Long-term workforce participation patterns following head and neck cancer
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This analysis describes the long-term workforce participation patterns of individuals diagnosed with head and neck cancer (HNC).
Survivors of HNC (ICD10 C00-C14, C32) diagnosed at least 8 months previously were identified from the National Cancer Registry Ireland and sent a survey including questions about working arrangements before and since diagnosis. Descriptive statistics and multivariate logistic regression were used to examine the factors that influence workforce participation at 0, 1 and 5 years after diagnosis.
Two hundred sixty-four individuals employed at the time of diagnosis responded to the survey, an average 6 years post-diagnosis. Seventy-seven percent took time off work after diagnosis, with a mean work absence of 9 months (range 0–65 months). Fifty-two percent of participants reduced their working hours (mean reduction 15 h/week). The odds of workforce participation following HNC were increased by not being eligible for free medical care (OR 2.61, 95 % CI 1.15–5.94), having lip, mouth or salivary gland cancer (compared to cancer of the pharynx or cancer of the larynx, OR 2.79, 1.20–6.46), being self-employed (OR 2.01, 1.07–3.80), having private health insurance (OR 2.06, 1.11–3.85) and not receiving chemotherapy (OR 2.82, 1.31–6.06). After 5 years, only the effect of medical card remained (i.e., medical insurance) (OR 4.03, 1.69–9.62).
Workforce participation patterns after HNC are complex and are influenced by cancer, treatment and employment factors.
Implications for Cancer Survivors
Patients should be informed of the potential impacts of HNC on workforce participation, and clinicians, policy makers and employers should be aware of these potential longer-term effects and related variables.
KeywordsHead and neck cancer Head and neck neoplasms [MESH] Work [MESH] Workforce participation Return to work [MESH]
We thank the participants and the consultants and their teams who assisted with reviewing subjects’ details. We are grateful to the following: Ciaran O’Neill for comments on the project proposal and National Cancer Registry Ireland staff involved in collection and processing of cancer registrations.
Financial and other support
This work was funded by a Health Research Board (HRB) Interdisciplinary Capacity Enhancement Award, which funds post-doctoral fellowships for Alison Pearce, Audrey Alforque Thomas and Aileen Timmons (ICE/2012/9). The SuN study survey development and data collection was funded by an HRB project grant (HRA/2009/262).
Conflict of interest
Alison Pearce, Aileen Timmons, Eleanor O’Sullivan, Pamela Gallagher, Rachael Gooberman-Hill, Audrey Alforque Thomas, Michal Molcho, Phyllis Butow and Linda Sharp declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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