Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Cancer. 2012 Mar 15;118(6):1664-74. doi: 10.1002/cncr.26478. Epub 2011 Aug 25.
Previous research has found an 80% return-to-work rate in mid-income white breast cancer survivors, but little is known about the employment trajectory of low-income minorities or whites. We set out to compare the trajectories of low-income Latina and non-Latina white survivors and to identify correlates of employment status.
Participants were low-income women who had localized breast cancer, spoke English or Spanish, and were employed at the time of diagnosis. Interviews were conducted 6, 18, and 36 months after diagnosis. Multivariate logistic regression was used to identify independent correlates of employment status at 18 months.
Of 290 participants, 62% were Latina. Latinas were less likely than non-Latina whites to be working 6 months (27% vs 49%; P = .0002) and 18 months (45% vs 59%; P = .02) after diagnosis, but at 36 months there was no significant difference (53% vs 59%; P = .29). Latinas were more likely to be manual laborers than were non-Latina whites (P < .0001). Baseline job type and receipt of axillary node dissection were associated with employment status among Latinas but not non-Latina whites.
Neither low-income Latinas nor non-Latina whites approached the 80% rate of return to work seen in wealthier white populations. Latinas followed a protracted return-to-work trajectory compared to non-Latina whites, and differences in job type appear to have played an important role. Manual laborers may be disproportionately impacted by surgical procedures that limit physical activity. This can inform the development of rehabilitative interventions and may have important implications for the surgical and postsurgical management of patients.
先前的研究发现，中等收入的白人乳腺癌幸存者中有 80%的人重返工作岗位，但对于低收入少数族裔或白人的就业轨迹却知之甚少。我们旨在比较低收入拉丁裔和非拉丁裔白人幸存者的就业轨迹，并确定就业状况的相关因素。
参与者为收入较低的女性，患有局部乳腺癌，会说英语或西班牙语，并且在诊断时就业。在诊断后 6、18 和 36 个月进行了访谈。使用多变量逻辑回归来确定 18 个月时就业状况的独立相关因素。
在 290 名参与者中，有 62%是拉丁裔。与非拉丁裔白人相比，拉丁裔在诊断后 6 个月（27%比 49%；P=0.0002）和 18 个月（45%比 59%；P=0.02）时更不可能工作，但在 36 个月时没有显著差异（53%比 59%；P=0.29）。拉丁裔比非拉丁裔白人更有可能从事体力劳动（P<0.0001）。基线工作类型和腋窝淋巴结清扫术的接受与拉丁裔的就业状况相关，但与非拉丁裔白人无关。
无论是低收入拉丁裔还是非拉丁裔白人，都没有达到富裕白人族群中 80%的返岗率。与非拉丁裔白人相比，拉丁裔的返岗轨迹更为漫长，而且工作类型的差异似乎起到了重要作用。体力劳动者可能会受到限制体力活动的手术程序的不成比例影响。这可以为康复干预措施的制定提供信息，并可能对患者的手术和术后管理产生重要影响。
