Returning to work after a sickness absence due to cancer: a cohort study of salaried workers in Catalonia (Spain)

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.

Work-Related Factors and Lung Cancer Survival: A Population-Based Study in Switzerland (1990–2014)

“…In Switzerland, elementary occupations have the highest proportion (>60%) of part-time workers, three-fourths of whom are women [ 63 ]. Depending on whether part-time work was voluntary or involuntary (when it was impossible to return to full-time work) [ 18 ], it could be either protective or a risk factor for survival. However, the evidence is very scarce.…”

“…Therefore, we could not fully rule out a selection bias. Assigning occupations as a time-dependent variable based on two time points could result in some misclassification, especially given that cancer survivors have a less stable employment trajectory than other workers [ 18 ]. Nevertheless, the information on the occupation at the time of the federal censuses is correct and we believe we assigned it accurately enough, since the majority of patients kept the same occupation between the two censuses [ 3 ].…”

“…Lung cancer survivors suffer from severe fatigue and have a worse health-related quality of life compared with other cancer survivors [ 15 ]. Moreover, lung cancer survivors experience a high risk of unemployment and very low professional reintegration after an interruption due to illness [ 16 , 17 , 18 ]. In Italy, a significant association between job loss and gender (male), low level of education, heavy work, advanced stage of cancer, chemotherapy, and comorbidity was reported [ 17 ].…”

“…In South Korea, compared to patients returning to work, unemployed cancer survivors are older, likely manual/service-oriented workers, have lower family income, have undergone chemotherapy, have fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions [ 20 , 21 ]. Cancer survivors able to return to work usually have a less stable employment trajectory than other workers [ 18 ] and may face financial problems due to a reduction in working hours [ 12 ]. Although the financial distress characteristic of cancer patients seems to be primarily determined by pre-diagnosis sociodemographic factors [ 22 ], financial and occupation-related factors that might change during the course of the disease can negatively affect the quality of life and survival [ 23 , 24 ].…”

Labour market participation after a sickness absence due to cancer: a dynamic cohort study in Catalonia (Spain)

“…Characterising the working paths of cancer survivors may shed light on how surviving the disease and subsequent career decisions may interact in the long term. In a previous study, we showed that cancer survivors are less likely to accumulate days of employment in the long term [12]. On the one hand, these changes in survivors' working life may be driven by personal decisions due to health or financial status or a desire to modify career paths after a reassessment of life priorities [13].…”