National patterns and factors predicting employment disruption in women diagnosed with endometrial cancer.

Abstract

e18093 Background: Cancer patients are less likely to return to work after diagnosis. As endometrial cancer is highly curable, it is important to assess whether patients are able to resume work after treatment. We evaluated rates of return to work following endometrial cancer diagnosis and assessed factors associated with a disruption in employment. Methods: A cohort of patients aged 18-63 years who were diagnosed (2010-2015) with endometrial cancer and underwent surgical staging were identified in Truven Marketscan, an insurance claims database of commercially insured patients in the United States. All patients who were working full or part-time when diagnosed were included, and all employment changes during the year following diagnosis were identified. Treatment information, including use of chemotherapy and radiation, and complications of treatment were identified and collected using Common Procedural Terminology codes, and International Statistical Classification of Diseases codes. Univariable analysis and multivariable logistic regression were used to evaluate the impact of treatment and demographic variables on change in employment status. Results: A total of 3547 women with endometrial cancer who held a full-time or part-time job 3 months prior to diagnosis were identified. The median age at diagnosis was 55 years, and the majority of patients (82%) had a Charlson comorbidity index of 0. While most women continued to work following diagnosis, 21% (736) experienced a disruption in employment. The majority (96.7%) held a full-time job prior to going on long-term disability, retirement, or stopping to work. In univariable analysis, chemotherapy recipients were 40% more likely to experience a disruption in employment (Odds ratio (OR) = 1.5, 95% confidence Interval (CI) 1.15-2.11), whereas radiation therapy did not influence employment (OR 1.3, 95% CI 0.99-1.61). In multivariable analysis including age, region of residence, Charlson comorbidity, radiation, chemotherapy, insurance plan and presence of surgical complications, receipt of chemotherapy remained a significant predictor of employment disruption (OR 1.46, p = 0.0257). Conclusions: Twenty-one percent of employed, insured women experienced a change in employment following diagnosis of endometrial cancer, an often-curable disease. Chemotherapy was a significant predictor of employment disruption. This is important to consider in development of interventions to maximize functional recovery following treatment for endometrial cancer.