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Modelling CRC patients likelihood of returning to work

Mon, 02/17/2020 - 14:56
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Evidence‐based prediction models for recovery after colorectal cancer treatment in the Netherlands has helped to guide patients - early in colorectal cancer treatment - about the likelihood of returning to work, and to identify and modify barriers that could facilitate this, report researchers from the VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.

The increase in prevalence of colorectal cancer among young patients coupled means that more patients are being diagnosed with colorectal cancer while still at work. The aim of the study, ‘Predicting return to work among patients with colorectal cancer’, published BJS Open, was to develop prediction models for return to work by one and two years after the start of sick leave.

The researchers used retrospective registry‐based cohort study from a nationwide occupational health service in the Netherlands. The study only included employed patients with colonic or rectal cancer treated with curative intent.

Outcomes

In total, 317 patients (175 patients with colonic and 142 with rectal cancer) were included in the research and their median time to return to ‘full‐time and sustainable work’ was 423 (range 379 -467) days, 223 patients (70.3 per cent) returning to work fully within two years. Predictors of not returning to work in the one‐year model included presence of metastases, adjuvant treatment, stoma, emotional distress and postoperative complications. Compared with presence of metastases, emotional distress, postoperative complications, company size and the trajectory of the return‐to‐work process were predictors of not returning to work in the two‐year model.

“An evidence‐based guideline for recovery after colorectal cancer treatment in the Netherlands has been developed. Potential benefits and harms of the use of the screening tools in this study population need to be evaluated by others in future studies and external validation of these models performed,” the authors concluded. “These studies should also include relevant occupational factors and patients' own expectations regarding ability to work. It would also be useful to develop separate models for colonic and rectal cancer to reflect the different characteristics and treatment options for tumours at each site.”

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