Abstract
PurposeAlthough young adults represent a significant portion of the working population, little is known about the work ability and cognitive impairments in adolescent and young adult (AYA) cancer patients (including the long-term course) following cancer treatment.MethodsAs part of the AYA-Leipzig study, we surveyed AYA cancer survivors (aged 18–39 years at diagnosis; time since diagnosis ≤ 4 years, including all cancer diagnoses) at two time points (t2 = 12 months after t1). Work ability (Work Ability Index, WAI-r) and cognitive impairments (Copenhagen Psychosocial Questionnaire, COPSOQ) were compared at both time points. We analysed predictors for work ability at, on average, 2 years post cancer diagnosis (t2) by using multivariate regression analyses.ResultsA total of 502 patients (74.7% women) participated in both measurements. Mean work ability increased significantly from t1 (6.0; SD = 2.3) to t2 (6.8; SD = 2.2) (t = −9.3; p < 0.001). As many as 380 (76%) AYA cancer survivors reported reduced work ability at t1; 1 year later, this still applied to 287 (57%) of them. Decreased work ability (t2) was associated with more cognitive impairment, higher effort coping with the disease, comorbidities, sick leave > 6 months (since diagnosis), and having children (adj R2 = .48). Cognitive impairments occurred in approximately every fifth patient at both surveys.ConclusionsAchieving maximum work ability is a major challenge for AYAs. Our results show the need for multimodal cancer survivorship and rehabilitation programmes with a special focus on improving cognitive and psychosocial functioning.Implications for Cancer SurvivorsAYAs with cancer should receive targeted occupational counselling early in the course of the disease.
Highlights
The National Cancer Institute (NCI) refers to young adult cancer patients between the ages of 15 and 39 as adolescents and young adults (AYAs) [1]
87% of the AYAs return to education or employment within 1 year of oncological rehabilitation [9], but some studies have suggested that the employment rates of AYA cancer survivors are lower than in the general population [7, 9, 10]
The employment rate must be distinguished from work ability (WA), with the latter being understood as an individual’s ability to cope with professional demands [11]
Summary
AYAs with cancer have been considered a distinct group in oncological research for a number of years, as they differ from paediatric and elderly cancer patients in biological, medical, and. The professional situation of working adults has been the subject of a large number of studies, yet that of AYAs has hardly been investigated. 87% of the AYAs return to education or employment within 1 year of oncological rehabilitation [9], but some studies have suggested that the employment rates of AYA cancer survivors are lower than in the general population [7, 9, 10]. Another study with older cancer patients has indicated that WA improves with time after diagnosis [13]. Dahl et al [12] found that comorbidities, cardiovascular disease, low educational attainment, subjective poor health, and increased depression are associated with decreased WA among AYAs as much as 16 years after diagnosis
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