Return to work and work productivity among Chinese cancer survivors

Abstract

Background: A substantial number of patients diagnosed with cancer are of working age. Understanding how cancer diagnosis affects return to work and work productivity will enable development of tailored vocational interventions to meet patients' needs and therefore to minimize productivity loss at the work force. This study examined the rate of return to work among cancer survivors after the completion of cancer treatment and factors influencing work productivity and activity impairment at one‐year post‐treatment. Methods: 1106 Chinese patients who completed cancer treatment within the past 6 months were recruited. Participants were assessed for return to work status, supportive care needs, psychological distress, and physical symptom distress at baseline; for work productivity at one‐year post treatment. Results: 674/1106 were in employment before cancer diagnosis; 629/674 (93%) had taken sick leave from work. For those who had taken time off from work, 206 (33%) had returned to work, 248 (39%) had resigned, 76 (12%) remained on paid sick leave, and 99 (16%) were on unpaid sick leave. Logistic regression analysis indicated respondents who had not yet returned to work reported more physical symptoms (odds ratio OR: 1.08, 95% CI 1.01‐1.16) and higher levels of depression (OR: 1.14, 95% CI 1.05‐1.25). Based on respondents who completed one‐year post‐treatment (444/629), high levels of baseline depression predicted greater work impairment (□=1.62) and activity impairment (□=1.02). Conclusion: Unmanaged physical symptoms and psychological distress not only delayed work resumption but led to subsequent work and activity impairment. The findings highlight the importance of continued symptom assessment and management in early cancer survivorship.