Key result
Childhood cancer survival is linked to ~259% greater risk of high sickness absence and disability.
Why the study?
Childhood cancer survivors are at high risk of chronic health conditions, but long-term trajectories of sickness absence and disability pension in young adult survivors are not well characterized.
Do childhood cancer survivors have higher rates of long-term sickness absence and disability pension compared to matched references?
Cohort (n=21,100)
Do childhood cancer survivors have higher rates of long-term sickness absence and disability pension compared to matched references?
Absolute Event Rate: 9.7% vs 2.7%
Childhood cancer survivors, particularly those with CNS tumors, are at significantly higher risk for long-term sickness absence and disability pension compared to the general population.
May support vocational monitoring in survivors; leaves open whether interventions reduce long-term disability.
BACKGROUND: Childhood cancer survivors are at high risk of chronic health conditions. We aimed to explore future long-term sickness absence and disability pension in young adult childhood cancer survivors and matched references. METHODS: We performed a prospective cohort study using microdata from five Swedish nationwide registers. Among all individuals born 1976-1998 and living in Sweden, we included 3632 childhood cancer survivors and 17,468 matched references that could be followed-up for 15, 10, or 5 years, respectively. A group-based trajectory model was applied to identify trajectories of mean annual sickness absence and/or disability pension days (SADP) in each sub-cohort, with 95% confidence intervals (CI). Potential risk factors for trajectory belonging were explored using χ2 test and multinomial logistic regression. RESULTS: Most young adult childhood cancer survivors (90.2-96.5%) and references (97.4-98.8%) followed a No SADP trajectory. A larger proportion of childhood cancer survivors than references followed a Moderate (33-102 days/year) or High (115-260 days/year) SADP trajectory (15-year follow-up cohorts: Moderate 4.6% versus 1.2%; High 5.1% versus 1.5%). Childhood cancer survivors of central nervous system (CNS) tumors were at higher risk of the High SADP trajectory than childhood cancer survivors of hematological or non-CNS solid tumors (hematological versus CNS: odds ratio = 2.30, 95% CI 1.23-4.30; hematological versus non-CNS: odds ratio = 0.32, 95% CI 0.13-0.79). CONCLUSIONS: Although most young adult childhood cancer survivors had no SADP during follow-up, 9.7% experienced moderate or high numbers of SADP days/year throughout the 15-year follow-up; compared to 2.7% among references. CNS tumor survivors were at particular risk of SADP long-term and need extra attention in their future work prospect.
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Baecklund et al. (2022) conducted a cohort in Childhood cancer survivors (n=21,100). Childhood cancer survivorship vs. Matched references without childhood cancer was evaluated on Moderate or high sickness absence and disability pension (SADP) trajectory over 15 years. Childhood cancer survivors were more likely to experience moderate or high numbers of sickness absence and disability pension days per year over a 15-year follow-up compared to matched references (9.7% vs 2.7%).
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