Breast cancer and early retirement: Associations with disease characteristics, treatment, comorbidity, social position and participation in a six-day rehabilitation course in a register-based study in Denmark
Breast cancer and early retirement: Associations with disease characteristics, treatment, comorbidity, social position and participation in a six-day rehabilitation course in a register-based study in Denmark
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DOI：
10.3109/0284186x.2010.531048
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发表时间：
2011-02-01
期刊：
影响因子：
3.1
通讯作者：
Dalton, Susanne Oksbjerg
中科院分区：
文献类型：
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作者：
Damkjaer, Lars Henrik;Deltour, Isabelle;Dalton, Susanne Oksbjerg
介绍。这项基于登记的研究的目的是确定与乳腺癌治疗妇女提前退休相关的疾病、治疗、社会人口统计学和共病因素，并评估参加为期六天康复课程的乳腺癌幸存者提前退休的风险。材料和方法。研究人群包括参加康复课程的856名妇女和没有参加丹麦乳腺癌合作小组确定的课程的1805名妇女作为对照组。我们获得了1996-2007年每年领取失业津贴、疾病津贴和提前退休养恤金的资料。采用多变量cox-回归模型分析与乳腺癌后提前退休相关的疾病特异性、治疗相关、合并症和社会人口因素，并评估参加康复课程对提前退休的影响。结果。患有身体疾病的女性的退休率更高（风险比[HR]， 1.91; 95% CI, 1.3；评分为1；风险比为2.9；风险比为1.42;95% CI, 0.7；评分为>= 2），既往抑郁症（风险比，2.29;95% CI, 1.7; 3.2）或在乳腺癌诊断前一年接受过疾病福利（风险比，3.75;95% CI, 1.8; 7.8）。与伴侣同居与提前退休的风险比降低相关（HR, 0.70; 95% CI, 0.5-0.9）。接受化疗，单独或联合抗激素治疗，降低了风险比（HR, 0.49; 95% CI, 0.3； 0.8和HR， 0.5; 95% CI, 0.3; 0.8）。妇女参加康复课程后一年的退休率较高，但在三年后恢复统一。讨论。这项研究的结果有助于识别高危妇女，并指出有必要进行量身定制的康复治疗，以避免因永久性劳动力市场退出而导致乳腺癌幸存者不必要的边缘化。
Introduction. The purpose of this register-based study was to identify factors related to disease, treatment, sociodemographics and comorbidity associated with taking early retirement among women treated for breast cancer, and to evaluate the risk for taking early retirement among breast cancer survivors who attended a six-day rehabilitation course. Material and methods. The study population consisted of 856 women who attended the rehabilitation course and a comparison group of 1 805 women who did not attend the course identified through the Danish Breast Cancer Cooperative Group. We obtained information on receipt of unemployment benefits, sickness benefits and early retirement pension for each of the years 1996-2007. Multivariate cox-regression models were used to analyze disease-specific, treatment-related, comorbidity and sociodemographics factors associated with early retirement after breast cancer and to evaluate the effect of attending a rehabilitation course on taking early retirement. Results. The rate of retirement was higher for women with somatic comorbidity (hazard ratio [HR], 1.91; 95% CI, 1.3; 2.9 for score 1, and HR 1.42; 95% CI, 0.7; 2.7 for score >= 2), previous depression (HR, 2.29; 95% CI, 1.7; 3.2) or having received sickness benefits in the year before their breast cancer diagnosis (HR, 3.75; 95% CI, 1.8; 7.8). Living with a partner was associated with a reduced hazard ratio for taking early retirement (HR, 0.70; 95% CI, 0.5-0.9). Having received chemotherapy, alone or in combination with anti-hormone treatment, reduced the hazard ratio (HR, 0.49; 95% CI, 0.3; 0.8 and HR, 0.5; 95% CI, 0.3; 0.8, respectively). The rate of retirement was higher for women the year after attending the rehabilitation course but returned to unity by three years. Discussion. The results of this study contribute to the identification of at-risk women and point to the need for tailored rehabilitation to avoid unnecessary marginalization of breast cancer survivors due to permanent labor market withdrawal.