Cancer treatment may have negative effects on job-related performance issues, according to results of a cross-sectional survey study of a cohort of adolescent/young adult (AYA) cancer survivors aged 15 to 39 years. This study was published online in Cancer.
Cancer rates in AYAs have increased in recent years; however, a knowledge gap exists with respect to the perceived long-term effects of cancer and its treatment in this population.
Eligibility for study participation included cancer diagnosis at age 18 to 39 years, treatment at 1 of 7 specific national comprehensive cancer centers, and completion of an online survey within 1 to 5 years after diagnosis and at least 1 year following completion of treatment.
The Survey for People Affected by Cancer, a patient-reported outcome survey developed by the LIVESTRONG Foundation in collaboration with the National Cancer Institute and other organizations, was administered to study participants to “ascertain how cancer has affected the lives of cancer survivors.” In addition, data related to treatment exposures were abstracted from medical records.
Of the 2005 cancer survivors deemed eligible to participate in the study, 872 completed the survey. In the overall study cohort, cancer diagnoses were breast cancer (241 patients), thyroid cancer (126 patients), leukemia/lymphoma (163 patients), and other cancers (342 patients). Of these patients, 84.4% of participants reported that they were employed at some point following their cancer diagnosis. Of those who reported a history of employment, 70.2% reported that their job required completion of some physical tasks.
After adjustments were made for confounding factors, such as age at diagnosis, gender, and history of radiation therapy and surgery, the odds ratio (OR) for lasting effects of treatment on ability to perform physical job-related tasks in the subgroup who received chemotherapy was 1.97 (95% CI, 1.22-3.11, P <.01) compared with the subgroup not exposed to chemotherapy.
Similarly, the odds ratio for lasting effects of chemotherapy on ability to perform mental job-related tasks in the subgroup who received chemotherapy was 3.22 (95% CI, 2.15-4.79; P < .01) compared with the subgroup not exposed to chemotherapy. In addition, chemotherapy treatment was also found to be significantly associated with more time taken off from work (OR = 3.56; 95% CI, 2.31-5.47; P < .01) and an increased likelihood of borrowing $10,000 or more (OR = 3.05; 95% CI, 1.53-6.09; P <.01), using the chemotherapy-naïve subgroup as a comparator.
“This work is important for understanding the challenges unique to AYA cancer survivors as they relate to employment during and after cancer therapy. The current results suggest that further longitudinal studies and interventions are needed to describe and support AYA cancer survivors in the workforce during and after cancer-directed therapy,” the study authors wrote in conclusion.
Ketterl TG, Syrjala KL, Casillas J, et al. Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors [published online February 1, 2019] Cancer. doi: 10.1002/cncr.31985