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Abstract
Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Accumulated days of employment were measured, and negative binomial models were applied to assess differences between comparison groups. Latent class models were applied to identify EPTs and multinomial regression models to analyse the probability of belonging to one EPT of each group. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). Men without SA had the highest probability of having high stable EPT compared to workers who had a SA due to cancer (adjusted RRR 3.21, 95% CI 1.87‒5.50). Even though workers with SA due to cancer continue working afterwards, they do it less often than matched controls and with a less stable employment trajectory. Health and social protection systems should guaranty cancer survivors the opportunity to continue voluntary participation in the labour market.
Highlights
Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work
Workers with sickness absence (SA) due to cancer accumulated the fewest number of days of employment (3.2 years average for men and 3.7 years for women), whereas salaried workers without SA accumulated the highest number of days of employment (4.0 years average for men and 4.1 for women; Table 1)
Salaried workers without SAs had a higher crude probability of continuing employment than those who had a SA due to cancer, especially among men (IRR 1.25, 95% confidence interval (CI) 1.03‒1.52 vs. 1.10, 95% CI 0.97‒1.25 in women)
Summary
Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). The steady increase in working age individuals diagnosed with cancer are expected to increase the number of people returning to work after treatment. Most cancer survivors attempt to RTW after t reatment[20], and studies have shown a steady increase in RTW as time after diagnosis increases[21]
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