Factors affecting job retention amongst cancer survivors five years after diagnosis: evidence from the French VICAN survey

Abstract

Background: Each year, 355,000 new individuals are diagnosed with cancer in France, nearly half of them are in working age and most of them interrupt their professional occupation during their treatment. Drawing on these findings, this study aims to investigate factors associated with job retention amongst cancer survivors. Method(s): VICAN is a French national survey on life conditions of cancers survivors diagnosed in 2010. Patient questionnaires were administered 2 and 5 years after diagnosis. The questionnaire dealt with access to healthcare, recovery after treatments and impact of the disease on personal and professional life in the two and five years following diagnosis, respectively (VICAN national surveys 2012 and 2015). Medical Da ta were collected from a questionnaire completed by the physician who initiated cancer treatment, and information from the national medicoadministrative Da tabase on reimbursement Da ta and hospital discharge records. A multinomial logistic regression was used to identify factors associated with job retention rather than switching or losing the job held before the diagnosis. Result(s): Among the 1,139 cancer survivors aged 17- 58 at diagnosis, 982 (86%) were employed at the time of diagnosis in 2010 whereas 78% of them had a professional activity five years later: 60% remained in the same job than five years ago and 18% have been in another occupation. The following factors are positively associated with the job retention during five years after a cancer diagnosis: educational level above high school graduation, open-ended job at the time of diagnosis, working in public sector and having had a working time reduction in the two years following cancer diagnosis. The medical factors identified were adverse evolution of cancer and being treated with radiotherapy, which negatively affect return to work. Conclusion(s): National guidelines are needed to better take in consideration cancer survivors with no university degree and private employees in order to help them to return to work. Improving information on working conditions is necessary to get better understanding of the professional issues faced by individuals with cancer.