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

Lookup NU author(s): Professor Linda Sharp



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2020, The Author(s).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.

Publication metadata

Author(s): de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, Bardi E, Bultmann U, Sharp L

Publication type: Review

Publication status: Published

Journal: Journal of Cancer Survivorship

Year: 2020

Volume: 14

Pages: 135-150

Online publication date: 11/03/2020

Acceptance date: 29/01/2020

ISSN (print): 1932-2259

ISSN (electronic): 1932-2267

Publisher: Springer


DOI: 10.1007/s11764-020-00862-2