Northern Ireland Cancer Registry, Mulhouse Building, Queen's University Belfast, Mulhouse Rd., Belfast, BT12 6DP, Northern Ireland.
Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK.
J Cancer Surviv. 2018 Oct;12(5):669-678. doi: 10.1007/s11764-018-0704-x. Epub 2018 Jul 30.
To investigate factors associated with job loss and early retirement in men diagnosed with prostate cancer (PCa) 18-42 months previously.
Men ≤ 60 years at diagnosis who completed the Life After Prostate Cancer Diagnosis (LAPCD) survey were identified. Men who moved from employment at diagnosis to unemployment (EtoU) or retirement (EtoR) at survey (18-42 months post-diagnosis) were compared to men remaining in employment (EtoE). Sociodemographic, clinical and patient-reported factors were analysed in univariable and multivariable analysis.
There were 3218 men (81.4%) in the EtoE, 245 (6.2%) in EtoU and 450 (11.4%) in the EtoR groups. Men with stage IV disease (OR = 4.7 95% CI 3.1-7.0, relative to stage I/II) and reporting moderate/big bowel (OR = 2.5, 95% CI 1.6-3.9) or urinary problems (OR = 2.0, 95% CI 1.4-3.0) had greater odds of becoming unemployed. Other clinical (≥ 1 comorbidities, symptomatic at diagnosis) and sociodemographic (higher deprivation, divorced/separated), living in Scotland or Northern Ireland (NI)) factors were predictors of becoming unemployed. Men who were older, from NI, with stage IV disease and with caring responsibilities had greater odds of retiring early. Self-employed and non-white men had lesser odds of retiring early.
PCa survivors who retire early following diagnosis do not report worse urinary or bowel problems compared to men remaining in employment. However, we identified clinical and sociodemographic factors which increased unemployment risk in PCa survivors.
Targeted support and engagement with PCa survivors at risk of unemployment, including their families and employers, is needed.
调查与 18-42 个月前被诊断患有前列腺癌（PCa）的男性失业和提前退休相关的因素。
确定在诊断时年龄≤60 岁且完成前列腺癌诊断后生活（LAPCD）调查的男性。将在调查（诊断后 18-42 个月）时从就业转为失业（EtoU）或退休（EtoR）的男性与仍在就业的男性（EtoE）进行比较。对社会人口统计学、临床和患者报告的因素进行单变量和多变量分析。
EtoE 组有 3218 名男性（81.4%），EtoU 组有 245 名男性（6.2%），EtoR 组有 450 名男性（11.4%）。患有 IV 期疾病的男性（OR=4.7，95%CI3.1-7.0，与 I/II 期相比）和报告有中度/大肠道（OR=2.5，95%CI1.6-3.9）或泌尿问题（OR=2.0，95%CI1.4-3.0）的男性失业的可能性更大。其他临床（≥1 种合并症，诊断时出现症状）和社会人口统计学（较高的贫困程度、离婚/分居）、居住在苏格兰或北爱尔兰（NI））因素是失业的预测因素。年龄较大、来自 NI、患有 IV 期疾病和有照顾责任的男性提前退休的可能性更大。自营职业和非白人男性提前退休的可能性较小。
与仍在工作的男性相比，诊断后提前退休的 PCa 幸存者报告的泌尿或肠道问题并不更严重。然而，我们确定了增加 PCa 幸存者失业风险的临床和社会人口统计学因素。
需要针对有失业风险的 PCa 幸存者，包括他们的家人和雇主，提供有针对性的支持和参与。
