Work-related outcomes among cancer survivors in Singapore

Background Cancer survivors have been reported to face challenges as they return to work after completing antineoplastic treatment. In order to understand the burden of return-to-work challenges among cancer survivors in Singapore, we aim to describe the work-related outcomes, including employment rates, absenteeism and presenteeism, among local cancer survivors. Methods This was a cross-sectional study conducted at the National Cancer Centre Singapore in 2018. Breast cancer, colorectal cancer and lymphoma survivors who were in disease remission and have completed treatment for at least 6 months were recruited. Employment history and absenteeism data in the past 6 months were collected using self-administered questionnaires. Presenteeism was self-reported using the Work Limitations Questionnaire. Results A total of 501 patients were recruited. Most participants were Chinese (79.6%), followed by Malay (11.8%), Indian (4.6%) and other ethnicities (4.0%). Over half were breast cancer survivors (69.5%), followed by colorectal cancer (15.5%) and lymphoma (15.0%) survivors. The median age of the participants was 55.7 years (IQR: 50.1 to 60.5 years) while the median time after primary treatment completion was 3.7 years (IQR: 1.9 to 6.1 years). The majority of cancer survivors were employed with most participants reporting working full-time (47.5%), followed by part-time workers (10.2%) and self-employed individuals (5.8%). Out of the survivors who did not have paid employment, a substantial proportion (24.3%) were unemployed due to health-related reasons. Among employed participants, 56.9% reported taking time off work due to ill health or to see a physician in the past 6 months. The median absenteeism rate reported among working survivors was 0.8% of working time (range: 0 to 73.1%) while the median presenteeism or productivity loss at work due to health-related problems was reported to be 1.2% (range: 0 to 20.3%). Conclusions A significant proportion of cancer survivors in Singapore require time off from work or leave employment due to health-related issues. Further studies should be conducted to identify survivors who are at high risk for return-to-work challenges and should be offered occupational rehabilitation. Legal entity responsible for the study The authors. Funding Singapore Cancer Society. Disclosure All authors have declared no conflicts of interest.