Factors associated with an adverse work outcome in breast cancer survivors 5–10 years after diagnosis: a cross-sectional study

Purpose: To identify which factors are associated with adverse work outcome 5-10 years after diagnosis.

Methods: In this cross-sectional study, breast cancer survivors, treated between 2003 and 2008, completed a questionnaire 5-10 years after diagnosis. Adverse work outcome was defined as not having paid employment or working > 20% less compared to prediagnosis. Logistic regression analyses were conducted.

Results: Of 906 participants, 326 (36%) had an adverse work outcome. In multivariable analyses, the probability of an adverse work outcome increased with age (OR, 1.03; 95% CI, 1.00-1.07), time since diagnosis (OR, 1.19; 95% CI, 1.03-1.37), and was higher among women who stated that work had become less important (OR, 2.99; 95% CI, 1.94-4.62). Factors associated with a lower probability of an adverse work outcome were having sufficient financial resources (OR, 0.23; 95% CI, 0.08-0.66), higher total work ability (OR, 0.61; 95% CI, 0.54-0.69), feeling supported at work (OR, 0.52; 95% CI, 0.33-0.80), and, prior to diagnosis, having more children to take care of (OR, 0.65; 95% CI, 0.54-0.79), being able to adjust working hours (OR, 0.55; 95% CI, 0.36-0.83) and not desiring to work less hours if that were to be financially feasible (OR, 1.8; 95% CI, 1.0-3.2).

Conclusions: Predominantly, work-related factors are associated with adverse work outcomes 5-10 years after diagnosis, whereas clinical factors are not. Our results need validation in prospective cohort studies, after which supportive interventions could be developed.

Implications for Cancer Survivors: Work-related factors should be considered in future interventions to prevent adverse work outcome 5-10 years after diagnosis.