Survivorship, Version 1.2021

Featured Updates to the NCCN Guidelines

Authors:
Amye Tevaarwerk University of Wisconsin Carbone Cancer Center;

Search for other papers by Amye Tevaarwerk in
Current site
Google Scholar
PubMed Close
 MD
,
Crystal S. Denlinger Fox Chase Cancer Center;

Search for other papers by Crystal S. Denlinger in
Current site
Google Scholar
PubMed Close
 MD
,
Tara Sanft Yale Cancer Center/Smilow Cancer Hospital;

Search for other papers by Tara Sanft in
Current site
Google Scholar
PubMed Close
 MD
,
Shannon M. Ansbaugh Patient Advocate;

Search for other papers by Shannon M. Ansbaugh in
Current site
Google Scholar
PubMed Close
,
Saro Armenian City of Hope National Medical Center;

Search for other papers by Saro Armenian in
Current site
Google Scholar
PubMed Close
 DO, MPH
,
K. Scott Baker Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

Search for other papers by K. Scott Baker in
Current site
Google Scholar
PubMed Close
 MD, MS
,
Gregory Broderick Mayo Clinic Cancer Center;

Search for other papers by Gregory Broderick in
Current site
Google Scholar
PubMed Close
 MD
,
Andrew Day UT Southwestern Simmons Comprehensive Cancer Center;

Search for other papers by Andrew Day in
Current site
Google Scholar
PubMed Close
 MD, MPH
,
Wendy Demark-Wahnefried O’Neal Comprehensive Cancer Center at UAB;

Search for other papers by Wendy Demark-Wahnefried in
Current site
Google Scholar
PubMed Close
 PhD, RD
,
Kristin Dickinson Fred & Pamela Buffett Cancer Center;

Search for other papers by Kristin Dickinson in
Current site
Google Scholar
PubMed Close
 PhD, RN
,
Debra L. Friedman Vanderbilt-Ingram Cancer Center;

Search for other papers by Debra L. Friedman in
Current site
Google Scholar
PubMed Close
 MD, MS
,
Patricia Ganz UCLA Jonsson Comprehensive Cancer Center;

Search for other papers by Patricia Ganz in
Current site
Google Scholar
PubMed Close
 MD
,
Mindy Goldman UCSF Helen Diller Family Comprehensive Cancer Center;

Search for other papers by Mindy Goldman in
Current site
Google Scholar
PubMed Close
 MD
,
Norah Lynn Henry University of Michigan Rogel Cancer Center;

Search for other papers by Norah Lynn Henry in
Current site
Google Scholar
PubMed Close
 MD, PhD
,
Christine Hill-Kayser Abramson Cancer Center at the University of Pennsylvania;

Search for other papers by Christine Hill-Kayser in
Current site
Google Scholar
PubMed Close
 MD
,
Melissa Hudson St. Jude Children's Research Hospital/The University of Tennessee Health Science Center;

Search for other papers by Melissa Hudson in
Current site
Google Scholar
PubMed Close
 MD
,
Nazanin Khakpour Moffitt Cancer Center;

Search for other papers by Nazanin Khakpour in
Current site
Google Scholar
PubMed Close
 MD
,
Divya Koura UC San Diego Moores Cancer Center;

Search for other papers by Divya Koura in
Current site
Google Scholar
PubMed Close
 MD
,
Allison L. McDonough Massachusetts General Hospital Cancer Center;

Search for other papers by Allison L. McDonough in
Current site
Google Scholar
PubMed Close
 MD
,
Michelle Melisko UCSF Helen Diller Family Comprehensive Cancer Center;

Search for other papers by Michelle Melisko in
Current site
Google Scholar
PubMed Close
 MD
,
Kathi Mooney Huntsman Cancer Institute at the University of Utah;

Search for other papers by Kathi Mooney in
Current site
Google Scholar
PubMed Close
 RN, PhD
,
Halle C.F. Moore Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute;

Search for other papers by Halle C.F. Moore in
Current site
Google Scholar
PubMed Close
 MD
,
Natalie Moryl Memorial Sloan Kettering Cancer Center;

Search for other papers by Natalie Moryl in
Current site
Google Scholar
PubMed Close
 MD
,
Javid J. Moslehi Vanderbilt-Ingram Cancer Center;

Search for other papers by Javid J. Moslehi in
Current site
Google Scholar
PubMed Close
 MD
,
Tracey O’Connor Roswell Park Comprehensive Cancer Center;

Search for other papers by Tracey O’Connor in
Current site
Google Scholar
PubMed Close
 MD
,
Linda Overholser University of Colorado Cancer Center;

