Impact of work-related changes on health-related quality of life in adolescent and young adult cancer survivors

Abstract

Adolescent and young adult (AYA) cancer survivors often face unique work-related challenges and poor health-related quality of life (HRQOL). This study aimed to (1) assess work-related changes after cancer diagnosis in AYA cancer survivors and (2) explore the association between work-related changes and HRQOL. In a cross-sectional web-based survey, AYA cancer survivors were assessed for work-related changes after cancer diagnosis and their HRQOL using the EuroQoL 5-Dimension 5-Level scale (EQ-5D-5L). The percentage of AYA cancer survivors who had experienced work-related changes was calculated. Multiple regression analysis was used to examine the association between EQ-5D-5L scores and work-related changes, demographics, and clinical variables. The participants were 206 AYA cancer survivors (180 women) with a mean age of 33.7 years (SD 4.3, range: 22–39 years). Among them, 115 (56%) had experienced work-related changes, including 53 (25.7%) who had quit their jobs after their cancer diagnosis. The EQ-5D-5L score (mean: 0.79) was lower in the AYA cancer survivors than in the general population. Moreover, AYA cancer survivors who experienced work-related changes had significantly lower EQ-5D-5L scores compared with AYA cancer survivors who did not (0.75 vs 0.84, P < .001). Multiple regression analyses indicated that lower income, reduced working hours, and lower performance status, as measured by the Eastern Cooperative Oncology Group Scale, were associated with lower EQ-5D-5L scores. More than half of the AYA cancer survivors reported work-related changes and had lower HRQOL. Identifying potential interventions supporting AYA cancer survivors with low physical and financial status may be useful for improving their HRQOL.