Drolet Mélanie, Maunsell Elizabeth, Mondor Myrto, Brisson Chantal, Brisson Jacques, Mâsse Benoît, Deschênes Luc
Unité de recherche en santé des populations, Centre de recherche du Centre Hospitalier Affilié Universitaire de Québec, Quebec, Qué.
CMAJ. 2005 Sep 27;173(7):765-71. doi: 10.1503/cmaj.050178.
Absence from work after breast cancer diagnosis may be part of the burden of disease for women with cancer, but little research has addressed this. We examined work absences of 4 weeks or more among women who had had breast cancer during the 3 years after diagnosis and compared their absences with those of women who had never had cancer.
Our 2 target study groups were women in Quebec 18-59 years of age who were working when they first received therapy for breast cancer between November 1996 and August 1997 and similarly aged women randomly selected from provincial health care files who had never had cancer and were working at the time of diagnosis in women who had cancer. We interviewed 646 women who had had breast cancer (73% of those eligible) and 890 women in the comparison group (51% of those eligible) by telephone 3 years after first diagnosis.
One year after diagnosis, 85% (459/541) of breast cancer survivors who remained free of disease during the 3-year study period were absent from work for 4 weeks or more compared with 18% (156/881) of healthy women (geometric mean total duration 5.6 v. 1.7 months, p < 0.001). By the third year, disease-free women were not absent more than women in the comparison group; however, more women who had experienced any new cancer event continued to be absent from work and to be absent from work for longer periods of time. Receiving adjuvant chemotherapy prolonged absence duration (9.5 v. 5.4 months among women not receiving chemotherapy). Compared with survivors belonging to a union, those who did not belong to a union (multivariate relative risk [RR] 7.54, 95% confidence interval [CI] 3.02-18.83) and those who were self-employed (RR 13.95, 95% CI 5.53-35.21) were more likely to report no work absence.
Most of the women with breast cancer took time off work (almost 6 months on average) after receiving the diagnosis. Three years after diagnosis, breast cancer survivors who remained disease-free--a large proportion of women with nonmetastatic breast cancer--were not absent from work more often or for longer periods of time than other working women.
乳腺癌确诊后缺勤可能是癌症女性疾病负担的一部分，但对此研究甚少。我们调查了确诊后3年内患乳腺癌女性4周及以上的缺勤情况，并将她们的缺勤情况与从未患癌女性进行比较。
我们的两个目标研究组分别是1996年11月至1997年8月首次接受乳腺癌治疗时正在工作的18 - 59岁魁北克女性，以及从省级医疗保健档案中随机选取的年龄相仿、从未患癌且在患癌女性确诊时正在工作的女性。首次诊断3年后，我们通过电话采访了646名患乳腺癌的女性（ eligible的73%）和890名对照组女性（ eligible的51%）。
诊断后1年，在3年研究期间无疾病复发的乳腺癌幸存者中，85%（459/541）缺勤4周及以上，而健康女性这一比例为18%（156/881）（几何平均总时长分别为5.6个月和1.7个月，p<0.001）。到第3年，无疾病复发的女性缺勤情况并不比对照组女性更严重；然而，更多经历过任何新癌症事件的女性继续缺勤且缺勤时间更长。接受辅助化疗会延长缺勤时长（未接受化疗的女性为5.4个月，接受化疗的女性为9.5个月）。与工会成员幸存者相比，非工会成员（多变量相对风险[RR] 7.54，95%置信区间[CI] 3.02 - 18.83）和个体经营者（RR 13.95，95% CI 5.53 - 35.21）报告无缺勤的可能性更大。
大多数乳腺癌女性在确诊后都请假不工作（平均近6个月）。诊断3年后，无疾病复发的乳腺癌幸存者——很大一部分非转移性乳腺癌女性——与其他在职女性相比，缺勤频率并不更高，缺勤时间也并不更长。
