One-third of patients fail to return to work 1 year after surgery for colorectal cancer
- 318 Downloads
Achieving full recovery after colorectal cancer surgery means a return to normal physical and psychological health and to a normal social life. Recovery data focusses on time to discharge rather than longer term functionality including return to work (RTW). We aim to assess return to normal holistic function at 1 year after colorectal cancer surgery.
Questionnaires were created and dispatched to 204 patients who had undergone surgery with curative intent for colorectal cancer, in 2011–2012, in a single teaching hospital.
Response rate was 75 % (153/204), 82 % (129/157) for open surgery (OS) and 51 % (24/47) for laparoscopic surgery (LS). Median age was 68 (48–91) years for OS and 65 (36–84) for LS. Eighty-four per cent of patients felt ‘ready’ and 95 % had adequate pain control upon discharge (no difference between groups). LS reported earlier ‘return to full fitness’ (1–3 months) than OS (>6 months; Mann–Whitney U, p < 0.05). Recovery from LS was ‘better than expected’ compared to OS ‘worse than expected’ (Mann–Whitney U test, p < 0.05). Forty-nine patients were employed preoperatively and 61 % (n = 30) returned to work. RTW was more frequent after LS (Chi-square test, p < 0.05). Length of time to RTW was significantly less after LS [44 (6–84) days] than OS [71 (14–252) days] (t test, p < 0.05). Levels of self-employment were equal between groups.
One-third of patients failed to RTW at 1 year post-surgery. Patients having LS returned to full fitness faster, felt recovery was shorter and returned to work earlier than OS. We must invest more in managing expectations and provide better post-discharge support to improve RTW.
KeywordsLaparoscopic surgery Return to work Recovery Colorectal cancer
The authors would like to thank the research and Governance department, Royal Derby Hospitals NHS Trust for their support.
Conflict of interest
- 4.Carlsen K, Harling H, Pedersen J, Christensen KB, Osler M (2013) The transition between work, sickness absence and pension in a cohort of Danish colorectal cancer survivors. BMJ Open 3Google Scholar
- 5.National Institute for Health and Care Excellence (2011) The diagnosis and management of colorectal cancer: full guideline (CG131). http://guidance.nice.org.uk/CG131. Accessed 5 Nov 2013
- 11.Office for National Statistics (2008) Cancer statistics registrations. Registrations of cancer diagnosed in 2005. http://www.statistics.gov.uk/downloads/theme_health/MB1_36/MB1_No36_2005.pdf. Accessed 5 Nov 2013
- 19.Office of National Statistics (2013) Percentage of public sector employment. http://www.ons.gov.uk/ons/rel/pse/public-sector-employment/q2-2013/sty-public-section-employment.html
- 21.Palmer KT, Coc RAF, Brown I (2007) Fitness for work: the medical aspects. Oxford University Press, OxfordGoogle Scholar
- 22.Johnson MVC (1993) Benefits of psychological preparation for surgery: a meta-analysis. Ann Behav Med 15:11Google Scholar