Impact of Perceived Cognitive Impairment on Work-Related Outcomes in Breast Cancer Survivors

Significance: Work is central for most adults in the United States, including women with breast cancer. More than 90% of breast cancer survivors (BCS) in the United States return to work following cancer treatment. Returning to work has been found to provide meaning and purpose in life and has been linked to overall sense of well-being for BCS. However, up to 30% of BCS report difficulty retuning to work due to lingering symptoms posttreatment. One symptom that has not received much attention in regard to work-related outcomes is perceived cognitive impairment. Current estimates suggest that anywhere from 30% to 75% of BCS report concerns with cognitive impairment after treatment.

Purpose: The purpose of this study was to examine the impact of perceived cognitive impairment on work-related outcomes, including work ability, work performance, and intent to turn over controlling for BCS characteristics (age, education, and time posttreatment), and emotional work demands.

Methods and Analysis: The cancer and work model by Feuerstein et al guided this cross-sectional, descriptive study. BCS who were employed and at least 1 year postadjuvant treatment completed questionnaires assessing perceived cognitive impairment (Functional Assessment of Cancer Therapy – Cognitive Subscale), emotional work demands (Self-Focused Emotional Labor Scale), work ability (Work Ability Index), work productivity (Work Limitations Questionnaire), and intent to turn over. Descriptive statistics and general linear regression were used.

Findings and Interpretation: 68 female BCS, ranging from 29 to 68 years of age (M = 52.1; SD = 8.6) and an average of 4.97 (SD = 3.36) years posttreatment, participated. Over one-fourth (26.5%) of BCS reported poor to moderate perceived work ability, indicating substantial concerns regarding work performance. Cognitive impairment predicted work ability (P <.000) and work productivity (P <.000), but not intent to turn over.

Discussion and Implications: Findings from this study improve our understanding regarding the impact of perceived cognitive impairment on work-related outcomes in BCS. Cognitive impairment is a common symptom reported by BCS. The growing set of options for treating breast cancer means that clinicians and patients will need to consider how best to balance the goals of treatment and risks to work once treatment is complete.

Innovation: This is one of the first studies to examine the impact of perceived cognitive impairment on work-related outcomes in BCS.

Note: This abstract was presented at the ONS 2017 Annual Conference as a podium presentation. Institutions involved are Indiana University and Indiana University Health North Hospital. This study was supported by a grant from the Walther Cancer Institute.