Trajectories of Cognitive Symptoms in Sick-Listed Cancer Survivors.

Kete M Klaver,Allard J Van Der Beek,Saskia F A Duijts,Sanne B Schagen,Jacobien M Kieffer

doi:10.3390/cancers13102444

Abstract

Simple SummaryThe effects of cognitive symptoms on the ability to work are of major concern for cancer survivors. The aim of our study was to explore trajectories of cognitive functioning in sick-listed cancer survivors with work capacity. We found that cognitive functioning improved between two and four years after first day of sick leave, although cognitive symptoms remained of clinical concern in cancer survivors who are non-durable work-disabled (partly or fully). This underlines the importance to provide partly and fully, non-durable work disabled cancer survivors with evidence-based treatment options for their self-perceived cognitive symptoms.Many non-central nervous system (CNS) cancer survivors experience cognitive symptoms, which may affect their self-perceived work ability. Little is known about trajectories of self-perceived cognitive functioning in cancer survivors in the period after work disability assessment. Therefore, we evaluated: (1) trajectories of self-reported cognitive functioning, in cancer survivors with work capacity, (2) differences in trajectories of self-reported cognitive functioning between three work disability groups, and (3) explanatory factors of trajectories of self-reported cognitive functioning. Participants (n = 206) were assessed on self-reported cognitive functioning at three time points between two and four years after first day of sick leave. A statistically significant improvement in cognitive functioning was found in the total group (β = 4.62, SE = 0.91, p < 0.001). When comparing cancer survivors in different work disability groups, similar trajectories of cognitive functioning were observed. Fatigue was the only factor found to be associated with the reported trajectory (β = −0.23, SE = 0.086, p = 0.08). Self-perceived cognitive functioning scores remained considerably lower than the mean score of the general Dutch population, indicating that cognitive symptoms are a persistent problem in sick-listed cancer survivors and that evidence-based treatment options are warranted.

Highlights

Recruitment and participant flow of the original cohort have been reported in detail elsewhere [25]
Cognitive functioning improved after work disability assessment, the effect size of the change in cognitive functioning over time was small to medium
Our results indicated that cognitive symptoms are of clinical concern in sick-listed cancer survivors with work capacity, up to four years after the first day of sick leave

Summary

Introduction

The past decades have seen rapid advances in cancer treatment, resulting in improved survival rates [1]. About 40–50% of cancer survivors are diagnosed at a working age [2]. Long term effects of cancer and cancer treatment on the ability to work are of major concern for cancer survivors and their family [3]. About 89% (range 84–94%) of cancer survivors, who were employed at the time of diagnosis, is able to (partly) return to work (RTW) within

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