Drolet Mélanie, Maunsell Elizabeth, Brisson Jacques, Brisson Chantal, Mâsse Benoît, Deschênes Luc
Unité de Recherche en Santé des Populations, Centre de Recherche du Centre Hospitalier, Universitaire du Québec, Canada.
J Clin Oncol. 2005 Nov 20;23(33):8305-12. doi: 10.1200/JCO.2005.09.500. Epub 2005 Oct 11.
Little is known about factors increasing likelihood of not working among breast cancer survivors compared with women in the general population.
A population-based retrospective cohort study was conducted in Quebec, Canada, based on the consecutive series of working women aged younger than 60 years when first treated for breast cancer (identified through the Quebec Tumor Registry), and on a group of randomly selected similar women, living in Quebec, who were working at the time of survivors' diagnoses, but who were without cancer (identified through provincial health care files). Data came from a telephone interview, 3 years after diagnosis for 646 survivors (73% of those eligible) or during a similar period for 890 comparison women (51%).
Slightly more survivors were not working 3 years after diagnosis compared with women never diagnosed with cancer (21% and 15%, respectively). Older age (for survivors and comparison women, relative risk [RR] = 4.62, P < .0001 and RR = 4.98, P < .0001, respectively) and union membership (RR = 1.88, P = .0003 and RR = 1.40, P = .06, respectively) increased the likelihood of not working at the end of follow-up. In addition, income less than 20,000 dollars compared with > or = 50,000 dollars was associated with not working only among survivors (RR = 3.18; P = .0008). Adjuvant treatments did not predict work cessation, but any new cancer event during follow-up did (RR = 2.14; P < .0001).
Although reassuring that adjuvant treatments did not appear to play a role in survivors' not working, other aspects of the cancer experience might nonetheless have influenced the decision to reduce work effort after breast cancer.
与普通人群中的女性相比，关于增加乳腺癌幸存者不工作可能性的因素，我们知之甚少。
在加拿大魁北克进行了一项基于人群的回顾性队列研究，研究对象为首次接受乳腺癌治疗时年龄小于60岁的在职女性连续系列病例（通过魁北克肿瘤登记处确定），以及一组随机选择的、居住在魁北克、在幸存者确诊时正在工作但无癌症的类似女性（通过省级医疗保健档案确定）。数据来自电话访谈，646名幸存者（ eligible者中的73%）在确诊3年后接受访谈，890名对照女性（51%）在类似时间段接受访谈。
与从未被诊断患有癌症的女性相比，确诊3年后不工作的幸存者略多（分别为21%和15%）。年龄较大（对于幸存者和对照女性，相对风险[RR]分别为4.62，P < .0001和RR = 4.98，P < .0001）以及工会会员身份（RR分别为1.88，P = .0003和RR = 1.40，P = .06）增加了随访结束时不工作的可能性。此外，收入低于20,000美元与收入≥50,000美元相比，仅在幸存者中与不工作相关（RR = 3.18；P = .0008）。辅助治疗并不能预测工作停止，但随访期间任何新的癌症事件则可以（RR = 2.14；P < .0001）。
尽管令人放心的是辅助治疗似乎在幸存者不工作方面没有起到作用，但癌症经历的其他方面可能仍然影响了乳腺癌后减少工作努力的决定。
