All authors: Karolinska Institutet, Stockholm, Sweden.
J Clin Oncol. 2017 Jun 20;35(18):2044-2052. doi: 10.1200/JCO.2015.66.0613. Epub 2017 May 1.
Purpose To explore future diagnosis-specific sickness absence and disability pension among women with breast cancer compared with women without breast cancer. Also, to examine associations with disease-related and sociodemographic factors among those with breast cancer. Methods Longitudinal register data on 3,547 women living in Sweden (age 20 to 65 years) who were first diagnosed with breast cancer in 2005, and a matched comparison cohort (n = 14,188), were analyzed for the annual prevalence of diagnosis-specific sickness absence and disability pension over 5 years. Logistic regressions were used to explore associations of disease-related and sociodemographic factors with future sickness absence and disability pension among women with breast cancer. Results Immediately after being diagnosed with breast cancer, the proportion of women with sickness absence was high but decreased continuously from the 1st through 5th year after diagnosis (71%, 40%, 30%, 22%, and 19%, respectively). In comparison, the range for women without breast cancer was 17% to 11%, respectively. The higher prevalence of sickness absence after breast cancer was mainly a result of breast cancer diagnosis, not a mental diagnosis, or other somatic diagnoses. Advanced cancer at diagnosis, > 90 days sickness absence before diagnosis, low education, and being born outside Sweden were associated with higher odds ratios for sickness absence and disability pension (odds ratio range, 1.40 to 6.45). Conclusion The level of sickness absence increased substantially in women with breast cancer during the first year after diagnosis and approached the level of breast cancer-free women in the following years; however, even in the first year, most women were not on sickness absence for a substantial time, and even in high-risk groups, many were not on sickness absence or disability pension in the following years. Information about relatively low future sickness absence and disability pension levels can be used by patients when planning their work, by health care professionals, and by social insurance officers. Employers and Occupational Health Services need this information to adequately handle workplace adjustments.
目的 探讨与未患有乳腺癌的女性相比，乳腺癌女性未来的特定疾病缺勤和残疾抚恤金情况。此外，还研究了乳腺癌患者中与疾病相关的和社会人口统计学因素的相关性。
方法 对 2005 年首次被诊断患有乳腺癌的 3547 名居住在瑞典的女性（年龄 20 至 65 岁）和与之相匹配的对照组（n=14188 名）的纵向登记数据进行分析，以了解 5 年内特定疾病的缺勤和残疾抚恤金的年度患病率。使用逻辑回归来探讨乳腺癌患者中与疾病相关的和社会人口统计学因素与未来病假和残疾抚恤金之间的关联。
结果 乳腺癌确诊后，立即出现较高比例的女性缺勤，但从诊断后的第 1 年到第 5 年，该比例持续下降（分别为 71%、40%、30%、22%和 19%）。相比之下，未患有乳腺癌的女性比例分别为 17%至 11%。乳腺癌后病假缺勤率较高的主要原因是乳腺癌诊断，而不是精神诊断或其他躯体诊断。诊断时癌症处于晚期、诊断前 90 天以上病假、教育程度较低以及出生在瑞典境外与病假和残疾抚恤金的较高比值比相关（比值比范围为 1.40 至 6.45）。
结论 乳腺癌女性在诊断后第一年的病假缺勤率大幅增加，随后几年逐渐接近无乳腺癌女性的水平；然而，即使在第一年，大多数女性也不会长时间缺勤，即使在高风险群体中，许多人在随后几年也不会请病假或残疾抚恤金。关于未来相对较低的病假和残疾抚恤金水平的信息可用于患者规划工作、医疗保健专业人员和社会保险官员，也可用于雇主和职业健康服务机构来充分处理工作场所调整。
