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Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing.

ABSTRACT: Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made.Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed.In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year follow-up. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13-0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00-0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23-93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors.When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor to consider. While expectation of being at work did not show any significant influence in cancer survivors, in heart attack survivors, it should not be disregarded though, when developing interventions to affect their employment status. Future research should focus on more specific measures for expectation, and additional behavioural factors, such as self-efficacy, and their effect on employment status.

SUBMITTER: Duijts SFA

PROVIDER: S-EPMC5547521 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Project description:BackgroundThe number of persons who have survived cancer has been increasing in India as elsewhere due to advances in detection and treatment of this disease. However, evidence on the standardised number of cancer survivors, their characteristics and their complex health challenges on a national level does not exist due to data limitations. This study, therefore, examines the profile of cancer survivors and their health status using the recently released Longitudinal Ageing Study in India (LASI) survey data.MethodsLASI wave 1 is a cross-sectional nationally representative survey of 65,562 middle and older adults aged 45 and above. We first calculated the socioeconomic, demographic and geographical characteristics of cancer survivors (per 100,000 population). We later estimated the adjusted odds of poor health, sleep problems, depressive symptoms, activities of living limitations (ADL and IADL), and hospitalisation of cancer survivors using multivariable logistic regression analysis.ResultsAccording to LASI estimates, there were 2.1 million cancer survivors in India (95% CI 1.8 million to 2.6 million) in 2017-18. Overall, 440 cancer survivors have been identified in this study, with considerable state variations. The number of cancer survivors per 1,00,000 population was relatively more in non-indigenous groups, people with a history of cancer in their families, those who worked earlier but currently not working and those in the richest quintile categories. As compared to those who never had cancer, the cancer survivors are at higher risk of hospitalisation (adjusted odds ratio (aOR) = 2.61 CI 1.86, 3.67), poor self-rated health (aOR = 3.77, CI 2.55, 5.54), depressive symptoms (aOR = 1.53, CI 1.41, 2.05) and sleep problems (aOR = 2.29, CI 1.50, 3.47). They also reported higher ADL (aOR = 1.61, CI 1.11, 2.34) and IADL (aOR = 1.49, CI 1.07, 2.07) limitations. Cancer survivors who had their cancer diagnosis in the past 2 years or a cancer-related treatment in the past 2 years have significantly higher odds of poor health status than middle-aged and older adults without a cancer history.ConclusionMiddle-aged and older cancer survivors, particularly those who underwent cancer diagnosis or treatment in the past 2 years, are at a significantly higher risk of experiencing poor self-reported health and other health challenges, suggesting the need for an integrated healthcare approach.

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Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing.

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