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Work- and insurance-related issues among Asian adolescent and young-adult cancer survivors: a qualitative study

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Abstract

Purpose

Work-related issues among Asian adolescent and young-adult (AYA) cancer survivors are poorly described in the literature. There has also been a paucity of reports regarding insurance-related concerns in this patient population. Focus groups were therefore carried out in Singapore to understand survivorship issues related to work and insurance coverage among Asian AYA cancer survivors.

Methods

Twenty-three AYA survivors and 18 healthcare professionals (HCPs) who care for AYA cancer patients were recruited for 11 focus group sessions. Thematic content analysis was carried out to identify major themes that emerged.

Results

Similar themes emerged from AYA and HCP focus groups. The majority of AYA survivors were eager to return to work post-treatment. However, some survivors were worried about not keeping up with expectations and struggled with disclosure of their medical history. In contrast, several survivors leveraged on their experience with cancer to bolster job opportunities. Despite facing challenges due to complications from cancer and restrictions at work, AYA survivors preferred to be treated normally. AYA survivors also expressed concerns about inadequate insurance coverage and a lack of information on this topic.

Conclusion

Contrary to expectations, Asian AYA survivors are motivated to return to work and address work-related challenges. Inadequate insurance coverage remains a pressing concern despite the availability of public health insurance and subsidies. Career coaches and financial counselors should be incorporated into survivorship care to aid AYA survivors.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgments

We would like to thank the focus group participants for their time and contributions. We would also like to acknowledge the assistance of Ms. Gan Yan Xiang who has rendered support in managing the logistics of the focus group sessions.

Funding

This work was supported by the National Medical Research Council (grant number NMRC/CIRG/1471/2017), and the Singapore Cancer Society.

Author information

Authors and Affiliations

  1. Department of Pharmacy, National University of Singapore, 21 Lower Kent Ridge Rd., Singapore, 117543, Singapore

    Chia Jie Tan, Yu Ke, Tabitha Ng, Isabel Mei Jun Tan & Alexandre Chan

  2. Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Dr., Singapore, 169610, Singapore

    Wei Lin Goh, Eileen Poon & Mohamad Farid

  3. Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr., Singapore, 169610, Singapore

    Patricia Soek Hui Neo

  4. Singapore Cancer Society, Singapore, Singapore

    Balasubramaniam Srilatha

  5. Department of Pharmacy, National Cancer Centre Singapore, 11 Hospital Dr., Singapore, 169610, Singapore

    Alexandre Chan

  6. Department of Clinical Pharmacy Practice, University of California, Irvine, CA 92697, USA

    Alexandre Chan

Authors
  1. Chia Jie Tan
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  2. Yu Ke
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  10. Alexandre Chan
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Corresponding author

Correspondence to Alexandre Chan.

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Conflict of interest

Dr. Balasubramaniam Srilatha was employed by the Singapore Cancer Society during the course of this study. All other authors declare that they have no conflict of interest. The authors also retain full control of all primary data and will allow the journal to review the data if requested.

Ethical approval and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (SingHealth Centralised Institutional Review Board, 2016/3117) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study.

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Tan, C.J., Ke, Y., Ng, T. et al. Work- and insurance-related issues among Asian adolescent and young-adult cancer survivors: a qualitative study. Support Care Cancer 28, 5901–5909 (2020). https://doi.org/10.1007/s00520-020-05430-z

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  • DOI: https://doi.org/10.1007/s00520-020-05430-z

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