Employment Status of Patients With Colorectal Cancer After Surgery: A Multicenter Prospective Cohort Study in Japan

BACKGROUND: Due to improved survival rates, colorectal cancer patients may try to return to work. Many countries, however, have limited knowledge of their employment status. OBJECTIVE: To explore the employment status of colorectal cancer patients after surgery in Japan and the risk factors affecting the same. DESIGN: This is a prospective multicenter cohort study that uses self-administered questionnaires. Patients were recruited from June 2019 to August 2020 and were followed up for 12 months after surgery. SETTING: Six community hospitals and one university hospital in Japan. PATIENTS: Patients with clinical stages I–III colorectal cancer, employed at the time of diagnosis. INTERVENTIONS: Patients who received surgical resection from June 2019 to August 2020. MAIN OUTCOME MEASUREMENTS: The time it takes patients to return to work after surgery and the proportion of working patients 12 months after surgery were collected using self-administered questionnaires. RESULTS: A total of 129 patients were included in the analyses. The median time to return to work was 1.1 months, and the proportion of working patients at 12 months after surgery was 79%. Risk factors for delayed return-to-work after surgery were an advanced tumor stage, stoma, severe postoperative complications, shorter years of service at the workplace, and lower willingness to return to work. Risk factors for not working 12 months after surgery were stoma, lower willingness to return to work, non-regular employee status, lower income, national health insurance, and no private medical insurance. LIMITATIONS: This study is limited by its short-term follow-up and small sample size. CONCLUSIONS: This study revealed that Japanese patients with stages I–III colorectal cancer found favorable employment outcomes in the 12 months following surgery. These results may help healthcare providers better understand the employment status of colorectal cancer patients and encourage them to consider returning to work after surgery.