Sickness absence and disability pension among Swedish women before breast cancer relapse.

Abstract

e14121 Background: Sickness absence (SA) and disability pension (DP) from diagnosis of primary breast cancer (BC) among patients who in a later stage will develop a recurrence or metastatic disease is unknown. This study explores the prevalence and risk factors of SA and DP in this study population before and after primary breast cancer diagnosis. Methods: Longitudinal register data on 1,310 female patients living in Sweden (age 20 to 63 years) diagnosed with primary BC between 1996 to 2011, were analyzed for annual prevalence of SA days and DP starting 2 years pre- to 5 years postdiagnosis. Logistic regressions were used to explore associations between primary BC characteristics and future SA. Results: 579 (44.2%) had loco-regional recurrence after a median of 2.5 years (interquartile range (IQR) = 1.3-4.3) and 731 (55.8%) had a metastatic disease after a median of 2.3 years (IQR = 1.3-4.1). 320 (24.4%) of 1,310 were still relapse-free 5 years postdiagnosis. SA was high during year 1 postdiagnosis but decreased steadily through year 5 (67.9%, 40.3%, 29.0%, 23.9%, 19.4%, respectively), while DP steadily increased during this time period (16.4%, 17.5%, 19.7%, 24.9%, 28.7%, respectively). The annual prevalence of SA over 180 days among patients who later were diagnosed with metastatic disease was constantly higher compared to patients who later were diagnosis of loco-regional recurrence. Pre-diagnosis SA, age < 50 years at the time of diagnosis, higher tumor stage, chemotherapy and future metastatic disease were associated with higher odds ratios for SA (odds ratio range, 1.56 to 4.42) Conclusions: In conclusion, longitudinal rates of SA and DP in a cohort of women with early BC, of whom a part developed disease relapse during follow-up were higher compared to previous studies. These are unique findings as previously published studies excluded patients with disease relapse. Patients at increased risk for SA, should be assessed and triaged to optimize chances for a smooth transition to return to work after oncological treatment.