Return to Work and Work Productivity During the First Year After Cancer Treatment

Serana Chun Yee So; Danielle Wing Lam Ng; Qiuyan Liao; Richard Fielding; Inda Soong; Karen Kar Loen Chan; Conrad Lee; Alice Wan Ying Ng; Wing Kin Sze; Wing Lok Chan; Victor Ho Fun Lee; Wendy Wing Tak Lam

doi:10.3389/fpsyg.2022.866346

Return to Work and Work Productivity During the First Year After Cancer Treatment

Front Psychol. 2022 Apr 12:13:866346. doi: 10.3389/fpsyg.2022.866346. eCollection 2022.

Authors

Serana Chun Yee So^{1

2}, Danielle Wing Lam Ng^{1

2}, Qiuyan Liao², Richard Fielding^{1

2}, Inda Soong³, Karen Kar Loen Chan⁴, Conrad Lee⁵, Alice Wan Ying Ng⁶, Wing Kin Sze⁶, Wing Lok Chan⁷, Victor Ho Fun Lee⁷, Wendy Wing Tak Lam^{1

2}

Affiliations

¹ LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
² School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
³ Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China.
⁴ Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
⁵ Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China.
⁶ Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China.
⁷ Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China.

Abstract

Objectives: Working-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work (RTW) after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment.

Methods: Of 1,106 cancer patients assessed at six-months post-cancer treatment (baseline), 593 previously worked; detailed work status, psychological distress (HADS), physical symptom distress (MSAS-SF), supportive care needs (SCNS-SF34-C), health-related quality of life (SF12), and illness perception (B-IPQ) were assessed. Six months later (follow-up), work productivity and activity impairment were assessed (WPAI; n = 402). Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors.

Results: At baseline, 39% (232/593) were working, 26% (153/593) on sick leave, and 35% (208/593) were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment.

Conclusion: Cancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity.

Keywords: cancer survivors; health-related quality of life; illness perception; occupation; return to work; work productivity.