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Meta-Analysis
. 2020 Apr;14(2):135-150.
doi: 10.1007/s11764-020-00862-2. Epub 2020 Mar 11.

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

Angela Gem de Boer  1 , Steffen Torp  2 , Adela Popa  3 , Trine Horsboel  4 , Vesna Zadnik  5 , Yakir Rottenberg  6 , Edit Bardi  7 , Ute Bultmann  8 , Linda Sharp  9
Affiliations
Meta-Analysis

Long-term work retention after treatment for cancer: a systematic review and meta-analysis

Angela Gem de Boer et al. J Cancer Surviv. 2020 Apr.

Abstract

Purpose: Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors.

Methods: We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized.

Results: Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both cross-sectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working.

Conclusion: Almost three-quarters of long-term cancer survivors working at diagnosis retain work.

Implications for cancer survivors: These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.

Keywords: Cancer; Employment; Longitudinal studies; Meta-analysis; Prospective studies; Return-to-work; Work ability; Work retention.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of included studies
Fig. 2
Fig. 2
Proportion of survivors who have returned to work 2+ years post-diagnosis by cancer site
Fig. 3
Fig. 3
Proportion of cancer survivors who have returned to work 2+ years post-diagnosis by geographical area
See this image and copyright information in PMC

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