Cancer survivors are a growing population, many with ongoing medical conditions that can potentially affect employment. This dissertation investigated two groups of cancer survivors to assess employment and occupational status following cancer treatment. The first study examined a cohort of hematopoietic cell transplantation (HCT) survivors to evaluate how physical and mental health status 6 months after transplant predicted return to full-time work using multivariable regression analyses. Survivors with normal physical functioning returned to work 2 times faster than those with lower functioning over the 5 years of follow-up. Female survivors were 47% less likely to return to work than males. Between 80%-87% of survivors working over the first three years after HCT reported limitations in their work ability compared to pre-illness. The second and third papers examined employment outcomes in childhood cancer survivors. Paper 2 assessed whether survivors were at higher risk of health-related unemployment and being unemployed but seeking work. In multivariable regression analyses, survivors were six times more likely to report health-related unemployment when compared to both a sibling sample and to age, sex, and race matched cohort from the National Health and Nutrition Examination survey. Both female sex and a history of certain surgeries were associated with health-related unemployment. Survivors with high-dose cranial radiation were at high risk for both unemployment outcomes. Unemployed survivors reported poorer physical functioning than employed survivors and were less educated, had lower incomes and were more likely to have public health insurance coverage than unemployed siblings. Paper 3 assessed occupational outcomes. In multivariable regression analyses survivors were less likely to hold higher-wage and higher-skill professional or managerial jobs than siblings. Survivors with a history of higher dose cranial radiation and central nervous tumor resection were also less likely to hold professional jobs and, if employed, were working in lower wage jobs that were nonphysical in nature. Survivors tended to have lower incomes than siblings within the same occupational classifications. By preparing patients, physicians and employers with realistic expectations regarding work-related abilities following cancer and developing strategies to address limitations, work outcomes can be improved for cancer survivors.
|Advisor:||Wickizer, Thomas W.|
|School:||University of Washington|
|School Location:||United States -- Washington|
|Source:||DAI-B 71/02, Dissertation Abstracts International|
|Keywords:||Cancer survivors, Employment outcomes, Occupational status|
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