Disability pension among patients with breast cancer: A Norwegian population-based controlled study.

Abstract

9039 Background: Cancer is sometimes followed by permanently reduced work ability, which in Norway qualifies for disability pension when the reduction is permanently 50% or more. The aim of this study is to examine various aspects about the 13-year risk of receiving disability pension in women with breast cancer compared to that of matched cancer-free controls. Methods: Cases included 1,555 breast cancer patients registered in the Cancer Registry of Norway, diagnosed 1992-96 and aged 45 to 54 years. For each case a randomly sampled age matched control was identified. All women were followed until they received disability pension or were censored due to retirement (67 years), death or 13 year censoring. Hazard ratios for disability pension were estimated using the Cox proportional hazard model, after adjustment for socio-demographic variables at diagnosis. Results: During the observation period 42.4% of cases and 25.8% of controls got disability pension. Compared to controls, adjusted hazard rate for having disability pension was 2.4 times higher for cases (95%CI 2.1–2.7). Low income, low education, older age, being not married, having no children <18 years and living in rural areas at diagnosis were associated with increased hazard rates of disability pension. Compared to stage I cases, hazard ratios for disability pension were 1.3 (95%CI 1.1-1.5), 1.8 (95%CI 1.1-2.9) and 2.9 (95%CI 2.0-4.3) for stage II, III and IV cases, respectively. Cases receiving disability pension shortly after diagnosis (<3 years) had more advanced cancer, compared to cases receiving later disability pension (>3 years) (p<0.001). Among stage I cases 24% had disability pension within 3 years after diagnosis, compared to 40% for stage II and III, and 66% for stage IV cases. Disability pension was provided at a shorter time from diagnosis in patients with lower versus higher educational level (p<0.002). Conclusions: Survivors of breast cancer are at significantly increased and persistent risk of getting disability pension compared to matched controls. The risk increases with more advanced cancer. Time from diagnosis to disability pension is shorter among survivors with low income, low education and more advanced cancer.