Women first diagnosed with breast cancer in 2010 saw a significant sickness absence and disability pension increase, which eventually decreased over time, according to a recent study published in Cancer.
The study identified three separate trajectories for sickness absence and disability pension for women included in the population, including increasing only in the first year postdiagnosis (61% of all), increasing then decreasing in the first year postdiagnosis (30%), and constantly very high (9%).
“The group-based trajectory model enabled us to identify [sickness absence/disability pension] trajectories in women with breast cancer over time, both pre- and post-diagnostically,” wrote the researchers. “Our findings showed that more than 60% of the women with a [breast cancer] diagnosis gradually returned to their pre-diagnostic [sickness absence/disability pension] levels of having almost no [sickness absence/disability pension] days.”
Specifically, approximately 60% of women had more than 90 sickness absence/disability pension days in year 1, but that number decreased to 40% in year 2 and 35% in year 3. For 180 of sickness absence/disability pension, more woman had 180 days than women with 90 or less days in the first year, but that was not the case in year 2 and 3. Within the investigated population, the mean number of sickness absence/disability pension days increased to 172.
The researchers recruited 3536 women aged 19-64 who were diagnosed with breast cancer in 2010 for the study. A majority of the population was 45 years or older (80%) and were born in Sweden (83%). During the 12 months prior to diagnosis, a majority of the women did not have sickness absence (89%) or disability pension (82%).
“Breast cancer treatments yield periods of both high and low levels of work capacity in women, whereas the number of sickness-related absence days can provide a more comprehensive picture of the relationship. Thus, from a public health perspective, [sickness absence] and [disability pension] are important outcomes, because they reflect adverse and long-term work-related social consequences in the population.”
This study is unique in a number of ways, including the way in which it utilizes a trajectory method for sickness absence/disability pension for women diagnosed with breast cancer. These trajectory methods were requested by physicians to better understand possible work situation patterns and sickness absence/disability pensions within those patterns.
As for study strengths, it uses “high-quality, longitudinal, population-based register data” of all working women diagnosed with breast cancer rather than a sample to eliminate any selection bias. The cohort allowed for subgroup analysis while avoiding dropouts, and the Swedish social insurance system allowed for high coverage of women in the population.
A limitation of the work is the lack of information regarding cancer treatment types and how those impacted sickness absence/disability pension findings. In response, information was included to account for disease severity to a degree, according to the researchers. Moreover, the lack of information regarding short sickness absence spells (≤14 days) was a limitation, in which researchers implemented shorter sickness absence numbers, meaning the issue would have little impact on the results.
“The majority (61%) of women with breast cancer followed the [sickness absence/disability pension] trajectory pattern that increased only in the first year postdiagnosis, whereas the trajectory of another 30% of women increased immediately after diagnosis and then decreased gradually during the third post-diagnostic year,” wrote the researchers. “Although more than 80% of women with incident BC diagnosis had some [sickness absence/disability pension] days in the first year after diagnosis, most gradually returned to previous levels over the years.”
Chen L, Alexanderson KAE. Trajectories of Sickness Absence and Disability Pension in the 2 Years Before and 3 Years After Breast Cancer Diagnosis: A Swedish Longitudinal Population-Based Cohort Study. Cancer. DOI: 10.1002/cncr.32820.