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癌症幸存者的受教育程度和工作残疾:诊断和合并症是否影响这种关联?

Educational attainment and work disability in cancer survivors: Do diagnosis and comorbidity affect this association?

机构信息

Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus C, Denmark.

DEFACTUM Social & Health Services and Labour Market, Aarhus C, Denmark.

出版信息

Eur J Cancer Care (Engl). 2020 Jul;29(4):e13228. doi: 10.1111/ecc.13228. Epub 2020 Jan 30.

Abstract

OBJECTIVES

To study whether educational attainment had less impact on work disability in cancer survivors than in individuals without cancer. To study whether comorbidity had a higher impact on work disability in low-educated cancer survivors than in high-educated and whether this impact differed when compared with individuals without cancer.

METHODS

Linkage of population-based public health survey data and the Danish Cancer Registry formed two groups: cancer survivors (n = 3,514) and cancer-free individuals (n = 171,262). In logistic regression models, the risk of experiencing an 8-week sick leave spell and the granting of disability pension within a 3-year follow-up period was studied in three educational levels and whether these associations were modified by history of cancer and comorbidity. Odds ratios (OR) with 95% confidence intervals (CI) are reported.

RESULTS

Non-stratified adjusted risk of experiencing an 8-week sick leave spell (OR: 1.41, 95% CI (1.33-1.49)) or being granted a disability pension (OR: 1.61, 95% CI (1.31-1.97)) was significantly higher in low-educated than in high-educated respondents. Cancer or comorbidity did not significantly interact with education on the risk of work disability.

CONCLUSIONS

A moderate impact of low education on future work disability was found for all respondents, neither history of cancer nor comorbidity modified this association.

摘要

目的

研究教育程度对癌症幸存者与非癌症个体工作残疾的影响程度是否不同。研究合并症对低教育程度癌症幸存者工作残疾的影响是否高于高教育程度者,以及与非癌症个体相比是否存在差异。

方法

将基于人群的公共卫生调查数据与丹麦癌症登记处进行关联,形成两组人群:癌症幸存者(n=3514)和非癌症个体(n=171262)。在逻辑回归模型中,研究了在 3 年随访期间经历 8 周病假和获得残疾抚恤金的风险,并按教育程度分为三个层次,同时研究了这些关联是否受癌症和合并症病史的影响。报告了比值比(OR)及其 95%置信区间(CI)。

结果

未经分层调整的 8 周病假(OR:1.41,95%CI(1.33-1.49))或获得残疾抚恤金(OR:1.61,95%CI(1.31-1.97))的风险在低教育程度者中显著高于高教育程度者。癌症或合并症与教育程度对工作残疾的风险之间没有显著的相互作用。

结论

对于所有受访者,低教育程度对未来工作残疾的影响中等,癌症或合并症病史均未改变这种关联。

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