Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Predictors of employment outcomes in cancer survivors: a systematic scoping review (#306)

Emma Kemp 1 , Anna Ugalde 2 , Skye Marshall 2 , Lisa Grech 3 4 , Hannah Jongebloed 2 , Imogen Ramsey 5 , Carolyn Taylor 6 , Deborah Kirk 7 , Georgia Halkett 8 , Cherith Semple 9 , Nicolas Hart 5 10 , Darren Haywood 10 , Bogda Koczwara 1 11
  1. Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  2. Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
  3. School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
  4. Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
  5. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  6. Global Focus on Cancer, New York, United States
  7. School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
  8. Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
  9. Ulster University, Jordanstown, United Kingdom
  10. Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney, Sydney, New South Wales, Australia
  11. Department of Medical Oncology, Flinders Medical Centre, Bedford Park, South Australia, Australia

Aims: Maintaining and returning to employment are common challenges for cancer survivors and impact psychosocial and financial outcomes. This study aimed to summarise recent research examining predictors of employment outcomes in cancer survivors.

Methods:

Systematic scoping review methodology was used to identify primary research papers that quantitatively examined prediction of any employment outcome in adult cancer survivors, from 2014 to March 2024. Data were extracted on population, setting, predictors, and employment outcomes. 

Results:

245 primary research papers were included. They most frequently examined employment outcomes in heterogeneous (n=77; 31.4%), and breast (n=75; 30.6%) cancer survivors. Study designs and sample sizes ranged from small cross-sectional surveys (minimum n=25) to national registry-based studies (maximum n=136,342). Variables examined as potential predictors related to disease (e.g. cancer type, stage), treatment (e.g. treatment type), sociodemographic (e.g. marital/partnered status), psychosocial (e.g. anxiety, social support), physical health (e.g. physical comorbidities, health behaviours), employment (e.g. role type, job security) and employer characteristics (e.g. workplace social support, employer-based health insurance). The most frequently examined outcomes included return to work (n=87; 35.5%) and employment status/participation (n=61; 24.9%). Studies less frequently examined work ability (n=22; 9.0%), unemployment/job loss (n=19; 7.8%), cessation/resignation/early retirement  (n=16; 6.5%), work-related disability (n=15; 6.1%), sickness absence (n=14; 5.7%), work sustainability (n=6; 2.5%), working hours (n=6; 2.5%), and work productivity (n=5; 2%). Studies were predominantly conducted in Europe (n=115; 46.9%) or North America (n=54; 23%). The vast majority were conducted in high-income economies (n=228; 93%), with minimal representation of lower middle-income (n=2; 0.8%) or low-income economies (n=0). Few focused on populations at risk of disadvantage (e.g. low income, rural, insecure work).

Conclusions:

Numerous studies examine predictors of employment after cancer. However, populations in low-to-middle income economies and/or experiencing disadvantaged circumstances are under-represented. Outcomes such as work sustainability and productivity remain understudied. Future research should prioritise addressing these gaps.