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Predicting return to work among patients with colorectal cancer.

ABSTRACT: BACKGROUND:The increase in prevalence of colorectal cancer among young patients coupled with an older retirement age in developed countries means that more patients are being diagnosed with colorectal cancer while still at work. The aim of this study was to develop prediction models for return to work by 1 and 2?years after the start of sick leave. METHODS:This was a retrospective registry-based cohort study of data from a nationwide occupational health service in the Netherlands. Only employed patients with colonic or rectal cancer treated with curative intent were included. Two predictor variable models were developed using multivariable logistic regression with backward selection. Calibration, discrimination and explained variance were used to assess model performance, and internal validation by bootstrapping was performed. RESULTS:Median time to return to work for 317 included patients was 423 (95 per cent c.i. 379 to 467)?days. Two-thirds of patients had returned to work by 2?years after the start of the sick leave. Presence of metastases, adjuvant treatment, stoma, emotional distress and postoperative complications were predictors of not returning to work in the 1-year model. In the 2-year model, presence of metastases, emotional distress, postoperative complications, company size and the trajectory of the return-to-work process were predictors. CONCLUSION:Almost 70 per cent of patients with colorectal cancer in this population returned to work within 2?years after the start of sick leave. The models can be used to guide patients early in colorectal cancer treatment about the likelihood of returning to work, and to identify and modify barriers that could facilitate this.

SUBMITTER: den Bakker CM

PROVIDER: S-EPMC6973054 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Predicting return to work among patients with colorectal cancer.

den Bakker C M CM Anema J R JR Huirne J A F JAF Twisk J J Bonjer H J HJ Schaafsma F G FG

The British journal of surgery 20191025 1

<h4>Background</h4>The increase in prevalence of colorectal cancer among young patients coupled with an older retirement age in developed countries means that more patients are being diagnosed with colorectal cancer while still at work. The aim of this study was to develop prediction models for return to work by 1 and 2 years after the start of sick leave.<h4>Methods</h4>This was a retrospective registry-based cohort study of data from a nationwide occupational health service in the Netherlands. ...[more]

PMID: 31654404

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Project description:Background and study aims An increasing number of cancer survivors are of working age. Cancer is also a known cause of people withdrawing early from the labour market and also a prolonged absence from work due to sickness. Cancer survivors in lower socioeconomic groups (for example, people who do lower skilled jobs) and/or suffer from another disease (co-morbidity) are at particular risk of recurrent sickness absence, unemployment or permanent withdrawal from the labour market. Not being able to work to the same ability and unfavourable work conditions can also mean that cancer survivors of lower socioeconomic status and/or co-morbidity find returning to work more difficult. Support from supervisors and adjustments that make it possible for the cancer survivor to do their job more easily (work accommodations) may be important in preventing sickness relapses due to the job environment affecting their state of health. It is not known how important occupational rehabilitation during cancer treatment might be in helping cancer survivors return to work and, in particular, how it may help those patients of lower socioeconomic status and/or co-morbidity. This study aims to increase the likelihood of cancer survivors returning to work through a programme (intervention) of individual support offered by a job consultant connected to the oncology ward at Aarhus University Hospital. Who can participate? Cancer patients between 18 and 60 years of age who are living in Randers or Silkeborg municipalities in Denmark diagnosed with breast, gastro-intestinal, head and neck, testis, ovarian or cervix cancer and being treated with chemotherapy or radiotherapy. They must be permanently or temporary employed (with at least 6 months left of their contract) and possibly on sick leave. What does the study involve? Patients that meet the criteria for participating in the trial and living in either Randers or Silkeborg municipalities in Denmark are placed in the intervention group. Patients that meet the criteria but live outside of these municipalities are placed in the control group. Those in the intervention group take part in an early, tailored return to work management programme that supports cancer patients as they are undergoing treatment. Those in the control group are offered the standard sick leave management programme. The return to work rates among cancer survivors in the intervention group is then compared to those in the control group. The effect of the intervention on cancer survivors of lower socioeconomic status and/or co-morbidity is also assessed.

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Predicting return to work among patients with colorectal cancer.

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Predicting return to work among patients with colorectal cancer.

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