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).
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.
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.
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
All authors have declared no conflicts of interest.