Trajectories of sickness absence and disability pension before and after colorectal cancer: A Swedish longitudinal population-based matched cohort study

Abstract

Objectives Working-aged colorectal cancer (CRC) patients have a much better survival, indicating the importance of their future work situation. We investigated trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19–62 when first diagnosed with CRC in 2008–2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level, Charlson’s Comorbidity Index, and prediagnostic mental disorders were the strongest factors determining the SADP trajectory groups. In references, three trajectories (“constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusion Approximately 80% of CRC survivors return to a low level of SADP at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for them. CRC survivors will benefit from early rehabilitation programs with identified risk factors.

Sickness absence and disability pension trajectories in childhood cancer survivors and references- a Swedish prospective cohort study

“…Hence, this group of young adult CCS may need extra support to prepare for and to stay in the labor market. An association between low education and higher risk of SADP later in life is well described in non-CCS cohorts [36][37][38]. We speculate that the underlying cause may be different among CCS.…”

Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders – a SWEREG-TMD population-based cohort study

“…In this study, more comorbidities among TMD patients resulted in more days of SL and DP. This finding is not surprising and multiple comorbidities have been shown to affect the trajectory and need of social insurance benefits for other conditions as well [ 27 – 31 ]. Our results also show increased reliance on social insurance benefits even before diagnosis and inclusion in the study.…”

Labor Market Attachment 2 Years After Colorectal Cancer Surgery

“…Other studies have found that labor market participation is affected among cancer patients in general 34 and among CRC patients in particular. 30,33,[35][36][37][38][39] Several prognostic factors have been investigated in cohorts of CRC patients, but the vast majority of individual factors were investigated in only 1 or 2 studies. Previous studies have shown, that (Neo)adjuvant therapy, higher age, low educational level, and comorbidity impact labor market attachment negatively; whereas unemployment, extensive surgical resection, and postoperative complications increase the risk of work disability.…”

“…Previous studies have shown, that (Neo)adjuvant therapy, higher age, low educational level, and comorbidity impact labor market attachment negatively; whereas unemployment, extensive surgical resection, and postoperative complications increase the risk of work disability. 38,40 Furthermore, return to work is impaired by the presence of metastases, emotional distress, postoperative complications, part-time employment at baseline, and being employed in a large company. 33,41 Although statistically significant associations between working 2 years after surgery and a number of sociodemographic and clinical factors were found in this study, the main reasons why 1 in 3 CRC survivors had not resumed work after 2 years, can only be hypothesized.…”