Horsboel Trine A, Nielsen Claus V, Nielsen Bendt, Andersen Niels T, De Thurah Annette
Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University , Denmark.
Acta Oncol. 2015 May;54(5):743-9. doi: 10.3109/0284186X.2014.999871. Epub 2015 Mar 9.
Patients with haematological malignancies have a poorer labour market prognosis than the general population. We have previously found that they have low rates of return to work, and a higher risk of being granted disability pension, than individuals without a history of these diseases. The aim of this study was to further investigate the labour market prognosis for these patients, by comparing the risk of being granted wage-subsidised (WS) employment as a result of permanently reduced work capacity among patients diagnosed with haematological malignancies to a reference cohort, and to determine if relative risks differ between subtypes of haematological malignancies.
We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until they were granted WS employment, disability pension, anticipatory pension, old age pension, emigration, death or until 26 February 2012, whichever came first.
A total of 310 (10%) patients and 795 (3%) reference individuals had their work capacity permanently reduced to an extent that they were granted WS employment during the follow-up period. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies, and four years after diagnosis they ranged from 2.47 (95% CI 1.46-4.16) for patients with Hodgkin lymphoma to 10.83 (95% CI 7.15-16.40) for patients with chronic myeloid leukaemia.
All eight subtypes of haematological malignancies were associated with an increased risk of being granted WS employment due to permanently reduced work capacity compared to the reference cohort. The relative risks differed according to haematological malignancy subtype, and the highest was found for patients with chronic myeloid leukaemia.
血液系统恶性肿瘤患者的劳动力市场预后比普通人群更差。我们之前发现，与没有这些疾病病史的个体相比，他们的重返工作岗位率较低，获得残疾抚恤金的风险更高。本研究的目的是通过比较被诊断为血液系统恶性肿瘤的患者因工作能力永久下降而获得工资补贴（WS）就业的风险与一个参照队列，进一步调查这些患者的劳动力市场预后，并确定血液系统恶性肿瘤各亚型之间的相对风险是否存在差异。
我们将丹麦国家登记处关于2000年至2007年间被诊断为血液系统恶性肿瘤的患者的数据与一个没有这些疾病病史的参照队列的数据相结合。总共3194名患者和28627名参照个体被随访，直到他们获得WS就业、残疾抚恤金、预期抚恤金、养老金、移民、死亡或直到2012年2月26日（以先发生者为准）。
在随访期间，共有310名（10%）患者和795名（3%）参照个体的工作能力永久下降到获得WS就业的程度。血液系统恶性肿瘤各亚组之间经年龄和性别调整后的相对风险存在显著差异，诊断后四年，从霍奇金淋巴瘤患者的2.47（95%可信区间1.46 - 4.16）到慢性髓性白血病患者的10.83（95%可信区间7.15 - 16.40）不等。
与参照队列相比，所有八种血液系统恶性肿瘤亚型都与因工作能力永久下降而获得WS就业的风险增加有关。相对风险因血液系统恶性肿瘤亚型而异，慢性髓性白血病患者的风险最高。
