Return to work among self-employed cancer survivors.

Abstract

The aim of this study is to investigate whether salaried and self-employed workers differ regarding factors relevant for return to work after being diagnosed with cancer. The possible mediators of an effect of self-employment on work ability were also investigated. A total of 1115 cancer survivors (1027 salaried and 88 self-employed) of common invasive cancer types who were in work at the time of diagnosis completed a mailed questionnaire 15-39months after diagnosis. Twenty-four percent of self-employed cancer survivors reported that they had not returned to work at the time of the survey, and 18% of those who were salaried had not. While 9% of the self-employed had received disability or early retirement pension, only 5% had received such a pension among salaried employees. Compared with the salaried workers, the self-employed people reported significantly more often reduced work hours (P<0.001), negative cancer-related financial (P<0.001), and occupational changes (P=0.005) and low overall health (P=0.02), quality of life (P=0.04), and total work ability (P=0.02). The negative effect of self-employment on total work ability seems to be mediated by reduced work hours and a negative cancer-related financial change. Compared with salaried, self-employed workers in Norway, they seem to struggle with work after cancer. This may be because the two groups have different work tasks and because self-employed people have lower social support at work and less legal support from the Working Environment Act and public health insurance. Self-employed people with cancer should be informed about the work-related challenges they may encounter and be advised to seek practical help from social workers who know about the legal rights of self-employed people.