Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors.
adolescent/young adult
cancer
employment
finances
survivorship
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
received:
24
09
2018
revised:
16
12
2018
accepted:
19
12
2018
pubmed:
2
2
2019
medline:
23
2
2020
entrez:
2
2
2019
Statut:
ppublish
Résumé
The impact of cancer and its treatment on employment and financial burden in adolescents/young adults (AYAs) is not fully known. Eligibility for this cross-sectional study of AYA cancer survivors included the diagnosis of a malignancy between ages 18 and 39 years and survey completion within 1 to 5 years from diagnosis and ≥1 year after therapy completion. Participants were selected randomly from the tumor registries of 7 participating sites and completed an online patient-reported outcomes survey to assess employment and financial concerns. Treatment data were abstracted from medical records. Data were analyzed across diagnoses and by tumor site using logistic regression and Wald-based 95% confidence intervals adjusting for age (categorized), sex, insurance status, education (categorized), and treatment exposures. Participants included 872 survivors (breast cancer, n = 241; thyroid cancer, n = 126; leukemia/lymphoma, n = 163; other malignancies, n = 342). Exposure to chemotherapy in breast cancer survivors was associated with an increase in self-reported mental impairment in work tasks (odds ratio [OR], 2.66) and taking unpaid time off (OR, 2.62); survivors of "other" malignancies reported an increase in mental impairment of work tasks (OR, 3.67) and borrowing >$10,000 (OR, 3.43). Radiation exposure was associated with an increase of mental impairment in work tasks (OR, 2.05) in breast cancer survivors, taking extended paid time off work in thyroid cancer survivors (OR, 5.05), and physical impairment in work tasks in survivors of "other" malignancies (OR, 3.11). Finally, in survivors of "other" malignancies, having undergone surgery was associated with an increase in physical (OR, 3.11) and mental impairment (OR, 2.31) of work tasks. Cancer treatment has a significant impact on AYA survivors' physical and mental work capacity and time off from work.
Sections du résumé
BACKGROUND
The impact of cancer and its treatment on employment and financial burden in adolescents/young adults (AYAs) is not fully known.
METHODS
Eligibility for this cross-sectional study of AYA cancer survivors included the diagnosis of a malignancy between ages 18 and 39 years and survey completion within 1 to 5 years from diagnosis and ≥1 year after therapy completion. Participants were selected randomly from the tumor registries of 7 participating sites and completed an online patient-reported outcomes survey to assess employment and financial concerns. Treatment data were abstracted from medical records. Data were analyzed across diagnoses and by tumor site using logistic regression and Wald-based 95% confidence intervals adjusting for age (categorized), sex, insurance status, education (categorized), and treatment exposures.
RESULTS
Participants included 872 survivors (breast cancer, n = 241; thyroid cancer, n = 126; leukemia/lymphoma, n = 163; other malignancies, n = 342). Exposure to chemotherapy in breast cancer survivors was associated with an increase in self-reported mental impairment in work tasks (odds ratio [OR], 2.66) and taking unpaid time off (OR, 2.62); survivors of "other" malignancies reported an increase in mental impairment of work tasks (OR, 3.67) and borrowing >$10,000 (OR, 3.43). Radiation exposure was associated with an increase of mental impairment in work tasks (OR, 2.05) in breast cancer survivors, taking extended paid time off work in thyroid cancer survivors (OR, 5.05), and physical impairment in work tasks in survivors of "other" malignancies (OR, 3.11). Finally, in survivors of "other" malignancies, having undergone surgery was associated with an increase in physical (OR, 3.11) and mental impairment (OR, 2.31) of work tasks.
CONCLUSIONS
Cancer treatment has a significant impact on AYA survivors' physical and mental work capacity and time off from work.
Identifiants
pubmed: 30707763
doi: 10.1002/cncr.31985
pmc: PMC6508988
mid: NIHMS1005993
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1908-1917Subventions
Organisme : NCI NIH HHS
ID : T32 CA009351
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA015704
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA201179
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA204378
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA215134
Pays : United States
Informations de copyright
© 2019 American Cancer Society.
Références
J Cancer Surviv. 2011 Sep;5(3):305-14
pubmed: 21274648
Chronic Illn. 2007 Dec;3(4):265-77
pubmed: 18083681
J Pediatr Oncol Nurs. 1999 Jul;16(3):136-44
pubmed: 10444941
Arch Pediatr Adolesc Med. 2010 Mar;164(3):218-24
pubmed: 20194253
J Cancer Surviv. 2017 Feb;11(1):48-57
pubmed: 27423439
J Pediatr Psychol. 1997 Feb;22(1):29-43
pubmed: 9019046
J Occup Rehabil. 2008 Sep;18(3):267-72
pubmed: 18670868
J Clin Oncol. 2012 Jul 1;30(19):2393-400
pubmed: 22614977
Lancet Oncol. 2017 Dec;18(12):1579-1589
pubmed: 29111259
CA Cancer J Clin. 2007 Jul-Aug;57(4):242-55
pubmed: 17626120
Health Aff (Millwood). 2016 Jan;35(1):54-61
pubmed: 26733701
Cochrane Database Syst Rev. 2015 Sep 25;(9):CD007569
pubmed: 26405010
Health Aff (Millwood). 2014 Jun;33(6):1024-31
pubmed: 24889952
J Cancer Surviv. 2018 Feb;12(1):28-37
pubmed: 28852970
Int Arch Occup Environ Health. 2009 Mar;82(4):543-6
pubmed: 18795317
Breast Cancer Res Treat. 2009 Aug;116(3):609-16
pubmed: 18855135
Med Care. 2010 Nov;48(11):1015-25
pubmed: 20940653