Abstract
BackgroundIn Japan, 55.5% of breast cancer survivors (BCSs) are of working age, so various perspectives regarding return to work (RTW) after cancer diagnosis need to be considered. Therefore, this study aimed to clarify the risk factors for resignation and taking sick leave (SL) among BCSs in continued employment at the time of diagnosis.MethodsA web-based retrospective cross-sectional survey was conducted on BCSs using data from a 2018 Japanese national research project (Endo-Han) commissioned by the Ministry of Health, Labour and Welfare of Japan. The subjects were women aged 18–69 years who had been diagnosed with breast cancer for the first time at least 1 year previously. The risk factors for resignation and taking SL after breast cancer diagnosis, including age at diagnosis, education level, cancer stage, surgery, chemotherapy, radiotherapy, employment status, and occupational type, were then analyzed using a logistic regression model.ResultsIn total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of the multivariable analysis indicated that lower education level (odds ratio [OR]: 3.802; 95% confidence interval [CI]: 1.233–11.729), taking SL (OR: 2.514; 95%CI: 1.202–5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221–0.998) were predictors of resignation. Of 229 patients who continued working, SL was taken by 72 (31.4%). In addition, undergoing surgery was found to be a predictor of taking SL (OR: 8.311; 95%CI: 1.007–68.621).ConclusionsIn total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of this study indicated that younger age, lower education level, and taking SL were predictors of resignation after breast cancer diagnosis.
Highlights
In Japan, 55.5% of breast cancer survivors (BCSs) are of working age, so various perspectives regarding return to work (RTW) after cancer diagnosis need to be considered
As the number of working women has been increasing in Japan [7], it is expected that more working-age women will be diagnosed with breast cancer in the near future, following trends seen in Western countries [8,9,10]
The following terms are generally defined as follows in Japan: RTW: returning to the workforce, resignation: leaving a job, sick leave (SL): after workers use up their paid leave, this generally becomes known as SL; during SL, employees are paid > 60% of their usual remuneration by their health insurance in accordance with the Labor Standards Act of Japan [19]
Summary
In Japan, 55.5% of breast cancer survivors (BCSs) are of working age, so various perspectives regarding return to work (RTW) after cancer diagnosis need to be considered. The number of breast cancer survivors (BCSs), along with their 5-year survival rates, continue to rise steadily in Japan because of early detection and advances in treatment [1]. As breast cancer survival rates have increased, issues surrounding the quality of life (QOL) of BCSs, including palliative care, mental health, and employment, have received more attention [2,3,4,5]. In 2015, approximately 55.5% of the 83,959 BCSs in Japan belonged to a working age group, typically defined as 20–64 years old [6]. In 2016, the Japanese government amended the Cancer Control Act (this law sets out a duty for employers to strive to keep cancer survivors [CSs] working) and published guidelines outlining support for individuals undergoing therapy during working life to aid employers in providing better support to employees with cancer, similar to the Netherlands [11]
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