Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille University, INSERM, IRD, SESSTIM, 27 Boulevard Jean Moulin, 13385, Marseille cedex 5, France.
ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
J Cancer Surviv. 2018 Feb;12(1):115-126. doi: 10.1007/s11764-017-0650-z. Epub 2017 Oct 4.
Chronic neuropathic pain (CNP) is more prevalent among cancer survivors than among the general population. This study aims to investigate the role of CNP on job retention among cancer survivors, 5 years after diagnosis.
In 2015, 2009 individuals diagnosed with cancer in 2010 were interviewed in the French national survey VIe après le CANcer. Logistic regression investigated the relationship between CNP-measured using the seven-item Douleur Neuropathique 4 (DN4) questionnaire-and employment.
Nine hundred sixty-nine individuals were aged 18-54 and employed at diagnosis and therefore were included. Eighty-two percent were still employed in 2015, 26% had fewer working hours than before diagnosis, and 55% had the same working hours. Thirty percent reported CNP 5 years after diagnosis. These cancer survivors were less likely to be employed in 2015 than those without CNP and, if employed, were more likely to work fewer hours. After adjustment for gender, medical variables (adverse cancer event, prognosis, chemotherapy, and comorbidities) were found to still significantly affect employment retention in cancer survivors, as well as reporting CNP.
Improving CNP screening and management is necessary to reduce its impact on cancer survivors' professional lives.
Healthcare policy and medical cancer survivor's follow-up must take into account the importance of the substantial impact of CNP on cancer survivors' daily lives. Therefore, in order to ensure greater employment retention for cancer survivors, raising awareness of care providers about diagnosis and management of CNP is needed.
慢性神经性疼痛（CNP）在癌症幸存者中的发病率高于普通人群。本研究旨在探讨 CNP 在癌症诊断后 5 年内对癌症幸存者保留工作的影响。
2015 年，对 2010 年确诊的 2009 名癌症患者进行了法国全国调查 VIe après le CANcer 的访谈。使用七项 Douleur Neuropathique 4（DN4）问卷测量 CNP，采用逻辑回归分析 CNP 与就业之间的关系。
969 名年龄在 18-54 岁且在诊断时就业的个体被纳入本研究。2015 年，82%的人仍在工作，26%的人工作时间比诊断前少，55%的人工作时间相同。30%的人报告诊断后 5 年内患有 CNP。与无 CNP 的癌症幸存者相比，这些癌症幸存者在 2015 年就业的可能性较低，即使就业，工作时间也较短。调整性别、医疗变量（不良癌症事件、预后、化疗和合并症）后，发现报告 CNP 仍然显著影响癌症幸存者的就业保留率。
有必要改善 CNP 的筛查和管理，以减轻其对癌症幸存者职业生活的影响。
医疗保健政策和癌症幸存者的医疗随访必须考虑到 CNP 对癌症幸存者日常生活的重大影响。因此，为了确保癌症幸存者保留更多的工作，需要提高护理提供者对 CNP 诊断和管理的认识。