Search for other papers by Linda Overholser in
Current site
Google Scholar
PubMed Close
 MD, MPH
,
Electra D. Paskett The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;

Search for other papers by Electra D. Paskett in
Current site
Google Scholar
PubMed Close
 PhD
,
Chirayu Patel Massachusetts General Hospital Cancer Center;

Search for other papers by Chirayu Patel in
Current site
Google Scholar
PubMed Close
 MD, MPH
,
Lindsay Peterson Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine;

Search for other papers by Lindsay Peterson in
Current site
Google Scholar
PubMed Close
 MD
,
William Pirl Dana-Farber/Brigham and Women's Cancer Center;

Search for other papers by William Pirl in
Current site
Google Scholar
PubMed Close
 MD
,
M. Alma Rodriguez The University of Texas MD Anderson Cancer Center;

Search for other papers by M. Alma Rodriguez in
Current site
Google Scholar
PubMed Close
 MD
,
Kathryn J. Ruddy Mayo Clinic Cancer Center;

Search for other papers by Kathryn J. Ruddy in
Current site
Google Scholar
PubMed Close
 MD, MPH
,
Lidia Schapira The University of Texas MD Anderson Cancer Center;

Search for other papers by Lidia Schapira in
Current site
Google Scholar
PubMed Close
 MD
,
Lillie Shockney The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;

Search for other papers by Lillie Shockney in
Current site
Google Scholar
PubMed Close
 RN, MAS
,
Sophia Smith Duke Cancer Institute;

Search for other papers by Sophia Smith in
Current site
Google Scholar
PubMed Close
 PhD, MSW
,
Karen L. Syrjala Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

Search for other papers by Karen L. Syrjala in
Current site
Google Scholar
PubMed Close
 PhD
,
Phyllis Zee Robert H. Lurie Comprehensive Cancer Center of Northwestern University; and

Search for other papers by Phyllis Zee in
Current site
Google Scholar
PubMed Close
 MD, PhD
,
Nicole R. McMillian National Comprehensive Cancer Network.

Search for other papers by Nicole R. McMillian in
Current site
Google Scholar
PubMed Close
 MS, CHES
, and
Deborah A. Freedman-Cass National Comprehensive Cancer Network.

Search for other papers by Deborah A. Freedman-Cass in
Current site
Google Scholar
PubMed Close
 PhD
Volume/Issue:
Volume 19: Issue 6
Online Publication Date:
30 Jun 2021
DOI:
https://doi.org/10.6004/jnccn.2021.0028
Restricted access

The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor’s complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.

  • Collapse
  • Expand
Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
  • 1.

    Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “silver tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomarkers Prev 2016;25:1029–1036.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Centers for Disease Control and Prevention (CDC). Cancer survivors—United States, 2007. MMWR Morb Mortal Wkly Rep 2011;60:269–272.

  • 3.

    Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin 2019;69:363–385.

  • 4.

    DeSantis CE, Lin CC, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 2014;64:252–271.

  • 5.

    Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013;119(Suppl 11):2151–2159.

  • 6.

    Kent EE, Forsythe LP, Yabroff KR, et al. Are survivors who report cancer-related financial problems more likely to forgo or delay medical care? Cancer 2013;119:3710–3717.

  • 7.

    Dusetzina SB, Keating NL. Mind the gap: why closing the doughnut hole is insufficient for increasing medicare beneficiary access to oral chemotherapy. J Clin Oncol 2016;34:375–380.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Nekhlyudov L, Madden J, Graves AJ, et al. Cost-related medication nonadherence and cost-saving strategies used by elderly Medicare cancer survivors. J Cancer Surviv 2011;5:395–404.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Sabatino SA, Coates RJ, Uhler RJ, et al. Health insurance coverage and cost barriers to needed medical care among U.S. adult cancer survivors age<65 years. Cancer 2006;106:2466–2475.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Keegan TH, Tao L, DeRouen MC, et al. Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers? J Cancer Surviv 2014;8:282–292.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    de Souza JA, Yap BJ, Wroblewski K, et al. Measuring financial toxicity as a clinically relevant patient-reported outcome: the validation of the COmprehensive Score for financial Toxicity (COST). Cancer 2017;123:476–484.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Moran JR, Short PF. Does cancer reduce labor market entry? Evidence for prime-age females. Med Care Res Rev 2014;71:224–242.

  • 13.

