ESMO 2017: NOR-CAYACS Trial: Factors That May Limit Work Ability of Young Adult Cancer Survivors

Key Points

  • A low Work Ability Index was associated with a low level of education, female sex, lymphedema, fatigue, depression, and reduced physical quality of life and self-reported health.
  • Non-Hodgkin lymphoma survivors had a higher risk for reduced work ability compared to the melanoma group.
  • Treatment intensity was not associated with work ability.

Factors that may limit the ability of young adult cancer survivors to work were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1110PD_PR).

Late side effects can occur months or years after cancer treatment. In patients diagnosed with cancer in young adulthood, these late effects may interfere with career development.

NOR-CAYACS

The NOR-CAYACS study investigated the work abilty of patients diagnosed with cancer at the ages of 19 to 39 years. Patients included in the trial were diagnosed with melanoma, colorectal cancer, breast cancer (stages I–III), non-Hodgkin lymphoma, or leukemia from 1985 to 2009, and were alive in September 2015. These patients were identified through the Cancer Registry of Norway.

Participants were mailed a questionnaire about late effects of treatment and work status, and then scored themselves from 0 (no work ability) to 10 (highest work ability) on the Work Ability Index.

A total of 1,198 participants answered the questionnaire. The median age at the time of the survey was 49 years; there was a median of 13 years since cancer treatment; and 60% of participants had a full-time job.

Findings

A low Work Ability Index was associated with a low level of education, female sex, lymphedema, fatigue, depression, and reduced physical quality of life and self-reported health. Non-Hodgkin lymphoma survivors had a higher risk for reduced work ability compared to the melanoma group. Treatment intensity was not associated with work ability.

“We found that psychological and physical late effects of cancer and other conditions were significantly associated with reduced work ability,” said lead author Cecilie Kiserud, MD, PhD, Chair, National Advisory Unit for Late Effects After Cancer Treatment, Oslo University Hospital, Oslo, Norway. “In comparison, treatment intensity and cancer type, apart from non-Hodgkin lymphoma, were not significantly related to work ability.”

She concluded, “Greater awareness is needed about the fact that cancer survivors may be less able to work after treatment because of the late effects they might experience.”

Commentary

Commenting on the study, Gilles Vassal, MD, PhD, Director of Clinical Research, Gustave Roussy, Villejuif, France, and Past President of the European Society for Paediatric Oncology (SIOPE), said, “Around 80% of young people with cancer can be cured, but the treatments are intensive and two-thirds of survivors have long-term physical and psychological consequences. This study shows that the psychological and somatic effects of treatment are associated with reduced work ability, rather than the cancer itself.”

“Young cancer survivors should be informed about potential toxicities and monitored to minimize the severity of long-term sequelae,” he added. “Prospective clinical trials are needed to find treatments that lower the risk of late toxicity without jeopardizing the probability of cure.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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