Elsa Caumette1,2, Antonio Di Meglio3,4, Inès Vaz-Luis3,4, Cécile Charles5, Julie Havas3,4,6, Garazi Ruiz de Azua1, Elise Martin3, Laurence Vanlemmens7, Suzette Delaloge3, Sibille Everhard8, Anne-Laure Martin8, Asma Dhaini Merimeche9, Olivier Rigal10, Charles Coutant11, Marion Fournier12, Christelle Jouannaud13, Patrick Soulie14, Paul-Henri Cottu15, Olivier Tredan16, Gwenn Menvielle1, Agnès Dumas17. 1. Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France. 2. Department of Maieutics, Université de Montpellier, Montpellier, France. 3. INSERM Unit U 981, Villejuif, France. 4. Breast Cancer Unit, Department of Cancer Medecine, Gustave Roussy, Villejuif, France. 5. Bordeaux Population Health Research Center (U1219), Université de Bordeaux, Bordeaux, France. 6. Clinical Research Department, Gustave Roussy, Villejuif, France. 7. Centre Oscar Lambret, Lille, France. 8. Unicancer, Paris, France. 9. Centre Alexis Vautrin, Vandoeuvre Les Nancy, France. 10. Centre Henri Becquerel, Rouen, France. 11. Centre George François Leclerc, Dijon, France. 12. Institut Bergonié, Bordeaux, France. 13. Institut Jean Godinot Reims, Reims, France. 14. Institut de Cancérologie de L'Ouest - Centre Paul Papin, Angers, France. 15. Institut Curie, Paris, France. 16. Centre Léon Bérard, Lyon, France. 17. Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France. agnes.dumas@inserm.fr.
Abstract
BACKGROUND: Return to work (RTW) after cancer can be modulated by psychosocial factors, including a reordering of one's life values, with more emphasis on private life than work-life. This change in patients' outlook on work-life is however poorly understood. METHODS: We used data from a French cohort (CANTO, NCT01993498) of women diagnosed with stage I-III primary breast cancer (BC) prospectively assessing life priorities between work and private life at diagnosis and 2 years after diagnosis. We identified women who reported a shift in life values toward private life, and we investigated the clinical, demographic, work-related, and psychosocial determinants of this change using logistic regressions. RESULTS: Overall, 46% (N = 1097) of the women had reordered their life priorities toward private life 2 years after diagnosis. The factors positively associated with this shift included being diagnosed with stage III BC, perceiving one's job as not very interesting, being an employee/clerk (vs. executive occupation), perceiving no support from the supervisor at baseline, perceiving negative interferences of cancer in daily life, and perceiving a positive impact from experiencing cancer. Depressive symptoms were negatively associated with this shift. CONCLUSION: After BC, there seems to be an important reordering of life values, with more emphasis on private life. This change is influenced by clinical determinants, but also by work-related and psychosocial factors. IMPLICATIONS FOR CANCER SURVIVORS: Stakeholders should consider this change in a patient's outlook on work-life as much as the classical physical late effects when designing post-BC programs to support RTW.
BACKGROUND: Return to work (RTW) after cancer can be modulated by psychosocial factors, including a reordering of one's life values, with more emphasis on private life than work-life. This change in patients' outlook on work-life is however poorly understood. METHODS: We used data from a French cohort (CANTO, NCT01993498) of women diagnosed with stage I-III primary breast cancer (BC) prospectively assessing life priorities between work and private life at diagnosis and 2 years after diagnosis. We identified women who reported a shift in life values toward private life, and we investigated the clinical, demographic, work-related, and psychosocial determinants of this change using logistic regressions. RESULTS: Overall, 46% (N = 1097) of the women had reordered their life priorities toward private life 2 years after diagnosis. The factors positively associated with this shift included being diagnosed with stage III BC, perceiving one's job as not very interesting, being an employee/clerk (vs. executive occupation), perceiving no support from the supervisor at baseline, perceiving negative interferences of cancer in daily life, and perceiving a positive impact from experiencing cancer. Depressive symptoms were negatively associated with this shift. CONCLUSION: After BC, there seems to be an important reordering of life values, with more emphasis on private life. This change is influenced by clinical determinants, but also by work-related and psychosocial factors. IMPLICATIONS FOR CANCER SURVIVORS: Stakeholders should consider this change in a patient's outlook on work-life as much as the classical physical late effects when designing post-BC programs to support RTW.
Authors: Li Wang; Brian Y Hong; Sean A Kennedy; Yaping Chang; Chris J Hong; Samantha Craigie; Henry Y Kwon; Beatriz Romerosa; Rachel J Couban; Susan Reid; James S Khan; Michael McGillion; Victoria Blinder; Jason W Busse Journal: J Clin Oncol Date: 2018-05-14 Impact factor: 44.544