Loss of Paid Employment up to 4 Years after Colorectal Cancer Diagnosis—A Nationwide Register-Based Study with a Population-Based Reference Group

Abstract

Cancer survivors consider work as a key aspect of cancer survivorship while previous research indicated that cancer survivors have a higher risk of unemployment. The objectives were to assess: (1) whether colorectal cancer survivors less often have paid employment at diagnosis compared to a population-based reference group, (2) whether colorectal cancer survivors with paid work have a higher risk of loss of employment up to 4 years after diagnosis compared to a population-based reference group and (3) which colorectal cancer survivors are at highest risk of loss of paid employment. In a nationwide register-based study, persons diagnosed with colorectal cancer (N = 12,007) as registered in the Netherlands Cancer Registry, were compared on loss of paid employment with a sex and age-matched population-based reference group (N = 48,028) from Statistics Netherlands. Cox regression analyses were conducted. Colorectal cancer survivors had a higher risk of loss of paid employment (HR 1.56 [1.42, 1.71]). Within the group of colorectal cancer survivors, risk of loss of paid employment was lower for older survivors (>60 vs. 45–55) (HR 0.64 [0.51, 0.81]) and higher for those with a more advanced cancer stage (IV vs. I) (HR 1.89 [1.33, 2.70]) and those receiving radiotherapy (HR 1.37 [1.15, 1.63]). Colorectal cancer survivors at high risk of loss of paid employment may benefit from work support interventions as part of cancer survivorship.

Experiences of resuming life after immunotherapy and associated survivorship care needs: a qualitative study among patients with metastatic melanoma

“…Besides persistent complaints, patients reported experiencing new problems in various life domains, among which work-related problems in particular made resuming life challenging. In line with this, previous studies showed that cancer survivors have a higher risk of loss of paid employment, 42,43 especially those with a more advanced cancer stage. 42 As being partly or fully work disabled increases the risk of impaired cognitive functioning, 44 it is important to pay more attention to (support in) return to work.…”

“…In line with this, previous studies showed that cancer survivors have a higher risk of loss of paid employment, 42,43 especially those with a more advanced cancer stage. 42 As being partly or fully work disabled increases the risk of impaired cognitive functioning, 44 it is important to pay more attention to (support in) return to work.…”

Short-term effect of colorectal cancer on income: analysis of an Italian cohort

“…Studies have documented that cancer survivors are more likely to report financial issues than the general population, including income and working hours reduction, loss of productivity, or even unemployment 6–11. The ability to fully return to work can be perceived as a key factor in cancer survivorship and better quality of life but has been reported to be challenging among many survivors 12 13…”

Short- and long-term impact of cancer on employment and financial outcomes of adolescents and young adults (AYAs): a large population-based case-control registry study in the Netherlands

“…prevent inclusion from those emigrating). Comparable choices were made in the study of de Wind and colleagues 46 who argue, however, that this has most likely not impacted study results. Secondly, of all AYAs, 4.4% could not be linked with their CBS ID.…”