Choi Yoon-Joo, Lee Weon-Young
Department of Preventive Medicine, College of Medicine, Chung-Ang University, 84, Heuk-Seok Dong, Dong-Jak Gu, Seoul, Republic of Korea.
Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Madu 1-dong, Ilsandong-gu, Goyang, Republic of Korea.
Support Care Cancer. 2023 Jan 26;31(2):135. doi: 10.1007/s00520-023-07603-y.
As the cancer survival rate increases, discussions on the employment status of cancer survivors should be actively carried out worldwide. This study examined patients' working status changes after cancer diagnosis to provide the basis for cancer survivors' return to work.
We established a nationwide cohort to determine long-term work changes after cancer diagnosis. All patients aged 19 to 50 years who were newly diagnosed with cancer while working for the previous 3 years were considered as the case group in 2010. Using propensity score matching (PSM), the cases were matched by sex and age at a ratio of 1:3 with the control group. Kaplan-Meier curve and Cox hazard model analyses were performed to determine the occurrence of unemployment and return to work in the case and control groups on a yearly basis.
According to the 6-year follow-up after cancer diagnosis, 26.5% of cancer patients and 23.2% of controls had lost their jobs by the end of the follow-up (P < .0001). Meanwhile, 50.5% of cancer patients and 57.4% of controls had returned to work after unemployment (P < .0001). Subsequently, based on the Cox hazard model, the unemployment risk of cancer patients was 1.42 times higher than that of the general population, while the proportion of those who returned to work was 1.15 times lower.
Employment is very closely related to the quality of life of cancer survivors. These results highlight the need for a system that can support cancer survivors' work maintenance and return to work after unemployment during the treatment period and the fact that awareness of this must be improved.
随着癌症生存率的提高,全球应积极开展关于癌症幸存者就业状况的讨论。本研究调查了癌症诊断后患者的工作状态变化,为癌症幸存者重返工作岗位提供依据。
我们建立了一个全国性队列,以确定癌症诊断后的长期工作变化。2010年,所有年龄在19至50岁之间、在过去3年工作期间新诊断为癌症的患者被视为病例组。使用倾向得分匹配(PSM),病例与对照组按1:3的性别和年龄比例进行匹配。每年进行Kaplan-Meier曲线和Cox风险模型分析,以确定病例组和对照组失业和重返工作岗位的情况。
根据癌症诊断后的6年随访,到随访结束时,26.5%的癌症患者和23.2%的对照组失去了工作(P <.0001)。同时,50.5%的癌症患者和57.4%的对照组在失业后重返工作岗位(P <.0001)。随后,基于Cox风险模型,癌症患者的失业风险比普通人群高1.42倍,而重返工作岗位的比例则低1.15倍。
就业与癌症幸存者的生活质量密切相关。这些结果凸显了在治疗期间需要一个能够支持癌症幸存者维持工作和失业后重返工作岗位的系统,以及必须提高对此的认识这一事实。