    Zajacova A, Dowd JB, Schoeni RF, et al. Employment and income losses among cancer survivors: estimates from a national longitudinal survey of American families. Cancer 2015;121:4425–4432.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Kim YA, Yun YH, Chang YJ, et al. Employment status and work-related difficulties in lung cancer survivors compared with the general population. Ann Surg 2014;259:569–575.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    de Boer AG, Taskila T, Ojajärvi A, et al. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA 2009;301:753–762.

  • 16.

    de Boer AG, Torp S, Popa A, et al. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv 2020;14:135–150.

  • 17.

    Dumas A, Vaz Luis I, Bovagnet T, et al. . Impact of breast cancer treatment on employment: results of a multicenter prospective cohort study (CANTO). J Clin Oncol 2020;38:734–743.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Duijts SF, van Egmond MP, Spelten E, et al. Physical and psychosocial problems in cancer survivors beyond return to work: a systematic review. Psychooncology 2014;23:481–492.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Moskowitz MC, Todd BL, Chen R, et al. Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors. J Cancer Surviv 2014;8:173–182.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Tevaarwerk AJ, Kwekkeboom K, Buhr KA, et al. Results from a prospective longitudinal survey of employment and work outcomes in newly diagnosed cancer patients during and after curative-intent chemotherapy: a Wisconsin Oncology Network study. Cancer 2021;127:801–808.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Hiltrop K, Heidkamp P, Halbach S, et al. Occupational rehabilitation of male breast cancer patients: return patterns, motives, experiences, and implications—a qualitative study [published online January 23, 2021] Eur J Cancer Care (Engl), doi: 10.1111/ecc.13402

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Employment Outcomes among Cancer Survivors. National Cancer Institute, Division of Cancer Control & Population Sciences. Accessed March 3, 2021. Available at: https://healthcaredelivery.cancer.gov/employment/

    • PubMed
    • Export Citation
  • 23.

    de Moor JS, Kent EE, McNeel TS, et al. Employment outcomes among cancer survivors in the United States: implications for cancer care delivery. J Natl Cancer Inst 2020;djaa084djaa084.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Siu AM, Hung A, Lam AY, et al. Work limitations, workplace concerns, and job satisfaction of persons with chronic disease. Work 2013;45:107–115.

  • 25.

    Duijts SF, Kieffer JM, van Muijen P, et al. Sustained employability and health-related quality of life in cancer survivors up to four years after diagnosis. Acta Oncol 2017;56:174–182.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    de Boer AG, Verbeek JH, Spelten ER, et al. Work ability and return-to-work in cancer patients. Br J Cancer 2008;98:1342–1347.

  • 27.

    Kamal KM, Covvey JR, Dashputre A, et al. A systematic review of the effect of cancer treatment on work productivity of patients and caregivers. J Manag Care Spec Pharm 2017;23:136–162.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Lerner D, Amick BC III, Lee JC, et al. Relationship of employee-reported work limitations to work productivity. Med Care 2003;41:649–659.

  • 29.

    Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 2011;77:109–130.

  • 30.

    Pearce A, Timmons A, O’Sullivan E, et al. Long-term workforce participation patterns following head and neck cancer. J Cancer Surviv 2015;9:30–39.

  • 31.

    Jagsi R, Hawley ST, Abrahamse P, et al. Impact of adjuvant chemotherapy on long-term employment of survivors of early-stage breast cancer. Cancer 2014;120:1854–1862.

  • 32.

    Verrill M, Wardley AM, Retzler J, et al. Health-related quality of life and work productivity in UK patients with HER2-positive breast cancer: a cross-sectional study evaluating the relationships between disease and treatment stage. Health Qual Life Outcomes 2020;18:353–364.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    de Moor JS, Dowling EC, Ekwueme DU, et al. Employment implications of informal cancer caregiving. J Cancer Surviv 2017;11:48–57.

  • 34.

    Longacre ML, Weber-Raley L, Kent EE. Cancer caregiving while employed: caregiving roles, employment adjustments, employer assistance, and preferences for support [published online December 20, 2019]. J Cancer Educ, doi: 10.1007/s13187-019-01674-4

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Mols F, Tomalin B, Pearce A, et al. Financial toxicity and employment status in cancer survivors. A systematic literature review. Support Care Cancer 2020;28:5693–5708.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    PDQ Adult Treatment Editorial Board. Financial Toxicity and Cancer Treatment (PDQ): Health Professional Version. Accessed April 26, 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK384502/

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Lentz R, Benson AB III, Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. J Surg Oncol 2019;120:85–92.

  • 38.

