Accommodating employees with breast cancer

A study of breast cancer survivors in Ontario [9] found 21% not in employment 3 years after diagnosis, in comparison to 15% of a matched cancer-free sample.In The Netherlands, Spelten [11] reported a rate of 82% among participants resident in the North-West of England.In addition, gaps in the existing literature are identified and future research possibilities are considered.Literature relating to the extent of work limitations experienced by cancer survivors is addressed in the accompanying article by Munir A number of studies conducted in North America suggest that the impact of cancer on work status may be generally transient rather than permanent.Cancer and paid work should thus be assessed in the context of individual priorities and values.‘Cancer’ refers to a heterogeneous group of diagnoses with a range of prognoses.

Feldman [2–4] identified cancer site as an important variable in this context in the late 1970s.

With improvements in diagnosis, treatment and survival rates, the impact of cancer on paid work is of increasing importance.

The following article provides an overview of the published literature examining the (i) rate of return to work for cancer survivors, (ii) models for understanding return to work after cancer survivorship and (iii) factors associated with return to work rates (Figure 1).

Another review [13] examined a total of 18 studies published between 19 using six methodological criteria: (i) use of population-based samples from cancer registries to avoid selection bias; (ii) prospective and longitudinal assessment commencing as near to diagnosis and initial treatment as possible to gauge short- and long-term impact; (iii) detailed assessment of work intensity, role and content at multiple time points; (iv) assessment of impact of cancer on individual and family's economic status; (v) identification of multi-dimensional moderators of return to work and function (e.g.

cancer site/stage, treatment modality, co-morbidities, age, family structure, health insurance status) with a particular focus on those amenable to intervention and (vi) sample sizes of sufficient number to allow multivariate analysis, with sufficient numbers in subgroups for provision of prognostic information.

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Factors facilitating work return were a positive attitude from co-workers and discretion over number of hours and nature of work undertaken.

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