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Factors associated with an adverse work outcome in breast cancer survivors 5–10 years after diagnosis: a cross-sectional study

  • Sietske J. Tamminga
  • Pieter Coenen
  • Carmen Paalman
  • Angela G. E. M. de Boer
  • Neil K. Aaronson
  • Hester S. A. Oldenburg
  • Flora E. van Leeuwen
  • Allard J. van der Beek
  • Saskia F. A. Duijts
  • Michael SchaapveldEmail author
Article

Abstract

Purpose

To identify which factors are associated with adverse work outcome 5–10 years after diagnosis.

Methods

In this cross-sectional study, breast cancer survivors, treated between 2003 and 2008, completed a questionnaire 5–10 years after diagnosis. Adverse work outcome was defined as not having paid employment or working > 20% less compared to prediagnosis. Logistic regression analyses were conducted.

Results

Of 906 participants, 326 (36%) had an adverse work outcome. In multivariable analyses, the probability of an adverse work outcome increased with age (OR, 1.03; 95% CI, 1.00–1.07), time since diagnosis (OR, 1.19; 95% CI, 1.03–1.37), and was higher among women who stated that work had become less important (OR, 2.99; 95% CI, 1.94–4.62). Factors associated with a lower probability of an adverse work outcome were having sufficient financial resources (OR, 0.23; 95% CI, 0.08–0.66), higher total work ability (OR, 0.61; 95% CI, 0.54–0.69), feeling supported at work (OR, 0.52; 95% CI, 0.33–0.80), and, prior to diagnosis, having more children to take care of (OR, 0.65; 95% CI, 0.54–0.79), being able to adjust working hours (OR, 0.55; 95% CI, 0.36–0.83) and not desiring to work less hours if that were to be financially feasible (OR, 1.8; 95% CI, 1.0–3.2).

Conclusions

Predominantly, work-related factors are associated with adverse work outcomes 5–10 years after diagnosis, whereas clinical factors are not. Our results need validation in prospective cohort studies, after which supportive interventions could be developed.

Implications for Cancer Survivors

Work-related factors should be considered in future interventions to prevent adverse work outcome 5–10 years after diagnosis.

Keywords

Cancer survivorship Employment Work Breast cancer 

Notes

Author contributions

MS, NA, FvL, HO, AdB were responsible for the study concept and design and obtained funding.

PC analysed the data, which was checked by ST.

All authors interpreted the data.

ST, PC and SD drafted the manuscript, which was critically revised by all authors.

Funding

This study was funded by the Dutch Pink Ribbon foundation (grant no. 2011.WO17.C102) and the Amsterdam Public Health Research Institute.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11764_2018_731_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 15 kb)
11764_2018_731_MOESM2_ESM.docx (17 kb)
ESM 2 (DOCX 16 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Sietske J. Tamminga
    • 1
    return OK on get
  • Pieter Coenen
    • 2
  • Carmen Paalman
    • 3
    • 4
  • Angela G. E. M. de Boer
    • 1
  • Neil K. Aaronson
    • 3
  • Hester S. A. Oldenburg
    • 5
  • Flora E. van Leeuwen
    • 3
  • Allard J. van der Beek
    • 2
  • Saskia F. A. Duijts
    • 2
    • 3
    • 6
  • Michael Schaapveld
    • 3
    • 4
    Email author
  1. 1.Amsterdam UMC, Coronel Institute of Occupational Health, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
  3. 3.Division of Psychosocial Research and EpidemiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  4. 4.Netherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
  5. 5.Department of Surgical OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  6. 6.Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands

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