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. 2018 Aug 15;13(8):e0200720.
doi: 10.1371/journal.pone.0200720. eCollection 2018.

Prognostic factors for return to work and work disability among colorectal cancer survivors; A systematic review

Chantal M den Bakker  1   2 , Johannes R Anema  1 , AnneClaire G N M Zaman  3 , Henrika C W de Vet  4 , Linda Sharp  5 , Eva Angenete  6 , Marco E Allaix  7 , Rene H J Otten  8 , Judith A F Huirne  9 , Hendrik J Bonjer  2 , Angela G E M de Boer  3 , Frederieke G Schaafsma  1
Affiliations

Prognostic factors for return to work and work disability among colorectal cancer survivors; A systematic review

Chantal M den Bakker et al. PLoS One. .

Abstract

Background: Colorectal cancer is diagnosed progressively in employed patients due to screening programs and increasing retirement age. The objective of this study was to identify prognostic factors for return to work and work disability in patients with colorectal cancer.

Methods: The research protocol was published at PROSPERO with registration number CRD42017049757. A systematic review of cohort and case-control studies in colorectal cancer patients above 18 years, who were employed when diagnosed, and who had a surgical resection with curative intent were included. The primary outcome was return to work or work disability. Potentially prognostic factors were included in the analysis if they were measured in at least three studies. Risk of bias was assessed according to the QUality In Prognosis Studies tool. A qualitative synthesis analysis was performed due to heterogeneity between studies. Quality of evidence was evaluated according to Grading of Recommendation Assessment, Development and Evaluation.

Results: Eight studies were included with a follow-up period of 26 up to 520 weeks. (Neo)adjuvant therapy, higher age, and more comorbidities had a significant negative influence on return to work. A previous period of unemployment, extensive surgical resection and postoperative complications significantly increased the risk of work disability. The quality of evidence for these prognostic factors was considered very low to moderate.

Conclusion: Health care professionals need to be aware of these prognostic factors to select patients eligible for timely intensified rehabilitation in order to optimize the return to work process and prevent work disability.

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Conflict of interest statement

CdB, AZ, HdV, LS, EA, MA, HB, AdB and FS have no conflicts of interest. JH received grants from Dutch government bodies such as NWO, ZonMw to perform research outside this submitted work. She received grants from Samsung and a personal fee from Olympus in support of attending scientific conferences. These grants are all outside the submitted work. JA holds a chair in Insurance Medicine paid by the Dutch Social Security Agency, he is stockholder of Evalua. He received grants from Dutch government bodies such as ZonMw/NWO, Instituut Gak, VWS, UWV, SZW and from health insurance companies as Achmea, CVZ/Zorg Instituut to perform research outside this submitted work. He received a grant from Pfizer in support of attending a scientific conference. These grants are all outside the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. PRISMA diagram showing selection of studies for systematic review.
Fig 2
Fig 2. Risk of bias according to the QUIPS tool.
Red circle = High risk of bias, orange circle = moderate risk of bias, green circle = low risk of bias.
Fig 3
Fig 3. Plots per prognostic factor, measured in at least 3 studies, for return to work (RTW).
1 Significant different. * direction of regression coefficient. Gordon is parent study, Lynch other study (both using the same study cohort).
Fig 4
Fig 4. Plots per prognostic factor, measured in at least 3 studies, for work disability.
1 Significant different. $ Converted from OR into RR.
See this image and copyright information in PMC

References

    1. GLOBOCAN. Estimated cancer incidence, mortality and prevalence worldwide in 2012. 2012. http://globocan.iarc.fr/Default.aspx
    1. Holleczek B, Rossi S, Domenic A, Innos K, Minicozzi P, Francisci S et al. Ongoing improvement and persistent differences in the survival for patients with colon and rectum cancer across Europe 1999–2007 –Results from the EUROCARE-5 study. Eur J Cancer 2015;51:2158–2168. 10.1016/j.ejca.2015.07.024 - DOI - PubMed
    1. Ferlay J, Shin HR, Bray F Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893–917. 10.1002/ijc.25516 - DOI - PubMed
    1. Schreuders EH, Ruco A, Rabeneck L, Schoen RE, Sung JJ, Young GP et al. Colorectal cancer screening: a global overview of existing programmes. Gut 2015;64:1637–1649. 10.1136/gutjnl-2014-309086 - DOI - PubMed
    1. de Boer AGEM, Taskila TK, Tamminga SJ, Feuerstein M, Frings-Dresen MH, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD007569. - PMC - PubMed

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