Abstract B009: A qualitative assessment of challenges to return to work for colorectal cancer survivors: Multistakeholder perspectives
Authors: Gruß Inga , Hanson Ginger C. , McMullen Carmit , Ritzwoller Debra , Bradley Cathy , Hodge Stephanie , Varga Alexandra , Banegas Matthew P. 
Published: August 2020

Abstract
Purpose: Individuals diagnosed with colorectal cancer (CRC) may experience significant physical, psychological, and emotional effects that pose challenges to retuning to work (RTW). Given the importance on employment as a source of income and health insurance, interruptions to work may impact both financial and health outcomes. Understanding the multistakeholder perspectives, CRC survivors and their employers, may offer insights into factors and shared concerns associated with RTW following cancer, and lead to interventions that improve employment outcomes among survivors. This study assessed the challenges and needs that CRC survivors experience in maintaining or RTW, from both the survivor and employer perspectives.
Methods: CRC survivors (n=10) who were ages 18-70 at diagnosis, English-speaking, believed to be employed at diagnosis, and members of Kaiser Permanente Northwest (KPNW) were recruited from the Patient Outcomes Research to Advance Learning (PORTAL) CRC cohort. Employers (n=4) were recruited from the twenty most common employer organizations of KPNW PORTAL CRC cohort participants. Using qualitative methodology, we conducted 14 semistructured interviews with CRC survivors and employers. Interviews were transcribed and coded, then analyzed based on thematic analysis using NVivo 12 software.
Results: CRC survivors reported several challenges to RTW following diagnosis, including: Occupational/institutional—lack of knowledge among employers about CRC and recovery, limited availability of (paid) leave, limited availability of workplace accommodations; and Individual—limited ability to take necessary leave, need to relearn control over bodily functions. Employers perceived challenges, including: Occupational/institutional—limited institutional flexibility to provide individualized accommodations, matching organizational structures and the needs of employees, communication with frontline managers to inform them about leave availability for employees, and communication with employees about legal possibilities and limitations; and Individual—limited willingness of employees to take leave.
Conclusions: Our findings highlight both shared concerns and unique challenges that CRC survivors and employers perceive to be important for the RTW process following cancer diagnosis. Multilevel interventions that focus on both survivors and employers have the potential to facilitate the RTW process by addressing factors unique to each stakeholder that foster improved employment outcomes and mitigate the financial and health impact of CRC survivors.
Citation Format: Inga Gruß, Ginger C. Hanson, Carmit McMullen, Debra Ritzwoller, Cathy Bradley, Stephanie Hodge, Alexandra Varga, Matthew P. Banegas. A qualitative assessment of challenges to return to work for colorectal cancer survivors: Multistakeholder perspectives [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B009.