Harvard University, Boston, MA, USA.
Breast Cancer Res Treat. 2010 Jan;119(1):213-20. doi: 10.1007/s10549-009-0389-y. Epub 2009 Apr 10.
Work loss is a potential adverse consequence of cancer. There is limited research on patterns and correlates of paid work after diagnosis of breast cancer, especially among ethnic minorities. Women with non-metastatic breast cancer diagnosed from June 2005 to May 2006 who reported to the Los Angeles County SEER registry were identified and asked to complete the survey after initial treatment (median time from diagnosis = 8.9 months). Latina and African American women were over-sampled. Analyses were restricted to women working at the time of diagnosis, <65 years of age, and who had complete covariate information (N = 589). The outcome of the study was missed paid work (<or=1 month, >1 month, stopped all together). Approximately 44, 24, and 32% of women missed <or=1 month, >1 month, or stopped working, respectively. African Americans and Latinas were more likely to stop working when compared with Whites [OR for stop working vs. missed <or=1 month: 3.0, 3.4, (P < 0.001), respectively]. Women receiving mastectomy and those receiving chemotherapy were also more likely to stop working, independent of sociodemographic and treatment factors [ORs for stopped working vs. missed <or=1 month: 4.2, P < 0.001; 7.9, P < 0.001, respectively]. Not having a flexible work schedule available through work was detrimental to working [ORs for stopped working 18.9, P < 0.001 after adjusting for sociodemographic and treatment factors]. Many women stop working altogether after a diagnosis of breast cancer, particularly if they are racial/ethnic minorities, receive chemotherapy, or those who are employed in an unsupportive work settings. Health care providers need to be aware of these adverse consequences of breast cancer diagnosis and initial treatment.
工作损失是癌症的潜在不良后果。针对乳腺癌诊断后的有偿工作模式和相关因素，尤其是少数民族群体，相关研究非常有限。自 2005 年 6 月至 2006 年 5 月，洛杉矶县 SEER 登记处登记了患有非转移性乳腺癌的女性，并在初始治疗后（诊断后中位数时间为 8.9 个月）邀请她们完成调查。对拉丁裔和非裔美国女性进行了超额采样。分析仅限于在诊断时工作的女性、年龄<65 岁且具有完整协变量信息的女性（N=589）。研究结果为错过的有偿工作（<或=1 个月、>1 个月、完全停止工作）。分别约有 44%、24%和 32%的女性错过<或=1 个月、>1 个月或停止工作。与白人相比，非裔美国人和拉丁裔更有可能停止工作[停止工作与错过<或=1 个月相比的比值比（OR）：3.0、3.4（P<0.001）]。接受乳房切除术和化疗的女性也更有可能停止工作，这与社会人口统计学和治疗因素无关[停止工作与错过<或=1 个月相比的比值比（OR）：4.2，P<0.001；7.9，P<0.001]。没有通过工作获得灵活的工作时间表对工作不利[在调整社会人口统计学和治疗因素后，停止工作的比值比（OR）为 18.9，P<0.001]。许多女性在诊断出乳腺癌后完全停止工作，特别是如果她们是少数族裔、接受化疗或在不支持工作的环境中工作。医疗保健提供者需要意识到乳腺癌诊断和初始治疗的这些不良后果。
