Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway,
J Cancer Surviv. 2014 Jun;8(2):239-47. doi: 10.1007/s11764-013-0324-4. Epub 2013 Dec 19.
This study seeks to assess the impact of breast cancer on survivors' annual income at 1 to 13 years of follow-up.
A Norwegian registry-based dataset with a 13-year follow-up period was used. The dataset contained case-control pairs, where each pair consisted of one breast cancer case and a cancer-free control, matched for age, marital status, and municipality of residence. A mixed linear model was used to analyse the average income development for cases and controls adjusting for available demographic variables not used in the matching procedure, such as education level, immigration history, and number of children. Individual income was only considered relevant for cancer survivors, thus case-control pairs were censored upon death. Income development by stage of tumour at time of diagnosis was also assessed.
The income of breast cancer survivors had reduced immediately following diagnosis. At 1 year after diagnosis, income development between cases and controls became significantly different (p = 0.006). Differences increased slightly but remained significant throughout the follow-up period. At 13 years after diagnosis, the estimated cumulative income loss for survivors was 39.403 € (p < 0.001). The income development of stage I breast cancer patients was similar to their controls. For higher stage breast cancer patients, the income differences were more pronounced but not always statistically significant.
Breast cancer has a significant negative effect on the individual incomes of survivors, even at 13 years after diagnosis. Effects increased for individuals with more advanced cancer stages.
In Norway, breast cancer survivors experience lower income than their cancer-free controls. This may indicate a need for financial compensations in order to maintain the standard of living for this group of patients.
本研究旨在评估乳腺癌对幸存者在 1 至 13 年随访期间的年收入的影响。
本研究使用了一个基于挪威登记的数据集,随访时间为 13 年。该数据集包含病例对照配对,每对由一名乳腺癌病例和一名无癌症对照组成,匹配年龄、婚姻状况和居住地市。使用混合线性模型分析病例和对照组的平均收入发展情况,调整了在匹配过程中未使用的可用人口统计学变量,如教育水平、移民历史和子女数量。个人收入仅与癌症幸存者相关,因此病例对照对在死亡时被剔除。还评估了诊断时肿瘤分期对收入发展的影响。
乳腺癌幸存者的收入在诊断后立即下降。在诊断后 1 年,病例和对照组之间的收入发展变得明显不同(p=0.006)。差异略有增加,但在整个随访期间仍然显著。在诊断后 13 年,幸存者估计累计收入损失为 39403 欧元(p<0.001)。I 期乳腺癌患者的收入发展与对照组相似。对于更高分期的乳腺癌患者,收入差异更为明显,但并不总是具有统计学意义。
乳腺癌对幸存者的个人收入有显著的负面影响,即使在诊断后 13 年也是如此。对于癌症分期较高的个体,影响更大。
在挪威,乳腺癌幸存者的收入低于无癌症对照组。这可能表明需要对这组患者进行财务补偿,以维持他们的生活水平。