Prospective study of work limitations in cancer patients (pts) undergoing curative chemotherapy (CT).

Abstract

18 Background: Impaired work performance that when significant leads to decreased productivity (work limitations) contribute to the “financial toxicity” of cancer treatment. Factors influencing work limitations and employment outcomes are poorly understood for cancer pts. We prospectively examined the proportion of cancer pts with significant increases in work limitations during curative treatment (co-primary endpoint). Methods: Eligible pts were ≥ 18 years, employed, intended to work during or after end of treatment (EOT), and had received ≤ 1 CT cycle. The Work Limitations Questionnaire (WLQ) survey was administered (baseline [BL], EOT, 3 and 6-months post EOT) to determine change in work limitations (WLQ index scale: 0 = no limitations to 28.6 = limited all of the time). “Significantly affected” pts had > 5-point increase in WLQ - an increase associated with decreased work productivity. Descriptive statistics (estimates with 95% confidence intervals [CI]; means with standard deviations [SD]) were calculated. A two-factor ANOVA (pt, timepoint) was used for analysis of WLQ changes over time. Results: 120 pts enrolled 5/2013 - 10/2015 at 8 sites (85 breast, 16 colon, 19 other). 110 took 1+ surveys: median age 50 (range 24-69), 92 (84%) female, 105 (96%) White; 93 (85%) had surgery, 110 (100%) CT, 57 (52%) RT. The mean increase in WLQ index from BL to EOT was +4.4 (95% CI [+2.1,+6.8], p < 0.001). A total of 44% were “significantly affected” by treatment (37/85, 95% CI [33%,55%]). WLQ index decreased at 3 and 6-mos (as compared to BL or EOT, see table). Conclusions: Among largely White pts getting CT, 44% experienced a significant increase in work limitations from BL to EOT. An improvement in group WLQ scores was noted after EOT. Analysis of factors (e.g., job type, education, symptoms) most associated with work limitations is underway to assist in prospectively identifying at-risk pts. [Table: see text]