    Tevaarwerk AJ, Hocking WG, Buhr KA, et al. A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment. Cancer 2019;125:1000–1007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Tamminga SJ, Jansen LP, Frings-Dresen MHW, et al. Long-term employment status and quality of life after cancer: a longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis. Work 2020;66:901–907.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Wright P, Wilding S, Watson E, et al. Key factors associated with social distress after prostate cancer: results from the United Kingdom Life after Prostate Cancer diagnosis study. Cancer Epidemiol 2019;60:201–207.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Gallups SF, Connolly MC, Bender CM, et al. Predictors of adherence and treatment delays among African American women recommended to receive breast cancer chemotherapy. Womens Health Issues 2018;28:553–558.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    van Muijen P, Weevers NL, Snels IA, et al. Predictors of return to work and employment in cancer survivors: a systematic review. Eur J Cancer Care (Engl) 2013;22:144–160.

  • 43.

    Bradley CJ, Wilk A. Racial differences in quality of life and employment outcomes in insured women with breast cancer. J Cancer Surviv 2014;8:49–59.

  • 44.

    Earle CC, Chretien Y, Morris C, et al. Employment among survivors of lung cancer and colorectal cancer. J Clin Oncol 2010;28:1700–1705.

  • 45.

    Clarke TC, Christ SL, Soler-Vila H, et al. Working with cancer: health and employment among cancer survivors. Ann Epidemiol 2015;25: 832–838.

  • 46.

    Tevaarwerk AJ, Lee JW, Sesto ME, et al. Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study. J Cancer Surviv 2013;7:191–202.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Spencer JC, Rotter JS, Eberth JM, et al. Employment changes following breast cancer diagnosis: the effects of race and place. J Natl Cancer Inst 2020;112:647–650.

  • 48.

    Barnes AJ, Robert N, Bradley CJ. Job attributes, job satisfaction and the return to health after breast cancer diagnosis and treatment. Psychooncology 2014;23:158–164.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Stergiou-Kita M, Grigorovich A, Tseung V, et al. Qualitative meta-synthesis of survivors’ work experiences and the development of strategies to facilitate return to work. J Cancer Surviv 2014;8:657–670.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Tevaarwerk AJ, Lee JW, Terhaar A, et al. Working after a metastatic cancer diagnosis: factors affecting employment in the metastatic setting from ECOG-ACRIN’s Symptom Outcomes and Practice Patterns study. Cancer 2016;122:438–446.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Rotter J, Spencer JC, Wheeler SB. Financial toxicity in advanced and metastatic cancer: overburdened and underprepared. J Oncol Pract 2019;15:e300–307.

  • 52.

    de Boer AG, Taskila TK, Tamminga SJ, et al. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev 2015:CD007569.

  • 53.

    de Moor JS, Alfano CM, Kent EE, et al. Recommendations for research and practice to improve work outcomes among cancer survivors. J Natl Cancer Inst 2018;110:1041–1047.

  • 54.

    Lamore K, Dubois T, Rothe U, et al. Return to work interventions for cancer survivors: a systematic review and a methodological critique. Int J Environ Res Public Health 2019;16:1343–1363.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Butow P, Laidsaar-Powell R, Konings S, et al. Return to work after a cancer diagnosis: a meta-review of reviews and a meta-synthesis of recent qualitative studies. J Cancer Surviv 2020;14:114–134.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Hoving JL, Broekhuizen ML, Frings-Dresen MH. Return to work of breast cancer survivors: a systematic review of intervention studies. BMC Cancer 2009;9:117–126.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Kong YC, Rauf N, Subramaniam S, et al. Working after cancer: in-depth perspectives from a setting with limited employment protection policies [published online October 22, 2020]. J Cancer Surviv Surviv, doi: 10.1007/s11764-020-00962-z

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Alleaume C, Paraponaris A, Bendiane MK, et al. The positive effect of workplace accommodations on the continued employment of cancer survivors five years after diagnosis. Support Care Cancer 2020;28:4435–4443.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 59.

    Salit R, Lee S, Syrjala K. Facilitators of successful return to work in 1-5 year post-HCT survivors [abstract]. Transplant Cell Ther 2021;27:S378–379. Abstract 464.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 60.

    Rosenzweig M, West M, Matthews J, et al. . Financial toxicity among women with metastatic breast cancer. Oncol Nurs Forum 2019;46: 83–91.

Copyright:
Copyright © 2021 by the National Comprehensive Cancer Network 2021
Page Numbers:
10
Article Category:
Research Article
Print Publication Date:
01 Jun 2021
Online Publication Date:
30 Jun 2021

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 6281 1529 131
PDF Downloads 3172 569 52
EPUB Downloads 0 0 0