Key result
Comorbidity linked to ~362% higher long-term sickness absence in women with relapsed breast cancer.
Why the study?
The longitudinal prevalence and predictors of sickness absence and disability pension in breast cancer women who eventually developed relapse were not well characterized.
Cohort (n=1,293)
Odds Ratio: 4.62 (95% CI 2.49–8.57)
Among women with breast cancer who later relapse, higher cancer stage, comorbidities, and receipt of neoadjuvant/adjuvant therapy strongly predict the need for long-term sickness absence.
Higher-stage disease, comorbidity, and multimodal therapy were associated with elevated long-term sickness absence risk; extends prior observational data but leaves open need for prospective intervention trials.
OBJECTIVE: We aimed to determine the longitudinal prevalence and the predictors of sickness absence (SA) and disability pension (DP) in breast cancer (BC) women who eventually developed relapse. METHODS: A total of 1293 BC women, who were ages 20-63 years, diagnosed between 1996 and 2011 and by 2016 had all developed relapse, were identified in Swedish registers and were followed from two years before to five years after their primary diagnosis, while they were relapse-free. Annual prevalence of SA and DP was calculated. Logistic regression was used to estimate adjusted odds ratios (AOR) for long-term SA (>30 days) at one (y1) and three (y3) years post-diagnosis. RESULTS: Prevalence of long-term SA was 68.1% in y1 and 16.3% in y5. Prevalence of DP progressively increased from 16.3% in y1 to 29.0% in y5. Predictors of long-term SA included age <50 years (y1:AOR = 1.79 [1.39-2.29]), TNM stage III (y1:AOR = 1.54 [1.03-2.31]; y3:AOR = 2.21 [1.32-3.72]), metastasis (y1:AOR = 1.64 [1.26-2.12]; y3:AOR = 1.51 [1.05-2.18]), comorbidity (y1:AOR = 2.41 [1.55-3.76]; y3 AOR = 4.62 [2.49-8.57]) and any combination of radiotherapy, chemotherapy and hormonal therapy (y1:AOR = 2.05-5.71). CONCLUSION: Among BC women who later developed relapse, those who had higher stages of BC, had comorbidity and received neoadjuvant and/or adjuvant therapy were at significantly higher risk of needing long-term SA after their diagnosis.
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Gernaat et al. (2020) conducted a cohort in Breast cancer with subsequent relapse (n=1,293). Comorbidity, advanced stage, and adjuvant therapies vs. Absence of these risk factors was evaluated on Long-term sickness absence (>30 days) at three years post-diagnosis (associated with comorbidity) (AOR 4.62, 95% CI 2.49-8.57). Among women with breast cancer who later relapsed, comorbidity strongly predicted long-term sickness absence at three years post-diagnosis (AOR 4.62; 95% CI 2.49-8.57).
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