The number of cancer survivors continues to increase in the United States and around the world. Cancer survivors typically have a higher rate of unemployment as compared to their healthy counterparts. Additionally, survivors were 4 times more likely to be employed when they received employment related supports. While other reviews of this subject have been conducted, this review includes more recent research, focuses more squarely on psychosocial interventions more broadly, and expands the definition of employment outcomes to include additional interventions.
This systematic review focuses on examining interventions that facilitate cancer survivors' employment outcomes, including (a) employment status, (b) return to work, (c) absenteeism, and (d) time spent on work disability or sick leave. This review expands the scope of previous reviews to include additional employment outcome measures, across additional databases.
Interventions included in this review typically took place in medical settings.
Twelve studies met the criteria for inclusion in this review and included over 2000 participants who had been diagnosed with cancer. Participants were typically over the age of 50. Only four studies reported ethnicity of participants.
Data collection in all included studies was done through a hospital or clinic. Recruitment was typically through referrals or after a medical procedure.
The interventions, for included studies described in this review, included behavioral, psychological, educational, or vocational content that facilitated cancer survivors' employment outcomes.
There was no control group.
There were 20,249 records found after the initial search. After screening, 70 records remained to be evaluated in full-text. Of those 70, 58 records were excluded with reasons. This left 12 studies to be evaluated in the quantitative synthesis. Of the 10 studies that included measures of employment status, those that were randomized controlled trials (RCTs) showed no significant difference when examined alone. When combined with Quasi Experimental Designs (QEDs) the weighted mean effect size for employment status was OR= 2.18, p=.002. Two studies measured number of hours worked, and showed no significant results, OR = 0.89, p =.67. Four RCTs measured sick leave and results were nonsignificant OR = 1.18, p =.39.
The multicomponent nature of the interventions in this review make it difficult to pinpoint exactly "what works". Further exploration of employment outcomes in relevant research would allow for a more in-depth analysis of intervention effects. Additional RCTs would also strengthen the field.