Ito H, Hozawa A., Yamashita H., Kubota I., Nemoto K., Yoshioka T., Kayama T. & Murakami M., 2015, Employment status among non-retired cancer survivors in Japan, European Journal of Cancer Care, 24 (5): 718-23, doi: 10.1111/ecc.12304.
要旨
Employed cancer patients confront some challenges as they attempt to return to work after treatment. We aimed to identify correlates of return to work for cancer survivors in Japan, with an emphasis on employment status. Participants were 260 patients (aged <65years) who had received a cancer diagnosis 1year previously and who were employed at the time of diagnosis. Participants completed questionnaires at consultations at any Regional Cancer Center Hospitals in Yamagata, Japan between 28 November 2011 and 9 December 2011. Logistic regression analysis was used to identify correlates of return to work. Data cross-tabulation was used to evaluate relationships to workplace and income-changes by employment status. A high proportion of patients (75.8%) had returned to work. Non-regularly employed survivors were less likely to return to work (odds ratio=5.03; 95% confidence interval, 1.18-21.35). Individuals with poor health, advanced-stage tumours, of advanced age and women were significantly less likely to return to work. Only 52.8% of non-regular employees continued to be employed, and their income decreased by as much as 61.1%. Social and financial support policies should be organised based on more intensive study of employment circumstances.
冒頭抜粋
Employed cancer patients confront some severe challenges as they recover from treatment and attempt to return to the workplace. Many cancer survivors are able to return to work (Gudbergsson et al. 2007; Taskila & Lindbohm 2007; Mehnert 2011), but are likely to encounter significant difficulties as a result of reduced working hours, fatigue and exhaustion (Bradley & Bednarek 2002; Ahn et al. 2008; Bieri et al. 2008; de Boer et al. 2008; Hansen et al. 2008; Ohguri et al. 2009). Some workers, especially those with a lower level of education and a lower income, become unemployed while coping with cancer (Bednarek & Bradley 2005; Drolet et al. 2005; Choi et al. 2007). Changes in work may have a considerable negative impact on self-esteem, quality of life and social or family roles (Peteet 2000; Gudbergsson et al. 2007, 2008a,b).
Medical expenses impose an excessive burden on patients. After public and private insurance pay, approximately 600 000 yen (EUR 4080), the average co-payment for cancer therapy is approximately 400 000 yen (EUR 2720; Koinuma 2011). In 2012, the need for national measures to improve the employment status of cancer survivors was recently discussed in the ‘Basic Plan to Promote Cancer Control Programs’ (Ministry of Health, Labour & Welfare 2012).
The effect of cancer and cancer treatment on work has been studied only infrequently in Japan. The 2004 ‘Report on Troubles and Burdens of Cancer Survivors’ (Ministry of Health, Labour and Welfare) reported that 30.5% of employed people voluntarily resigned, and 4.2% of them were discharged, after a cancer diagnosis (Yamaguchi 2004). The report did not consider demographic, clinical and employment characteristics as factors that affect return to work. The lifetime employment and seniority-based wages characterising the ‘Japanese style of management’ have eroded (Abegglen 2006). The numbers of low-wage and unstable non-regular employees are increasing (38.2% in 2012, compared with 21.7% in 1992; Ministry of Health, Labour & Welfare 2013). Work impairment may be one of the most burdensome consequences of cancer.
Using multivariate analyses and subsidiary analyses, we studied several different factors to identify correlates associated with return to work for cancer survivors. The purpose of this research was to examine the effect of demographic, clinical and employment characteristics on return to work for newly diagnosed cancer patients in Japan, with a particular emphasis on non-regular employees……