Service des Maladies Professionnelles et Environnementales, CHU Toulouse, F-31000, Toulouse, France.
Service d'Oncologie, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse - Oncopole, F-31000, Toulouse, France.
Support Care Cancer. 2020 Jan;28(1):185-192. doi: 10.1007/s00520-019-04799-w. Epub 2019 Apr 17.
The objective of our study was to assess the rate of work adjustments 1 year after the diagnosis in a population of female breast cancer (BC) survivors, in the context of the French system of social protection. We also characterised these adjustments and their influence on the reduction of professional exclusion of patients 1 year after the diagnosis.
This observational, prospective study was conducted from February 2015 to April 2016 among female patients with BC. Inclusion criteria were women aged between 18 and 65 years, treated for BC and integrated into the labour market at the time of diagnosis (working or on sick leave). Exclusion criteria were metastatic BC, retired patients and refusal to participate. A 1-year follow-up was scheduled, and data collection was performed with questionnaires.
In total, 213 patients were included between February 2015 and April 2016. One year after the diagnosis (T1), among 185 BC survivors, 78 (42.2%) patients were working. Among them, 13 patients did not interrupt their occupational activity and 65 returned to work after a period of sick leave. Sixty-four patients returned to work after the end of chemotherapy (after 6 months), and one returned to work before this therapeutic threshold. Sixty-six patients (35.7%) benefited from at least one adjustment of their work conditions to facilitate their return to work (RTW) or maintenance at work: working hours were decreased for 43 patients, and workstation changes were performed for 22 patients. An occupational health physician was involved for some patients; work adjustments were prescribed to 42 patients, 7 patients had medical restrictions for physical reasons and 4 patients had restrictions for psychological reasons. Forty-three patients benefited from part-time work prescribed for therapeutic reasons.
Referral to occupational health physicians and work adjustments remain limited in the process of RTW or maintenance at work after BC in France, despite their positive impact.
本研究旨在评估法国社会保障体系下，乳腺癌（BC）幸存者群体在诊断后 1 年内的工作调整率。我们还对这些调整进行了特征描述，并分析了其对降低患者诊断后 1 年内职业排斥的影响。
这是一项从 2015 年 2 月至 2016 年 4 月开展的观察性、前瞻性研究，纳入对象为女性 BC 患者。纳入标准为年龄 18-65 岁、接受 BC 治疗且在诊断时（在职或休病假）融入劳动力市场的女性。排除标准为转移性 BC、退休患者和拒绝参与的患者。我们计划了为期 1 年的随访，并通过问卷收集数据。
2015 年 2 月至 2016 年 4 月期间，共纳入 213 名患者。诊断后 1 年（T1），在 185 名 BC 幸存者中，78 名（42.2%）患者正在工作。其中，13 名患者未中断职业活动，65 名患者在休病假后返回工作岗位。64 名患者在化疗结束后（6 个月后）返回工作岗位，1 名患者在治疗阈值之前返回工作岗位。66 名患者（35.7%）至少进行了一次工作条件调整，以促进他们重返工作岗位（RTW）或维持工作：43 名患者减少了工作时间，22 名患者改变了工作岗位。一些患者请了职业健康医生；42 名患者接受了工作调整，7 名患者因身体原因被限制工作，4 名患者因心理原因被限制工作。43 名患者因治疗原因接受了规定的兼职工作。
尽管对 RTW 或维持工作有积极影响，但在法国，BC 后 RTW 或维持工作过程中，向职业健康医生转诊和工作调整仍然有限。
