountability need further investigation. A thorough understanding of the independent and combined effects of disease/treatment, work and person related factors can assist in the appropriate implementation of RTW strategies for breast cancer survivors. For many breast cancer survivors, returning to work is used as a gauge of healing and control over breast cancer, providing encouragement for the future.
    No preview · Article · Jan 2013
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