Colon and rectal cancer survivors face unique challenges that could influence their ability to work after completion of treatment. However, these challenges have not been studied.
The aim of this research is to characterize work outcomes for colon and rectal cancer survivors with regard to the influence of symptoms, functional status, and work situational factors. The main hypothesis that will be evaluated is: for colon or rectal cancer survivors, medical and demographic factors, symptoms, functional status and work situational factors will be associated with work outcomes. An exploratory hypothesis is: compared with colon cancer survivors, a higher number and severity of symptoms and poorer functional status will be associated with poorer work outcomes for rectal cancer survivors (controlling for work situation factors and demographic and medical factors). The research method will be a population-based mailed survey. The Pennsylvania Cancer Registry will draw a sample of 664 living survivors (half with colon and half with rectal cancer). African Americans will be oversampled to comprise 15% of the final sample to ensure that race can be evaluated as a covariate. The final sample will consist of 300 completed surveys. The primary dependent variable of interest is work outcomes at the time of the survey. Eligible individuals will include: 1) survivors of non-metastatic colon or rectal cancer (local or regional disease) who were diagnosed in the same calendar year and have completed primary treatment (surgery, neo-adjuvant and/or adjuvant chemotherapy, and/or radiotherapy) by the time of the survey;2) were employed in a paid job at the time of cancer diagnosis;3) self-reported that they are clinically free of cancer;4) are between the ages of 25 and 70 years of age;5) read and understand English;and 6) have no visual or hearing impairment that would interfere with the completion of the survey or interview. Individuals will be excluded if they were not employed in a paid job at the time of cancer diagnosis or are currently undergoing therapy for metastatic disease or palliative intent. For hypothesis 1, multiple regression analysis will be performed separately for each diagnosis and each work outcome: work status, work intensity, time to return to work, and satisfaction with work. Medical and demographic factors, symptoms, functional status, and work situation variables will be evaluated for association with work outcomes. To test exploratory hypothesis 2, two regression models will be compared to evaluate differential outcomes for colon and rectal cancer survivors. This research has the potential to identify modifiable risk factors for poor work outcomes. The findings will aid in identifying targets for future intervention trials.

Public Health Relevance

With advances in diagnosis and treatment, colon and rectal cancer (CRC) survivors can concern themselves with quality of life issues, including work, instead of focusing exclusively on diagnosis, treatment, and prognosis. It is not well-known to what extent CRC diagnosis and treatment affects work outcomes. Research is warranted to understand how symptoms, functional status, and work situation factors influence work outcomes so that modifiable factors can be identified and interventions to facilitate the transition back to the workplace can be developed.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Exploratory/Developmental Grants (R21)
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Nursing and Related Clinical Sciences Study Section (NRCS)
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Marden, Susan F
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Fox Chase Cancer Center
United States
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