Nordic Healthcare Group, Helsinki, Finland.
Hanken School of Economics, Helsinki, Finland.
Acta Oncol. 2023 Oct;62(10):1331-1337. doi: 10.1080/0284186X.2023.2254483. Epub 2023 Sep 12.
Being able to work during and after breast cancer treatments is important for patients to have a sense of normalcy, financial security, and improved quality of life, and for society due to the economic burden of sick leave. Factors influencing the length of sick leave can be sociodemographic factors, workplace adaptations, recurrences, symptoms, and type of treatment. The aim of this study is to analyse factors associated with prolonged sick leave after adjuvant breast cancer treatments.
The population of this registry study consists of 1333 early breast cancer patients diagnosed and treated in Helsinki University Hospital between 2016 and 2018. Data on patient demographics, disease characteristics, treatment, and healthcare resource utilization were obtained from Helsinki University Hospital and data on income level and sick leave were obtained from Kela sickness benefits registry. Prolonged sick leave was determined as the patient accumulating 30 or more reimbursed sick leave days during a 60-day follow-up period after the end of active oncological treatment. Univariate analysis and multivariate analysis were conducted.
A total of 26% of the patients in this study were on sick leave for 30 or more days after the active treatments ended. Study findings show that chemotherapy, triple-negative breast cancer, reconstructive surgery, amount of outpatient visits, and income are associated with prolonged sick leave. Independent predictors of prolonged sick leave were treatment line, number of outpatient contacts, reconstruction, and triple-negative breast cancer.
Our study shows that prolonged sick leave affects a substantial number of working-age women with early breast cancer. Independent predictors for prolonged sick leave were all treatment-related. Targeted support for treatment-related side-effects already during the treatment period could lead to better recovery and earlier return to work.
对于患者来说，在乳腺癌治疗期间和之后能够工作，有助于他们获得正常感、经济保障和更高的生活质量，同时也有助于社会减轻病假带来的经济负担。影响病假长短的因素可能包括社会人口因素、工作场所适应、复发、症状和治疗类型。本研究的目的是分析与辅助乳腺癌治疗后延长病假相关的因素。
本注册研究的人群包括 2016 年至 2018 年期间在赫尔辛基大学医院诊断和治疗的 1333 名早期乳腺癌患者。患者人口统计学、疾病特征、治疗和医疗资源利用的数据来自赫尔辛基大学医院，收入水平和病假数据来自 Kela 疾病津贴登记处。将 30 天或更多的已报销病假天数累积在主动肿瘤治疗结束后的 60 天随访期内定义为延长病假。进行了单变量分析和多变量分析。
本研究中，26%的患者在积极治疗结束后有 30 天或更多的病假。研究结果表明，化疗、三阴性乳腺癌、重建手术、门诊就诊次数和收入与延长病假有关。延长病假的独立预测因素是治疗线、门诊接触次数、重建和三阴性乳腺癌。
我们的研究表明，延长病假会影响相当数量的患有早期乳腺癌的育龄妇女。延长病假的独立预测因素均与治疗相关。在治疗期间针对与治疗相关的副作用提供有针对性的支持，可能会促进更好的康复和更早地重返工作岗位。
