Resignation and return to work in patients receiving allogeneic hematopoietic cell transplantation close up

• Published in: Journal of cancer survivorship 2022-10, Vol.16 (5), p.1004-1015
• Main Authors: Kurosawa, Saiko, Yamaguchi, Takuhiro, Mori, Ayako, Matsuura, Tomoko, Mori, Takehiko, Tanaka, Masatsugu, Kondo, Tadakazu, Umemoto, Yukari, Goto, Hideki, Yoshioka, Satoshi, Machida, Shinichiro, Sato, Takahiko, Katayama, Yuta, Kato, Seiko, Shono, Katsuhiro, Mizuno, Ishikazu, Fujiwara, Shin-ichiro, Kohno, Akio, Takahashi, Miyako, Fukuda, Takahiro
• Format: Article
• Language: English
• Subjects: Diagnosis; Employment; Health Informatics; Health Promotion and Disease Prevention; Medicine; Medicine & Public Health; Occupational health; Oncology; Patients; Primary Care Medicine; Public Health; Quality of Life Research; Questionnaires; Resignations; Stem cell transplantation; Surveys; Survival; Transplantation
• ISSN: 1932-2259; 1932-2267
• DOI: 10.1007/s11764-021-01092-w

Purpose To characterize the issues regarding work and employment specific to allogeneic hematopoietic cell transplantation (allo-HCT) survivors, we conducted a nationwide cross-sectional questionnaire survey. Methods We targeted allo-HCT survivors employed at diagnosis, aged 20–64 at survey, and survived ≥2 years without relapse. The questionnaire included the timing of and reasons for resignation (termination of employment contract), and patient-related, HCT-related, work-related, and HCT center-related factors. Results A total of 1048 eligible participants were included in the analysis (response rate, 60%). The median time after allo-HCT was 5 years (range, 2–30) at the time of survey. After diagnosis, 41% of participants resigned from work throughout the course of treatment. The most frequent timing of the first resignation was “after discharge post-HCT” (46%), followed by “from diagnosis to initial treatment” (27%). Factors significantly associated with resignation included female gender, older age, and part-time employment. Favorable factors included the presence of occupational health staff at the workplace, employment of ≥10 years, and self-employed/freelance. After resignation, the overall incidence of return to work with some accommodations was 76% at 5 years after HCT, but it was 52% without any accommodation. Conclusions Overall, the rate of resignation was 41%, and the most frequent timing of resignation was after discharge post-HCT, accounting for approximately half of the resignations (46%). Workplace accommodations increased the rate of return to work from 52% to 76%. Implications for Cancer survivors Early detection of employment-related concerns and support throughout the treatment process are necessary for patients receiving allo-HCT.