Long-term workforce participation patterns following head and neck cancer

Purpose: This analysis describes the long-term workforce participation patterns of individuals diagnosed with head and neck cancer (HNC). Methods: Survivors of HNC (ICD10 C00-C14, C32) diagnosed at least 8 months previously were identified from the National Cancer Registry Ireland and sent a survey including questions about working arrangements before and since diagnosis. Descriptive statistics and multivariate logistic regression were used to examine the factors that influence workforce participation at 0, 1 and 5 years after diagnosis. Results: Two hundred sixty-four individuals employed at the time of diagnosis responded to the survey, an average 6 years post-diagnosis. Seventy-seven percent took time off work after diagnosis, with a mean work absence of 9 months (range 0–65 months). Fifty-two percent of participants reduced their working hours (mean reduction 15 h/week). The odds of workforce participation following HNC were increased by not being eligible for free medical care (OR 2.61, 95 % CI 1.15–5.94), having lip, mouth or salivary gland cancer (compared to cancer of the pharynx or cancer of the larynx, OR 2.79, 1.20–6.46), being self-employed (OR 2.01, 1.07–3.80), having private health insurance (OR 2.06, 1.11–3.85) and not receiving chemotherapy (OR 2.82, 1.31–6.06). After 5 years, only the effect of medical card remained (i.e., medical insurance) (OR 4.03, 1.69–9.62). Conclusions: Workforce participation patterns after HNC are complex and are influenced by cancer, treatment and employment factors. Implications for Cancer Survivors: Patients should be informed of the potential impacts of HNC on workforce participation, and clinicians, policy makers and employers should be aware of these potential longer-term effects and related variables.