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Purpose: To investigate the effects of clinical, sociodemographic, and occupational factors on time to return to work (RTW) during the 2 years after cancer diagnosis and to analyze whether sex differences exist., Patients and Methods: This study was based on a French national cross-sectional survey involving 4,270 cancer survivors. Time to RTW was estimated through the duration of sick leave of 801 cancer survivors younger than 58 years who were employed during the 2-year survey. Multivariate analysis of the RTW after sick leave was performed using a Weibull accelerated failure time model., Results: We found some sex differences in the RTW process. Older men returned to work more slowly than older women (P = .013), whereas married men returned to work much faster than married women (P = .019). Duration dependence was also sex-specific. In men, the time spent on sick leave was independent of the probability of returning to work, whereas in women, this duration dependence was positive (P < .001). For both men and women, clinical factors including chemotherapy, adverse effects, and cancer severity were found to delay RTW (P = .035, P = .001, and P < .001, respectively). Survivors investing most strongly in their personal lives also delayed their RTW (P = .006), as did those with a permanent work contract (P = .042). The factor found to accelerate RTW was a higher educational level (P = .014)., Conclusion: The RTW process 2 years after cancer diagnosis differed between men and women. A better knowledge of this process should help the national implementation of more cost-effective strategies for managing the RTW of cancer survivors.

The aim of this study was to describe 2 years cancer survivors' perception of the cancer risk running in their family, and to describe how frequently these survivors recommended cancer screening to their relatives. A national cross-sectional survey was launched by the French Ministry of Health to investigate the living conditions of adult cancer patients 2 years after cancer diagnosis. Among the 13,923 patients identified, 6,957 were eligible to participate in this study and 4460 (64.1%) answered the questionnaire administered by telephone. One participant out of every two (50.8%) reported that they thought their relatives' risk of cancer was greater than that of the relatives of unaffected persons. Higher percentages were recorded among breast and colorectal cancer patients (65 and 65.1%, respectively), and lower percentages among those with lung and hematological cancer (34.9 and 28.4%, respectively). Overall, 61.1% of the participants had already advised relatives to undergo cancer screening and 10.4% planned to do so. Eighty-one percent of the participants with breast cancer and 76.3% of those with colorectal cancer said they had advised relatives to undergo screening. Lower percentages were obtained among patients with urinary tract (41.7%) and hematological malignancies (27.1%). Although patients' perceptions tend to fit the latest data on the frequency of cancer germline mutations, physicians should help their patients to convey more accurate advice to their families. If survivors were better informed, they could play a critical role by conveying relevant and sound risk reduction messages to their relatives.

We investigated whether health-related quality of life (HRQL) depends on cancer type, after adjustment for demographic and medical variables. A French national population-based survey was conducted between November and December 2004 to assess surviving cancer patients' HRQL 2 years after diagnosis. HRQL was measured by the 36-Item Short Form Survey scale. The sample included 3900 persons. All cancer diagnoses were entered in the study. We demonstrated that medical and treatment variables have an impact on patients' physical HRQL but not on mental HRQL. Cancer type impacted on physical HRQL, with those suffering from upper aerodigestive tract /lung cancers and haematological malignancies being affected to a greater degree. Disturbing side effects impacted both HRQL domains. Socio-demographic variables had statistically significant effects but not clinically meaningful ones. Socio-economic variables led to potentially clinically meaningful differences for cancer patients' HRQL and represented a socio-economic gradient in HRQL among cancer survivors. From our results, we may assert that cancer survivors, 2 years after cancer diagnosis, share a similar pattern of psychological morbidity, independent of cancer type. Patients disproportionately affected by cancer, such as those with lower educational levels and income, need to be identified and targeted and interventions which address their unique needs and concerns need to be developed., (© 2010 Blackwell Publishing Ltd.)

Objective: To describe patients who reported treatment-induced infertility 2 years after cancer diagnosis and to highlight what factors are related to the patients' lack of information on this topic before starting therapy., Design: Cross-sectional study by telephone interview., Setting: Representative French national sample of survivors 2 years after cancer diagnosis., Patient(s): 282 women (<45 years) and 1137 men (<71 years)., Intervention(s): None., Main Outcome Measure(s): Self-reported treatment-induced infertility, and what information was provided on this issue before starting treatment, including information on systematic sperm cryopreservation., Result(s): Among the participants, 104 women (37%) and 346 men (30%) reported having treatment-induced infertility. Among them, 31 women (30%) and 45 men (13%) reported that they had not been informed about the risk of infertility before they started treatment. Logistic regressions showed that a lack of information was associated with older age and treatment without hormone therapy among women and older age, cancers other than prostate, and a lack of participation in treatment decision-making among men., Conclusion(s): Information about infertility risks and preservation methods should be provided more systematically to all treated patients, irrespective of their age.