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Public health policy and health economics

3665 - Factors associated with reduced work ability in a nation-wide cohort of long-term cancer survivors treated in young adulthood (19-39 years) – the NOR-CAYACS study

Date

09 Sep 2017

Session

Public health policy and health economics

Presenters

Cecilie Kiserud

Citation

Annals of Oncology (2017) 28 (suppl_5): v605-v649. 10.1093/annonc/mdx440

Authors

C.E. Kiserud1, H.C. Lie1, A. Finset2, S. Fosså1, J.H. Loge1, E. Ruud3, A.A. Dahl1

Author affiliations

  • 1 Department Of Oncology, Oslo University Hospital, 0424 - Oslo/NO
  • 2 Department Of Behavioral Science In Medicine, University of oslo, Oslo/NO
  • 3 Dept Of Peadiatrics, Oslo University Hospital, Oslo/NO
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Abstract 3665

Background

Young adulthood (19-39 years) is a phase of life focused on career development and establishment of a family. Cancer during these years may interfere considerably with solving these tasks. We examined factors associated with reduced work ability among cancer survivors treated in young adulthood (YACSs).

Methods

The Cancer Registry of Norway identified 3,617 YACSs alive at September 1, 2015 and diagnosed with cancer from 1985 to 2009, who were mailed a questionnaire. The response rate was 41% and we included 1,198 YACSs (198 melanoma, 494 breast cancer, 148 colorectal cancer, 222 non-hodgkin lymphoma and 136 leukemia), excluding YACSs who were in treatment, did not report on treatment, or had their last cancer diagnosed < 2 years before survey. Self-reported treatment was categorized in 6 groups by increasing intensity from minor surgery to 4-6 treatment modalities. The dataset was analyzed with block-wise linear regression analysis with current work ability (0=none to 10=optimal) as dependent variable.

Results

Mean age at diagnosis was 34 years, mean age at survey 50 years and 60% were in full time job. Our five steps block-wise model explained 54% of the variance in work ability. Late effects and cancer-related variables explained 16%, socio-demography 5%, self-reported health and somatic diseases 27%, mental distress 5%, and lifestyle 1%. Cancer diagnosis and treatment burden did not contribute significantly to the model, while cognitive problems, neuropathy, lymphedema, and radiation sequelae in skin, connective tissue and/or muscles contributed significantly to reduced work ability. The same was true for being female, having a low level of education, having poor self-rated health and cardiovascular disease including hypertension. Higher levels of anxiety, fatigue, depression and fear of recurrence were also significantly associated with poorer work ability. Drinking alcohol ≥ once a week was the only life-style variables with such association.

Conclusions

Among YACSs many psychosocial and somatic features, but not cancer type or treatment intensity, were significantly associated with reduced work ability.

Clinical trial identification

Legal entity responsible for the study

National Advisory Unit for Late Effects

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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