Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
Department of Haematology, Rigshospitalet, Copenhagen, Denmark.
J Cancer Surviv. 2024 Jun;18(3):727-738. doi: 10.1007/s11764-022-01305-w. Epub 2022 Nov 28.
Little is known about the employment situation of long-term Hodgkin lymphoma (HL) survivors despite their young age at diagnosis and the favorable prognosis of the disease. In this cross-sectional study, we aim to describe the employment situation in a cohort of long-term HL survivors compared to the general population and investigate the associations with disease characteristics and treatment exposure.
HL survivors > 25 years (n = 1961) were matched 1:25 to controls (n = 49,025) from the European Union Labour Force Survey. Individual treatment information was obtained from trial records. Employment and socio-demographic characteristics were collected using the Life Situation Questionnaire. Logistic regression models were used to estimate associations between disease and treatment characteristics with employment status and work-related attitudes.
At employment assessment, 69.7% of survivors (95% CI: 67.6-71.7%) were working; of these, 68.9% (95% CI: 66.3-71.3%) worked full-time, a figure comparable to that of controls (p value 0.17). The risk of not working was associated with increasing age at diagnosis, increasing age at survey, female sex, lower educational level, and relapse history. Of those who were at work during treatment, 16.8% (95% CI: 14.5-19.3%) stated their income had subsequently decreased, which was attributed to their HL by 65.4% (95% CI: 57.5-72.8). Among those not at work, 25.1% (95% CI: 20.7-29.8) survivors were disabled compared to only 14.5% (95% CI: 13.8-15.3%) of controls.
In this cohort of HL survivors, employment status was comparable to that of the general population. However, increasing age at follow-up, female sex, lower educational level, and relapse history are risk factors for unemployment, a perceived decrease in income, and disability.
To further improve follow-up care, special attention should be paid to these vulnerable subgroups.
尽管霍奇金淋巴瘤（HL）患者的诊断年龄较小，且疾病预后良好，但人们对其就业情况知之甚少。在这项横断面研究中，我们旨在描述与普通人群相比，长期 HL 幸存者的就业情况，并探讨与疾病特征和治疗暴露相关的因素。
HL 幸存者（年龄＞25 岁）（n=1961）与来自欧盟劳动力调查的对照组（n=49025）以 1:25 的比例进行匹配。个体治疗信息从临床试验记录中获得。使用生活状况问卷收集就业和社会人口统计学特征。采用逻辑回归模型来估计疾病和治疗特征与就业状况和与工作相关的态度之间的关联。
在就业评估时，69.7%的幸存者（95%CI：67.6-71.7%）正在工作；其中 68.9%（95%CI：66.3-71.3%）全职工作，这一比例与对照组相当（p 值 0.17）。不工作的风险与诊断时年龄增加、调查时年龄增加、女性、较低的教育水平和复发史相关。在治疗期间工作的人中，有 16.8%（95%CI：14.5-19.3%）表示他们的收入随后下降，其中 65.4%（95%CI：57.5-72.8%）归因于他们的 HL。在不工作的人中，有 25.1%（95%CI：20.7-29.8%）的幸存者残疾，而对照组只有 14.5%（95%CI：13.8-15.3%）。
在本 HL 幸存者队列中，就业状况与普通人群相当。然而，随访时年龄增加、女性、较低的教育水平和复发史是失业、收入下降和残疾的危险因素。
为了进一步改善癌症幸存者的随访护理，应特别关注这些弱势群体。
