Returning to work in lung cancer survivors—a multi-center cross-sectional study in Germany

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Abstract

Purpose

To investigate the work situation of lung cancer survivors and to identify the factors associated with their returning to work.

Methods

Descriptive analysis and logistic regression were used to evaluate study population characteristics and independent factors of subsequently returning to work. To analyze time to return to work, Cox regression was used.

Results

The study sample included 232 lung cancer survivors of working age from 717 enrolled participants in the multi-center cross-sectional LARIS (Quality of Life and Psychosocial Rehabilitation in Lung Cancer Survivors) study. About 67% of the survivors were not employed during the survey. More than 51% of the survivors who were employed before their illness did not return to their work. The survivors who had returned to their careers were younger, associated with higher household income, lower fatigue score, and stable relationship and vocational training. Patients who received social service counseling showed a higher chance of regaining their career.

Conclusions

Lung cancer survivors were found to be associated with a high risk of unemployment and very low professional reintegration after interruption due to illness. More comprehensive studies are needed to support lung cancer survivors and targeting of patients in need of special attention in rehabilitation that would benefit from the findings in the present study.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-020-05886-z.

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Most cited references 29

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Work ability and return-to-work in cancer patients

A. de Boer, J. Verbeek, E Spelten … (2008)

The extent to which self-assessed work ability collected during treatment can predict return-to-work in cancer patients is unknown. In this prospective study, we consecutively included employed cancer patients who underwent treatment with curative intent at 6 months following the first day of sick leave. Work ability data (scores 0–10), clinical and sociodemographic data were collected at 6 months, while return-to-work was measured at 6, 12 and 18 months. Most of the 195 patients had been diagnosed with breast cancer (26%), cancer of the female genitals (22%) or genitourological cancer (22%). Mean current work ability scores improved significantly over time from 4.6 at 6 months to 6.3 and 6.7 at 12 and 18 months, respectively. Patients with haematological cancers and those who received chemotherapy showed the lowest work ability scores, while patients with cancer of urogenital tract or with gastrointestinal cancer had the highest scores. Work ability at 6 months strongly predicted return-to-work at 18 months, after correction for the influence of age and treatment (hazard ratio=1.37, CI 1.27–1.48). We conclude that self-assessed work ability is an important factor in the return-to-work process of cancer patients independent of age and clinical factors.

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Multicollinearity in hierarchical linear models.

Han Geun Yu, Kenneth Land, Shanhe Jiang (2015)

This study investigates an ill-posed problem (multicollinearity) in Hierarchical Linear Models from both the data and the model perspectives. We propose an intuitive, effective approach to diagnosing the presence of multicollinearity and its remedies in this class of models. A simulation study demonstrates the impacts of multicollinearity on coefficient estimates, associated standard errors, and variance components at various levels of multicollinearity for finite sample sizes typical in social science studies. We further investigate the role multicollinearity plays at each level for estimation of coefficient parameters in terms of shrinkage. Based on these analyses, we recommend a top-down method for assessing multicollinearity in HLMs that first examines the contextual predictors (Level-2 in a two-level model) and then the individual predictors (Level-1) and uses the results for data collection, research problem redefinition, model re-specification, variable selection and estimation of a final model.

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Employment challenges for cancer survivors.

Anja Mehnert, Angela G.E.M. de Boer, Michael Feuerstein (2013)

There is a considerable body of evidence about the adverse effects of cancer and cancer treatments on employment, work ability, work performance, and work satisfaction among cancer survivors. There is also a growing consensus that cancer survivorship research needs to address the large variety of short-term and long-term work-related problems and that programs to support return to work and employment should be developed and integrated into the follow-up survivorship care of cancer patients. Cancer survivorship and employment can be considered from the perspective of the cancer survivor, the caregiver and the family, the employer and coworkers, the health care providers, and the community or society-elements that comprise many similarities but also differences between Europe and the Unites States and that may affect employment and return to work among cancer survivors in different ways. Previous research has specifically addressed the likelihood and timeliness of work return, including factors that promote and hinder return to work and work performance, and intervention studies and programs that focus on psychological, physical, pharmacologic, or multidisciplinary approaches to work. The area of work disability has emerged as an international field with research from areas throughout the globe. In this article, the authors provide an overview of the current state of scientific research in these areas and further provide a cancer survivorship and work model that integrates significant individual cancer-related, treatment-related, and work-related factors and outcomes. The report concludes with a discussion of European and American contributions and possible future directions for the enhancement of current efforts. Copyright © 2013 American Cancer Society.

