Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Acta Oncol. 2021 Dec;60(12):1643-1650. doi: 10.1080/0284186X.2021.1974551. Epub 2021 Sep 11.
Colorectal cancer (CRC) has negative long-term impacts on survivors' health and work capacity. We aimed to investigate specialized healthcare use and sickness absence and disability pension among CRC survivors and matched references.
In this longitudinal register-based cohort study, 6679 patients with a first primary CRC in 2008-2011 (when aged 18-62) and 26,716 CRC-free matched references were followed from 2 years before up to 5 years after diagnosis date. Mean numbers of hospital days and outpatient visits were illustrated for survivors and references for the 7-year period. Crude and adjusted mean numbers of sickness absence/disability pension net days were calculated for post-diagnosis Years 3 and 5.
Survivors' healthcare use was higher compared to their references throughout the 7 years around CRC diagnosis and was mostly due to CRC, secondary neoplasms, and digestive disorders. In Year 5, survivors had 1.94 mean outpatient visits and 2.13 mean inpatient days (compared to 1.00 and 0.82 for references, respectively). Survivors' adjusted mean sickness absence/disability pension days amounted to 85 d in Year 3 and 77 in Year 5 (compared to 57 and 54 d in the references). Higher mean number of future days was found among women, lower-educated, foreign-born, with previous comorbidities or previous mental disorders. Those with many sickness absence days in 2 years pre-diagnosis had the highest number of future sickness absence/disability pension days.
Post-diagnostic healthcare use remained high among CRC survivors, mostly due to cancer (CRC and other neoplasms) and digestive diagnoses. Their sickness absence and disability pension decreased gradually over the period but remained higher than among references. Pre-morbid characteristics may be used in early work-related clinical planning for the survivors.
结直肠癌（CRC）对幸存者的健康和工作能力有长期的负面影响。我们旨在研究CRC 幸存者与匹配对照者之间的专科医疗保健使用情况、病假和残疾抚恤金情况。
在这项纵向基于登记的队列研究中，2008-2011 年间（患者年龄 18-62 岁）诊断出首例原发性 CRC 的 6679 名患者和 26716 名无 CRC 的匹配对照者在诊断日期前 2 年至后 5 年进行随访。在 7 年期间，为幸存者和对照者展示了住院天数和门诊就诊次数的平均值。计算了诊断后第 3 年和第 5 年的病假/残疾抚恤金净天数的粗调整和平均数量。
与对照者相比，CRC 诊断前后 7 年期间，幸存者的医疗保健使用量较高，主要归因于 CRC、继发性肿瘤和消化系统疾病。在第 5 年，幸存者的平均门诊就诊次数为 1.94 次，平均住院天数为 2.13 天（而对照者的相应平均值分别为 1.00 和 0.82）。幸存者调整后的平均病假/残疾抚恤金天数在第 3 年为 85 天，在第 5 年为 77 天（而对照者的相应平均值分别为 57 天和 54 天）。女性、受教育程度较低、外国出生、有既往合并症或既往精神障碍的患者平均未来病假/残疾抚恤金天数更高。在诊断前 2 年有较多病假的患者，未来的病假/残疾抚恤金天数最多。
CRC 幸存者的诊断后医疗保健使用仍然较高，主要是由于癌症（CRC 和其他肿瘤）和消化系统疾病。他们的病假和残疾抚恤金逐渐减少，但仍高于对照者。发病前的特征可用于幸存者的早期与工作相关的临床规划。
