Sickness absence and disability pension after breast cancer: a five-year nationwide cohort study
Year: 2016
Type: article
Study design: Observational Study
Abstract: Background Breast cancer is a major health problem affecting many women of working ages and knowledge is needed on sickness absence (SA) and disability pension (DP) before and after the diagnosis for a whole population, not a sample. Purpose: To explore the rate of SA and DP among women diagnosed with breast cancer, before and after diagnosis, and possible associations between disease-related and socio-demographic factors with future SA and DP. Methods A prospective cohort study of SA and DP among all 3547 women in Sweden aged 20-65 with a first breast cancer diagnosis in 2005. Logistic regression models were used to estimate odds ratios (OR) with 95% condfidence intervals (CI) for SA and DP during a five-year follow-up period. Results During the first 12 months post-diagnosis, 71% of the women had at least some SA reimbursed from the Social Insurance Agency. In the second year post-diagnosis, this proportion was 40% and in the third year it was 30%. At five years post-diagnosis the proportion of women with SA had decreased to pre-diagnosis level (19%). Proportion with DP was approximately the same throughout follow up. Women with more advanced cancer had higher likelihood of SA (OR SA year 3, stage III-IV: 4.29, 95% CI: 2.84, 6.50; OR SA year 5, stage III-IV: 4.76, 95% CI: 2.73, 8.31) and DP (OR DP: 3.69, 95% CI: 2.02, 6.74) compared to those with early stage breast cancer. Women with high level of pre-diagnosis SA (>90 days) were more likely to be on SA or DP as compared to women with no pre-diagnosis SA. Women with low educational level and those not born in Sweden had higher odds of DP and of SA. Conclusions Despite the often extensive medical treatments following a breast cancer diagnosis, not all women of working ages with breast cancer are on SA or are granted DP. The proportion with SA decreased much in the 2-3 years after diagnosis. Those with advanced cancer stage and long-term pre-diagnosis SA have substantially higher risk of long-term SA and DP. Key messages: Not all women of working ages with breast cancer are on SA or are granted DP and the proportion with SA decreases to a large extent in 2-3 years after breast cancer diagnosis More advanced cancer stage at diagnosis and previouse long-term sickness absence are strong predictors of long-term SA and DP amonog women diagnosed with breast cancer
Authors: P Kvillemo, E Mittendorfer-Rutz, R Bränström, K Nilsson, K Alexanderson
Institution: Karolinska Institutet
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2587205805