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Patient and provider communication about employment following a cancer diagnosis
Janet S de Moor1, Kisha Coa2, Erin E Kent3
1Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute/National Institutes of Health, 9609 Medical Center Drive, Room 3E438, Rockville, MD, 20850, USA. demoorjs@mail.nih.gov.
Purpose:
Cancer treatment can precipitate functional limitations that restrict survivors' ability to work. Yet, it is unclear whether healthcare providers discuss the potential for employment limitations with their patients. We assessed the frequency of patient-provider communication about employment, from the perspectives of survivors, and examined whether receiving a treatment summary was associated with employment communication.
Methods:
Cancer survivors who were working at diagnosis were identified from the Health Information National Trends Survey-4, conducted in 2014 (n = 290). Separate multivariable regression analyses examined the associations between survivor characteristics and employment communication and receipt of a treatment summary and employment communication.
Results:
Among cancer survivors who were working at diagnosis, 62.69% (95% CI 54.42-70.95) reported discussing employment with any healthcare provider at any time since diagnosis. Younger cancer survivors and those more recently treated were more likely to ever have employment discussions. Survivors who received a treatment summary were also more likely to ever discuss employment with any healthcare provider than survivors who did not receive a treatment summary (OR = 3.47, 95% CI 1.02-11.84).
Conclusions:
Approximately two thirds of cancer survivors who were working at diagnosis ever discussed employment with a healthcare provider. Thus, for a sizable portion of cancer survivors, the potential impact of cancer on employment is never discussed with any healthcare provider.
Implications For Cancer Survivors:
Efforts are needed to proactively screen patients for cancer-related work limitations, empower patients to discuss employment concerns with their healthcare providers, and develop interventions that support survivors' goals for working throughout treatment and recovery.
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