Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain.
IMIM - Parc Salut Mar, Barcelona, Spain.
BMC Public Health. 2019 May 3;19(1):506. doi: 10.1186/s12889-019-6792-3.
Due to the progress in screening and cancer treatments, survivor's prognosis has improved enabling a more likely return to work. However, return to work after a cancer diagnosis may be complex because of an unbalanced health status and work demands relationship that may push them out of the labor market. The aim of this study is to assess the risk of dropping out of the labor market due to unemployment, partial retirement, and permanent disability during the year following an episode due to a malignant neoplasm compared to other non-malignant pathologies.
Cohort study of 9699 workers affiliated with the Social Security System in Catalonia, who had a sickness absence episode between 2012 and 2013 due to malignant neoplasm, mental, musculoskeletal disorders, cardiovascular diseases and injuries. Competing risk regression models were applied to assess the risk of dropping out of the labor market, by calculating subhazard ratios (SHR) in both sexes. Models were adjusted for age, occupational category, type of contract, economic activity, annual median salary and duration of the SA episode as potential confounders.
Sickness absence due to malignant neoplasia represented 1.7% out of the 9699 episodes included between 2012 and 2013. Although, 80% of individuals continued working in the year following an episode due to malignant neoplasm, women showed a trend towards exiting the labor market because of partial retirement [SHR = 8.4(1.5-45.5)] and permanent disability [SHR = 5.8(1.5-22.9)] compared to non-malignant pathologies. There were no significant differences for unemployment either in women [SHR = 0.4(0.2-0.9)] and in men [SHR = 0.2(0.1-0.6)].
Although return to work is a common pathway among cancer survivors, partial retirement and permanent disability seem to be potential pathways to exit the labor market among women.
由于筛查和癌症治疗的进展，幸存者的预后得到了改善，使他们更有可能重返工作岗位。然而，由于健康状况和工作需求之间的不平衡关系，癌症诊断后的重返工作可能会很复杂，这可能会使他们退出劳动力市场。本研究的目的是评估与其他非恶性病理相比，由于失业、部分退休和永久性残疾，在恶性肿瘤发病后的一年内退出劳动力市场的风险。
这是一项队列研究，共纳入了 9699 名在加泰罗尼亚社会保障系统中工作的工人，他们在 2012 年至 2013 年期间因恶性肿瘤、精神、肌肉骨骼疾病、心血管疾病和损伤而请病假。应用竞争风险回归模型评估了因失业、部分退休和永久性残疾而退出劳动力市场的风险，通过计算两性的亚危险比（SHR）来评估。模型调整了年龄、职业类别、合同类型、经济活动、年平均工资和病假持续时间等潜在混杂因素。
2012 年至 2013 年期间，9699 个病假中恶性肿瘤占 1.7%。尽管 80%的恶性肿瘤患者在发病后的一年内仍继续工作，但女性由于部分退休[SHR=8.4（1.5-45.5）]和永久性残疾[SHR=5.8（1.5-22.9）]而退出劳动力市场的趋势更为明显，与非恶性疾病相比。女性失业的风险无显著差异[SHR=0.4（0.2-0.9）]，男性也无显著差异[SHR=0.2（0.1-0.6）]。
尽管重返工作岗位是癌症幸存者的常见途径，但部分退休和永久性残疾似乎是女性退出劳动力市场的潜在途径。
