Work Outcomes of Colon and Rectal Cancer Survivors

描述(申请人提供)：结肠癌和直肠癌幸存者面临着独特的挑战，这些挑战可能会影响他们在完成治疗后的工作能力。然而，这些挑战还没有被研究过。这项研究的目的是根据症状、功能状态和工作环境因素的影响来表征结肠癌和直肠癌幸存者的工作结果。将被评估的主要假设是：对于结肠癌或直肠癌幸存者，医疗和人口因素、症状、功能状况和工作环境因素将与工作结果相关。一个探索性假设是：与结肠癌幸存者相比，直肠癌幸存者的症状数量和严重程度越高，功能状态越差，工作结果就越差(控制了工作环境因素以及人口和医疗因素)。研究方法将是以人口为基础的邮寄调查。宾夕法尼亚州癌症登记处将抽取664名在世幸存者(一半患有结肠癌，一半患有直肠癌)作为样本。非洲裔美国人将被过度抽样，占最终样本的15%，以确保种族可以作为协变量进行评估。最终样本将包括300份已完成的调查。感兴趣的主要因变量是调查时的工作结果。符合资格的人士将包括：1)于同一历年确诊并已完成初步治疗(手术、新辅助化疗及/或辅助化疗及/或放射治疗)的非转移性结肠癌或直肠癌(局部或区域性疾病)的幸存者；2)癌症诊断时已受雇从事有偿工作的人士；3)自报在临床上没有癌症的人士；4)年龄在25至70岁之间；5)阅读及听懂英语；及6)没有视力或听力受损而影响调查或访问的完成。如果个人在癌症诊断时没有受雇于有偿工作，或者目前正在接受转移性疾病或姑息治疗，那么他们将被排除在外。对于假设1，将分别对每个诊断和每个工作结果进行多元回归分析：工作状态、工作强度、重返工作的时间和对工作的满意度。将评估医疗和人口统计因素、症状、功能状态和工作情况变量与工作结果的关联。为了检验探索性假设2，将比较两种回归模型以评估结肠癌和直肠癌幸存者的不同结果。这项研究有可能找出工作成果不佳的可修改风险因素。这些发现将有助于确定未来干预试验的目标。 公共卫生相关性：随着诊断和治疗的进步，结肠癌和直肠癌(CRC)幸存者可以关注包括工作在内的生活质量问题，而不是只关注诊断、治疗和预后。目前还不清楚CRC的诊断和治疗在多大程度上影响工作成果。有必要进行研究，以了解症状、功能状态和工作环境因素如何影响工作结果，以便确定可修改的因素，并制定促进过渡回工作场所的干预措施。

DESCRIPTION (provided by applicant): Colon and rectal cancer survivors face unique challenges that could influence their ability to work after completion of treatment. However, these challenges have not been studied. The aim of this research is to characterize work outcomes for colon and rectal cancer survivors with regard to the influence of symptoms, functional status, and work situational factors. The main hypothesis that will be evaluated is: for colon or rectal cancer survivors, medical and demographic factors, symptoms, functional status and work situational factors will be associated with work outcomes. An exploratory hypothesis is: compared with colon cancer survivors, a higher number and severity of symptoms and poorer functional status will be associated with poorer work outcomes for rectal cancer survivors (controlling for work situation factors and demographic and medical factors). The research method will be a population-based mailed survey. The Pennsylvania Cancer Registry will draw a sample of 664 living survivors (half with colon and half with rectal cancer). African Americans will be oversampled to comprise 15% of the final sample to ensure that race can be evaluated as a covariate. The final sample will consist of 300 completed surveys. The primary dependent variable of interest is work outcomes at the time of the survey. Eligible individuals will include: 1) survivors of non-metastatic colon or rectal cancer (local or regional disease) who were diagnosed in the same calendar year and have completed primary treatment (surgery, neo-adjuvant and/or adjuvant chemotherapy, and/or radiotherapy) by the time of the survey; 2) were employed in a paid job at the time of cancer diagnosis; 3) self-reported that they are clinically free of cancer; 4) are between the ages of 25 and 70 years of age; 5) read and understand English; and 6) have no visual or hearing impairment that would interfere with the completion of the survey or interview. Individuals will be excluded if they were not employed in a paid job at the time of cancer diagnosis or are currently undergoing therapy for metastatic disease or palliative intent. For hypothesis 1, multiple regression analysis will be performed separately for each diagnosis and each work outcome: work status, work intensity, time to return to work, and satisfaction with work. Medical and demographic factors, symptoms, functional status, and work situation variables will be evaluated for association with work outcomes. To test exploratory hypothesis 2, two regression models will be compared to evaluate differential outcomes for colon and rectal cancer survivors. This research has the potential to identify modifiable risk factors for poor work outcomes. The findings will aid in identifying targets for future intervention trials. PUBLIC HEALTH RELEVANCE: With advances in diagnosis and treatment, colon and rectal cancer (CRC) survivors can concern themselves with quality of life issues, including work, instead of focusing exclusively on diagnosis, treatment, and prognosis. It is not well-known to what extent CRC diagnosis and treatment affects work outcomes. Research is warranted to understand how symptoms, functional status, and work situation factors influence work outcomes so that modifiable factors can be identified and interventions to facilitate the transition back to the workplace can be developed.