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Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study

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Abstract

Introduction

Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed.

Methods

We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined.

Results

The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2–15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8–5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1–4.7), distress (OR = 3.9, 95 % CI, 1.7–9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1–6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group.

Conclusions

Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors.

Implications for Cancer Survivors

This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.

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Acknowledgments

The authors would like to thank the patients, research staff, and physicians who participated in the SOAPP study.

Disclosures

All authors report no financial disclosures. Dr. Tevaarwerk is supported by an Institute of Clinical and Translational Research KL2 Scholar grant, 9U54TR00021.

Funding source

This study was conducted by the Eastern Cooperative Oncology Group (Robert L. Comis, M.D.) and supported in part by Public Health Service Grants CA3403, CA21076, CA17145, and CA15488, and from the National Cancer Institute, National Institutes of Health, and the Department of Health and Human Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

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Authors and Affiliations

  1. University of Wisconsin Carbone Comprehensive Cancer Center, 1111 Highland Avenue, Room 6037, Madison, WI, 53705-2275, USA

    A. J. Tevaarwerk

  2. Dana-Farber Cancer Institute, Boston, MA, USA

    J. W. Lee & J. Manola

  3. University of Wisconsin, 5110 Medical Sciences Center 1300 University Avenue, Madison, WI, 53706, USA

    M. E. Sesto

  4. University of Wisconsin, 211 Warf Office Building, 610 Walnut St, Madison, WI, 53726, USA

    K. A. Buhr

  5. University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA

    C. S. Cleeland & M. J. Fisch

  6. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    L. I. Wagner

  7. VA New Jersey Health Care System, East Orange, NJ, USA

    V. T. S. Chang

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  1. A. J. Tevaarwerk
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  2. J. W. Lee
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  3. M. E. Sesto
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Correspondence to A. J. Tevaarwerk.

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Tevaarwerk, A.J., Lee, J.W., Sesto, M.E. et al. Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study. J Cancer Surviv 7, 191–202 (2013). https://doi.org/10.1007/s11764-012-0258-2

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  • DOI: https://doi.org/10.1007/s11764-012-0258-2

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