Working ability and educational level among long-term survivors of testicular cancer (TCSS) compared to a general population (GenPop)

Abstract

4640 Background: The working ability and educational level in long-term TCSs may be negatively influenced by the experience of cancer and its treatment during young adulthood. Methods: Sociodemographic data and data on working ability were obtained by a postal questionnairy national multicenter survey in1383 TCSs aged 23–66 years (mean: 44 years) treated between 1980 and 1994 (12 years mean follow up). Working ability was defined as “employed/self-employed” and “not working, but seeking work”. Five groups were constructed based on the overall treatment: surveillance only, SURV (n=116); retroperitonal lymph node dissection, RPLND (n=152); radiation only, RAD (n=574); cisplatin-based chemotherapy: cisplatin <850mg, CHEM-1 (n=439); cisplatin >850mg, CHEM-2 (n=102). Data from the GenPop were obtained from a health status study within a Norwegian county (HUNT-2) comprising 23 844 aged matched men. Results: There was no difference in working ability between the TCSs and the GenPop (89% and 88%). However, 6% of the GenPop received unemployment benefits compared to only 2.6% of the TCSs (p<0.0001). There were no differences between the groups regarding economical compensation for absences due to disease, rehabilitation or invalidity. Among side effects due to treatment, persisting peripheral neuropathy and Reynauds phenomena did significantly affect the working ability. The working disability risk was 3-fold higher in CHEM-2 compared to SURV. Such difference was not seen for any of the other subgroups. A significantly larger proportion of the TCSs (19%) obtained a higher university education compared to the GenPop, (9%, p<0.0001). Conclusions: The working ability of long-term TCSs is similar to the GenPop, and TSCs are employed/self-employed at a larger extent than the GenPop, possibly due to a higher educational level. TSCs receiving more than 4 courses with cisplatin have the highest risk of disability. No significant financial relationships to disclose.