Maunsell Elizabeth, Drolet Mélanie, Brisson Jacques, Brisson Chantal, Mâsse Benoit, Deschênes Luc
Unité de recherche en santé des populations, Hôpital du Saint-Sacrement, 1050 chemin Sainte-Foy, Québec, QC, Canada G1S 4L8.
J Natl Cancer Inst. 2004 Dec 15;96(24):1813-22. doi: 10.1093/jnci/djh335.
Breast cancer may adversely affect work experience. We assessed whether there was evidence of discrimination at work, defined as negative or involuntary changes in employment situation (including changes in position, wages, and other conditions), associated with a breast cancer diagnosis in a population-based retrospective cohort study conducted in Quebec, Canada.
The study was based on the consecutive series of women aged less then 60 years when first treated for breast cancer (identified through the Quebec Tumor Registry) and a random sample of frequency-matched women living in Quebec (identified from provincial health care files) who had never been diagnosed with cancer. Eligibility for the study was restricted to women who were employed at the time of diagnosis (for breast cancer survivors) or the same calendar period (for women in the comparison group). We conducted telephone interviews of eligible women 3 years after diagnosis for 646 survivors or after the matched calendar period for 890 women in the comparison group. Binomial regression was used to evaluate the relationship between having breast cancer and work situation. All statistical tests were two-sided.
Working conditions were similar between the two groups at the beginning of follow-up. After 3 years, slightly more survivors (21%) than women in the comparison group (15%) were unemployed (adjusted relative risk for being unemployed = 1.29, 95% confidence interval = 1.05 to 1.59), although most women who were not working (84% of unemployed survivors and 76% of unemployed women in the comparison group) said that the decision to stop working was their own. Among women still employed, no deterioration in working conditions was observed in either group.
We found little evidence that women diagnosed with breast cancer experience discrimination at work. This information may be helpful for working women concerned about employment after breast cancer.
乳腺癌可能对工作经历产生不利影响。在加拿大魁北克省开展的一项基于人群的回顾性队列研究中，我们评估了是否存在与乳腺癌诊断相关的工作歧视证据，工作歧视定义为就业状况的负面或非自愿变化（包括职位、工资和其他条件的变化）。
该研究基于首次接受乳腺癌治疗时年龄小于60岁的连续系列女性（通过魁北克肿瘤登记处确定）以及居住在魁北克的频率匹配女性的随机样本（从省级医疗保健档案中确定），这些女性从未被诊断出患有癌症。研究对象仅限于诊断时（乳腺癌幸存者）或同一日历期间（对照组女性）就业的女性。我们在诊断后3年对646名幸存者进行了电话访谈，对对照组的890名女性在匹配的日历期后进行了电话访谈。采用二项式回归评估患乳腺癌与工作状况之间的关系。所有统计检验均为双侧检验。
随访开始时，两组的工作条件相似。3年后，失业的幸存者（21%）略多于对照组女性（15%）（失业的调整相对风险=1.29，95%置信区间=1.05至1.59），尽管大多数不工作的女性（失业幸存者中的84%和对照组失业女性中的76%）表示停止工作的决定是她们自己做出的。在仍在工作的女性中，两组均未观察到工作条件恶化。
我们几乎没有发现证据表明被诊断患有乳腺癌的女性在工作中受到歧视。这一信息可能有助于关注乳腺癌后就业问题的职业女性。
