Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
Previous affiliation: Research Support Services, Oslo University Hospital, Sogn Arena, Klaus Torgårds vei 3, 3. Floor, 0372, Oslo, Norway.
BMC Cancer. 2021 Feb 8;21(1):143. doi: 10.1186/s12885-021-07836-2.
This study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT.
All survivors treated with HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged ≥18 years at HDT-ASCT and alive at survey in 2012-2013 were eligible. We divide survivors by current employment status (full-time, part-time and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients employed when diagnosed but not before HDT-ASCT.
Of the 274 who completed the survey, 82% (N = 225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 70% of the average annual wage in Norway in 2012.
For a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors' probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.
本研究描述了接受大剂量化疗联合自体造血干细胞移植（HDT-ASCT）治疗的淋巴瘤幸存者的治疗后工作模式。其旨在确定 HDT-ASCT 后参与劳动力和被排除在外的决定因素。
1995 年至 2008 年间在挪威接受 HDT-ASCT 治疗的所有淋巴瘤幸存者，在 HDT-ASCT 时年龄≥18 岁且在 2012-2013 年调查时存活，均符合条件。我们根据当前的就业状况（全职、兼职和失业）对幸存者进行分类。主要结局是当前的就业状况、工作时间和工作能力。撤回人员是指在诊断时已就业但在 HDT-ASCT 之前未就业的患者。
在完成调查的 274 名患者中，82%（N=225）纳入最终分析。调查时的平均年龄为 52 岁，39%为女性，85%在诊断时就业，77%在 HDT-ASCT 之前就业，69%在调查时就业。HDT-ASCT 之前的就业与给定症状负担下调查时就业的可能性更高相关。在最广泛的统计模型中，它增加了 37.3 个百分点。HDT-ASCT 后撤回人员的工作时间骤降，而工作能力则出现反弹效应。他们重新进入劳动力市场的潜在经济收益相当于 2012 年挪威平均年薪的 70%。
在给定的症状负担下，在诊断和治疗期间保持就业与未来就业的可能性更高相关。这些结果支持在诊断和治疗后实行劳动力包容政策，以提高癌症幸存者未来就业的可能性。然而，我们需要更多关于撤回机制以及促进包容的政策措施的研究。
