Impact of cancer on work and education among adolescent and young adult cancer survivors

Helen M. Parsons, Linda C. Harlan, Charles F. Lynch, Ann S. Hamilton, Xiao Cheng Wu, Ikuko Kato, Stephen M. Schwartz, Ashley W. Smith, Gretchen Keel, Theresa H Keegan

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Purpose: To examine the impact of cancer on work and education in a sample of adolescent and young adult (AYA) patients with cancer. Patients and Methods: By using the Adolescent and Young Adult Health Outcomes and Patient Experience Study (AYA HOPE) - a cohort of 463 recently diagnosed patients age 15 to 39 years with germ cell cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma, sarcoma, and acute lymphocytic leukemia from participating Surveillance, Epidemiology, and End Results (SEER) cancer registries - we evaluated factors associated with return to work/school after cancer diagnosis, a belief that cancer had a negative impact on plans for work/school, and reported problems with work/school after diagnosis by using descriptive statistics, χ 2 tests, and multivariate logistic regression. Results: More than 72% (282 of 388) of patients working or in school full-time before diagnosis had returned to full-time work or school 15 to 35 months postdiagnosis compared with 34% (14 of 41) of previously part-time workers/students, 7% (one of 14) of homemakers, and 25% (five of 20) of unemployed/disabled patients (P < .001). Among full-time workers/students before diagnosis, patients who were uninsured (odds ratio [OR], 0.21; 95% CI, 0.07 to 0.67; no insurance v employer-/school-sponsored insurance) or quit working directly after diagnosis (OR, 0.15; 95% CI, 0.06 to 0.37; quit v no change) were least likely to return. Very intensive cancer treatment and quitting work/school were associated with a belief that cancer negatively influenced plans for work/school. Finally, more than 50% of full-time workers/students reported problems with work/studies after diagnosis. Conclusion: Although most AYA patients with cancer return to work after cancer, treatment intensity, not having insurance, and quitting work/school directly after diagnosis can influence work/educational outcomes. Future research should investigate underlying causes for these differences and best practices for effective transition of these cancer survivors to the workplace/school after treatment.

Original languageEnglish (US)
Pages (from-to)2393-2400
Number of pages8
JournalJournal of Clinical Oncology
Volume30
Issue number19
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

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Survivors
Young Adult
Education
Neoplasms
Insurance
Return to Work
Students
Odds Ratio
Germ Cell and Embryonal Neoplasms
Hodgkin Disease
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Practice Guidelines
Workplace
Sarcoma
Non-Hodgkin's Lymphoma
Registries
Epidemiology
Cohort Studies
Therapeutics
Logistic Models

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Impact of cancer on work and education among adolescent and young adult cancer survivors. / Parsons, Helen M.; Harlan, Linda C.; Lynch, Charles F.; Hamilton, Ann S.; Wu, Xiao Cheng; Kato, Ikuko; Schwartz, Stephen M.; Smith, Ashley W.; Keel, Gretchen; Keegan, Theresa H.

In: Journal of Clinical Oncology, Vol. 30, No. 19, 01.07.2012, p. 2393-2400.

Research output: Contribution to journalArticle

Parsons, HM, Harlan, LC, Lynch, CF, Hamilton, AS, Wu, XC, Kato, I, Schwartz, SM, Smith, AW, Keel, G & Keegan, TH 2012, 'Impact of cancer on work and education among adolescent and young adult cancer survivors', Journal of Clinical Oncology, vol. 30, no. 19, pp. 2393-2400. https://doi.org/10.1200/JCO.2011.39.6333
Parsons, Helen M. ; Harlan, Linda C. ; Lynch, Charles F. ; Hamilton, Ann S. ; Wu, Xiao Cheng ; Kato, Ikuko ; Schwartz, Stephen M. ; Smith, Ashley W. ; Keel, Gretchen ; Keegan, Theresa H. / Impact of cancer on work and education among adolescent and young adult cancer survivors. In: Journal of Clinical Oncology. 2012 ; Vol. 30, No. 19. pp. 2393-2400.
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abstract = "Purpose: To examine the impact of cancer on work and education in a sample of adolescent and young adult (AYA) patients with cancer. Patients and Methods: By using the Adolescent and Young Adult Health Outcomes and Patient Experience Study (AYA HOPE) - a cohort of 463 recently diagnosed patients age 15 to 39 years with germ cell cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma, sarcoma, and acute lymphocytic leukemia from participating Surveillance, Epidemiology, and End Results (SEER) cancer registries - we evaluated factors associated with return to work/school after cancer diagnosis, a belief that cancer had a negative impact on plans for work/school, and reported problems with work/school after diagnosis by using descriptive statistics, χ 2 tests, and multivariate logistic regression. Results: More than 72{\%} (282 of 388) of patients working or in school full-time before diagnosis had returned to full-time work or school 15 to 35 months postdiagnosis compared with 34{\%} (14 of 41) of previously part-time workers/students, 7{\%} (one of 14) of homemakers, and 25{\%} (five of 20) of unemployed/disabled patients (P < .001). Among full-time workers/students before diagnosis, patients who were uninsured (odds ratio [OR], 0.21; 95{\%} CI, 0.07 to 0.67; no insurance v employer-/school-sponsored insurance) or quit working directly after diagnosis (OR, 0.15; 95{\%} CI, 0.06 to 0.37; quit v no change) were least likely to return. Very intensive cancer treatment and quitting work/school were associated with a belief that cancer negatively influenced plans for work/school. Finally, more than 50{\%} of full-time workers/students reported problems with work/studies after diagnosis. Conclusion: Although most AYA patients with cancer return to work after cancer, treatment intensity, not having insurance, and quitting work/school directly after diagnosis can influence work/educational outcomes. Future research should investigate underlying causes for these differences and best practices for effective transition of these cancer survivors to the workplace/school after treatment.",
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AU - Lynch, Charles F.

AU - Hamilton, Ann S.

AU - Wu, Xiao Cheng

AU - Kato, Ikuko

AU - Schwartz, Stephen M.

AU - Smith, Ashley W.

AU - Keel, Gretchen

AU - Keegan, Theresa H

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