Hauglann Beate K, Saltytė Benth Jūratė, Fosså Sophie D, Tveit Kjell M, Dahl Alv A
National Resource Center for Late Effects after Cancer , Oslo University Hospital, Norwegian Radium Hospital, Oslo , Norway.
Acta Oncol. 2014 Jun;53(6):735-43. doi: 10.3109/0284186X.2013.844354. Epub 2013 Dec 17.
To investigate long-term development of sickness absence and disability pension among colorectal cancer (CRC) survivors compared to matched cancer-free controls, and to assess to what degree socio-demographic and disease characteristics influence these outcomes.
In a register-based cohort study with data from the Cancer Registry of Norway and longitudinal data from other national registries, 740 patients with CRC diagnosed 1992-1996 at the age 45-54 years were observed up to 14 years post-diagnosis. Also 740 matched controls were observed over the same time period.
During the first year after diagnosis, 85% of the CRC survivors were on sick-leave at some point, compared to 19% of the controls. Among survivors with localized cancer, 21% were on sick-leave 12 months after diagnosis, versus 33% with regional, and 52% with distant cancer. Survivors with rectum cancer were more likely than colon cancer survivors to be on sick-leave the first year after diagnosis (OR 2.53, 95% CI 1.61-3.98). CRC survivors were at higher risk for disability pension (DP) than controls, depending on extent of disease. Hazard ratios for DP were 1.67 (95% CI 1.13-2.46) for survivors with localized cancer, 3.12 (95% CI 2.06-4.72) for regional, and 10.13 (95% CI 4.17-24.62) for distant cancer, respectively. In survivors, distant cancer, low level of education, not having children<18 years in the household, pre-diagnostic sick-leave and not being employed at diagnosis were associated with increased likelihood for DP.
A considerable proportion of CRC survivors, for years after diagnosis, will experience reduced work ability compared to controls. Rehabilitation and workplace adjustment to reduce sickness absence and improve work ability should be a long-term concern.
与匹配的无癌对照者相比，调查结直肠癌（CRC）幸存者病假缺勤和残疾抚恤金的长期发展情况，并评估社会人口统计学和疾病特征在多大程度上影响这些结果。
在一项基于登记的队列研究中，利用挪威癌症登记处的数据以及其他国家登记处的纵向数据，对1992年至1996年期间确诊的740例年龄在45至54岁之间的CRC患者进行了长达诊断后14年的观察。同时在同一时期对740名匹配的对照者进行了观察。
在诊断后的第一年，85%的CRC幸存者在某个时间点休过病假，而对照者为19%。在局限性癌症幸存者中，21%在诊断后12个月休过病假，区域癌症幸存者为33%，远处癌症幸存者为52%。直肠癌幸存者在诊断后的第一年比结肠癌幸存者更有可能休病假（比值比2.53，95%置信区间1.61 - 3.98）。CRC幸存者领取残疾抚恤金（DP）的风险高于对照者，这取决于疾病的程度。局限性癌症幸存者领取DP的风险比为1.67（95%置信区间1.13 - 2.46），区域癌症为3.12（95%置信区间2.06 - 4.72），远处癌症为10.13（95%置信区间4.17 - 24.62）。在幸存者中，远处癌症、低教育水平、家庭中没有未满18岁的子女、诊断前休病假以及诊断时未就业与领取DP的可能性增加有关。
与对照者相比，相当一部分CRC幸存者在诊断后的数年里工作能力会下降。康复和工作场所调整以减少病假缺勤并提高工作能力应成为长期关注的问题。
