Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
Faculty of Medicine, Kyoto University, Yoshida-Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan.
Support Care Cancer. 2023 May 10;31(6):331. doi: 10.1007/s00520-023-07796-2.
Colorectal cancer is one of the most diagnosed cancers in Japan and the number of cancer survivors has increased. Work-related issues of cancer survivors have been investigated in relation to occupational health, and sufficient evidence in clinical practice is needed to support this. This study aimed to obtain the relevant information, intending to support the employment of patients with colorectal cancer for clinical settings.
We conducted a prospective, multicenter cohort study, which included patients who underwent surgery with clinical stage I-III colorectal cancer. An electronic survey was used at the time of hospital admission to collect the patients' occupational information, including job resignation soon after cancer diagnosis. A cross-sectional analysis was performed to evaluate the patients' employment situations.
Of 129 eligible patients, 46 (36%) were female. Thirty-nine (30%) were self-employed and 72 (56%) worked at small-sized workplaces, which are not obliged to have occupational physicians. Most patients (89%) expressed their desire to return to work, but eight patients (6%) left their jobs soon after being diagnosed with colorectal cancer before undergoing surgery for several reasons stemming from worries about future treatment and its consequences. Multivariable analyses indicated that nonregular employees and the self-employed might be at a disadvantage in keeping their job at diagnosis.
Surgeons should address work-related issues for survivorship, which begins at cancer diagnosis and, when available, collaborate with occupational physicians while being mindful that patients working at smaller companies do not have immediate access to occupational physicians.
结直肠癌是日本最常见的癌症之一,癌症幸存者人数有所增加。已经针对癌症幸存者的与职业健康相关的工作问题进行了调查,临床实践中需要足够的证据来支持这一点。本研究旨在获取相关信息,旨在为结直肠癌患者的临床就业提供支持。
我们进行了一项前瞻性、多中心队列研究,纳入了接受 I-III 期结直肠癌手术的患者。在入院时使用电子调查收集患者的职业信息,包括癌症诊断后不久辞职的情况。进行横断面分析以评估患者的就业情况。
在 129 名符合条件的患者中,46 名(36%)为女性。39 名(30%)为自营职业者,72 名(56%)在小型工作场所工作,这些场所没有义务配备职业医生。大多数患者(89%)表示希望重返工作岗位,但由于对未来治疗及其后果的担忧,有 8 名患者(6%)在诊断出结直肠癌后不久就辞去了工作,接受手术治疗。多变量分析表明,非正规员工和自营职业者在诊断时保住工作可能处于不利地位。
外科医生应解决与生存相关的工作问题,这些问题始于癌症诊断,并在有条件的情况下与职业医生合作,同时要注意到在较小的公司工作的患者无法立即获得职业医生的帮助。