内容紹介
Summary
The 5-year relative survival rate of cancer patients in Japan has reached 62.1% owing to advances in cancer treatments. Half of the people are diagnosed with cancer at some point in their lifetime, and one-third of cancer patients belong to the working-age generation between the ages of 20 and 65. In Japan, various governmental policies have been developed in a short period of time with the aim of balancing cancer treatment and employment. The Basic Plan to Promote Cancer Control Programs in Japan, enacted in 2017, specifies the need to prevent cancer patients from leaving employment and to support re-employment, as well as the need for further collaboration among medical institutions, occupations, and local communities. However, Japanese people's perceptions regarding employment of cancer patients is still negative. Employment support for cancer patients is regarded as an important topic in cancer survivorship, and various findings have been accumulated in Japan and other countries. The impact of onset of cancer on the employment of patients is influenced not only by medical factors but also by other factors such as individual factors, health status, psychosocial factors, willingness to work, and workplace-related factors. Hence, the situations of individuals differ greatly. It is necessary to examine the current state of research and support based on these factors. Points to keep in mind when providing support to balance both cancer and employment include: 1) there are many persons related to working cancer patients who are involved and 2) it is difficult for physicians to understand the full picture of a patient's job based on the labor contract. Appropriate information sharing; environmental improvement; and mutual cooperation in medical treatment sites, workplaces, and local communities are essential. Key words: Cancer patients, Return to work, Employment support, Cancer survivorship, Corresponding author: Sawako Kaku, Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
要旨
がん治療の進歩により日本におけるがん患者の5年相対生存率は62.1%に達している。生涯で1/2の人はがんに罹患し,がん患者の1/3が20～65歳までの就労世代に属する。がん治療と就労の両立に向けて,わが国では短期間に様々な政策が展開されている。2017年に制定された第3期がん対策推進基本計画では,がん患者の離職防止や再就職支援の必要性,医療機関,職場,地域におけるさらなる連携の必要性が明記されている。しかし国民ががん患者の就労に対して抱くイメージは依然厳しい。がん患者の就労支援はがんサバイバーシップのなかでも重要トピックとされており,国内外で様々な知見が蓄積されている。がん発病が患者の就労に及ぼす影響は医学的要因に加えて,個人要因,健康状態,心理社会的要因,就労意欲,職場関連要因などの多要因に影響され,状況は個別性が極めて高い。これらの要因を踏まえた上で研究と支援のあり方を検討することが必要である。がんと就労の両立支援における留意点として,第一に働くがん患者本人に関係する登場人物が多いこと,第二に医師は労働契約を踏まえた患者の就労の全体像を把握しにくい点がある。医療機関・職場・地域のそれぞれにおける適切な情報共有,環境整備,相互連携は不可欠である。
目次
The 5-year relative survival rate of cancer patients in Japan has reached 62.1% owing to advances in cancer treatments. Half of the people are diagnosed with cancer at some point in their lifetime, and one-third of cancer patients belong to the working-age generation between the ages of 20 and 65. In Japan, various governmental policies have been developed in a short period of time with the aim of balancing cancer treatment and employment. The Basic Plan to Promote Cancer Control Programs in Japan, enacted in 2017, specifies the need to prevent cancer patients from leaving employment and to support re-employment, as well as the need for further collaboration among medical institutions, occupations, and local communities. However, Japanese people's perceptions regarding employment of cancer patients is still negative. Employment support for cancer patients is regarded as an important topic in cancer survivorship, and various findings have been accumulated in Japan and other countries. The impact of onset of cancer on the employment of patients is influenced not only by medical factors but also by other factors such as individual factors, health status, psychosocial factors, willingness to work, and workplace-related factors. Hence, the situations of individuals differ greatly. It is necessary to examine the current state of research and support based on these factors. Points to keep in mind when providing support to balance both cancer and employment include: 1) there are many persons related to working cancer patients who are involved and 2) it is difficult for physicians to understand the full picture of a patient's job based on the labor contract. Appropriate information sharing; environmental improvement; and mutual cooperation in medical treatment sites, workplaces, and local communities are essential. Key words: Cancer patients, Return to work, Employment support, Cancer survivorship, Corresponding author: Sawako Kaku, Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
要旨
がん治療の進歩により日本におけるがん患者の5年相対生存率は62.1%に達している。生涯で1/2の人はがんに罹患し,がん患者の1/3が20～65歳までの就労世代に属する。がん治療と就労の両立に向けて,わが国では短期間に様々な政策が展開されている。2017年に制定された第3期がん対策推進基本計画では,がん患者の離職防止や再就職支援の必要性,医療機関,職場,地域におけるさらなる連携の必要性が明記されている。しかし国民ががん患者の就労に対して抱くイメージは依然厳しい。がん患者の就労支援はがんサバイバーシップのなかでも重要トピックとされており,国内外で様々な知見が蓄積されている。がん発病が患者の就労に及ぼす影響は医学的要因に加えて,個人要因,健康状態,心理社会的要因,就労意欲,職場関連要因などの多要因に影響され,状況は個別性が極めて高い。これらの要因を踏まえた上で研究と支援のあり方を検討することが必要である。がんと就労の両立支援における留意点として,第一に働くがん患者本人に関係する登場人物が多いこと,第二に医師は労働契約を踏まえた患者の就労の全体像を把握しにくい点がある。医療機関・職場・地域のそれぞれにおける適切な情報共有,環境整備,相互連携は不可欠である。