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Author and article information

Contributors

Humayra Rashid:

ORCID: https://orcid.org/0000-0001-5032-2102

hurashid@uni-mainz.de

Journal

Journal ID (nlm-ta): Support Care Cancer

Journal ID (iso-abbrev): Support Care Cancer

Title: Supportive Care in Cancer

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0941-4355

ISSN (Electronic): 1433-7339

Publication date (Electronic): 19 November 2020

Publication date PMC-release: 19 November 2020

Publication date (Print): 2021

Volume: 29

Issue: 7

Pages: 3753-3765

Affiliations

[1 ]GRID grid.5802.f, ISNI 0000 0001 1941 7111, Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, , Johannes Gutenberg University Mainz, ; Obere Zahlbacher Straße 69, 55131 Mainz, Germany

[2 ]University Cancer Center Mainz, Mainz, Germany

[3 ]GRID grid.4488.0, ISNI 0000 0001 2111 7257, National Center for Tumor Diseases (NCT/ UCC), University Hospital Carl Gustav Carus, , Technische Universität Dresden, ; Dresden, Germany

[4 ]Institute of Clinical Physiology of the Italian National Research Council, Lecce, Italy

[5 ]GRID grid.411937.9, Department of Clinical Oncology, , Saarland University Medical Center, ; Homburg, Germany

[6 ]GRID grid.5802.f, ISNI 0000 0001 1941 7111, Pulmonary Department, University Medical Center, , Johannes Gutenberg University Mainz, ; Mainz, Germany

[7 ]GRID grid.5802.f, ISNI 0000 0001 1941 7111, Department of Radiation-Oncology, University Medical Center, , Johannes Gutenberg University Mainz, ; Mainz, Germany

[8 ]GRID grid.7839.5, ISNI 0000 0004 1936 9721, Department of Internal Medicine, University Hospital Frankfurt, , Goethe University, ; Frankfurt, Germany

[9 ]Department of Thoracic Surgery, Katholisches Klinikum Mainz, Mainz, Germany

[10 ]Department of Pneumology, Katholisches Klinikum Mainz, Mainz, Germany

[11 ]Department of Radiation Oncology, Maria Hilf Hospital Moenchengladbach, Moenchengladbach, Germany

[12 ]GRID grid.7708.8, ISNI 0000 0000 9428 7911, Department of Radiation Oncology, , University Medical Center Freiburg, ; Freiburg, Germany

[13 ]GRID grid.411339.d, ISNI 0000 0000 8517 9062, Department of Pneumology, , University Medical Center Leipzig, ; Leipzig, Germany

Author information

Humayra Rashid https://orcid.org/0000-0001-5032-2102

Article

Publisher ID: 5886

DOI: 10.1007/s00520-020-05886-z

PMC ID: 8163665

PubMed ID: 33211206

SO-VID: fd3a6e38-167f-4406-ba35-3eb93f71cf48

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 4 February 2020

Date accepted : 6 November 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100012353, Deutschen Konsortium für Translationale Krebsforschung;

Award ID: ''LARIS''

Award Recipient : Susanne Singer

Custom metadata

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: returning to work,employment,lung cancer,early retirement

Data availability:

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: returning to work, employment, lung cancer, early retirement

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Returning to work in lung cancer survivors—a multi-center cross-sectional study in Germany

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Abstract

Purpose

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Conclusions

Supplementary Information

Related collections

Karger: Oncology

Most cited references 29

Work ability and return-to-work in cancer patients

Multicollinearity in hierarchical linear models.

Employment challenges for cancer survivors.

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Contributors

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Cited by 4

Most referenced authors 325