99 Residual work capacity and (in)ability to work fulltime among applicants with cancer DISCUSSION Our results show that 42.6% of a year cohort of disability benefit applicants with cancer as their primary diagnosis were assessed with no residual work capacity. Specifically, applicants diagnosed with cancers of the digestive organs, respiratory organs, urinary tract, and skin showed significant higher odds for no residual work capacity. Although the majority of the applicants (57.4%) had residual work capacity, almost 70% of this sample was assessed with an inability to work fulltime. Of the applicants assessed with inability to work fulltime, 81.8% could work no more than 4 h per day. For inability to work fulltime, lymphoid and haematopoietic cancers showed significantly higher odds, and cancers of the locomotor system significantly lower odds. Age and gender were significantly associated with both outcomes. Multimorbidity was associated with residual work capacity in all cancer groups. Within cancer groups, higher age, for applicants with cancers of the breast, and female gender, for applicants with lymphoid and haematopoietic cancers, were significantly associated with higher odds for inability to work fulltime. In our study, only 15.3% of all applicants with cancer were assessed with a normal ability to work fulltime. Although this outcome can be seen as proof of the severity of cancer and its impact on work capacity, our findings also point out that a small majority (57.4%) of the applicants with cancer had residual work capacity, i.e. that they could work with or despite limitations and restrictions for work [31]. We could not find many studies on (no) residual work capacity and inability to work fulltime as outcome of work disability assessment in cancer patients. Most previous research focusses on actual return to work or being employed and work functioning. One study by Van Muijen and colleagues studied assessment outcomes within cancer patients [24]. Their results showed that 17.4% of sick-listed employed cancer survivors were assessed with no residual work capacity 2 years after sick leave. The possible cause of this lower percentage, compared to our study, is the difference in study sample. We included a year cohort of disability benefit applicants who were, mostly, already 2 years on sick leave. In the study of Van Muijen, 531 sick-listed (employed) workers were included at the first day of sick leave and followed until the disability assessment, 24 months later [24]. In our recently published study, using data of all applicants for a disability benefit in 2016 with residual work capacity, we found that the prevalence of inability to work fulltime was 39.4% [28]. In the current study, only including applicants with a cancer diagnosis from the same cohort, the prevalence is extremely higher, namely 69.8%. This extremely higher percentage indicates the severity of cancer compared to other diseases with regard to work capacity. However, the distribution of the degree of inability to work fulltime within the current study is comparable to the year cohort including all diseases [28]. 5
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