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. 2016 Jan 12;114(1):81-7.
doi: 10.1038/bjc.2015.431.

Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study

C H Paalman  1 , F E van Leeuwen  1 , N K Aaronson  1 , A G E M de Boer  2 , L van de Poll-Franse  3   4 , H S A Oldenburg  5 , M Schaapveld  1   3
Affiliations

Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study

C H Paalman et al. Br J Cancer. .

Abstract

Background: Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment.

Methods: Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000-2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events.

Results: BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4-1.8) or any work-related event up to 5-7 years (HR 1.5, 95% CI 1.3-1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6-2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4-1.7) or losing paid employment (HR 1.3, 95% CI 1.2-1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1-1.3) and after chemotherapy (HR 1.7; 95% CI 1.5-1.9) during the first 5 years after diagnosis.

Conclusions: BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC.

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Figures

Figure 1
Figure 1
Prevalence of work-related outcomes in BC survivors and the general population comparison sample in the year prior to BC diagnosis and at 2,5,7 and 10 years of follow-up. (A) % women with income from employment. (B) % women with disability benefits. (C) % women with unemployment benefits. (D) % women on welfare. *P<0.05; **P<0.01; ***P<0.001.
Figure 2
Figure 2
Cumulative incidence of losing paid employment and the uptake of social benefits during follow-up in BC patients and general population controls. (A) Loss of personal income. (B) Disability benefits. (C) Unemployment benefits. (D) Welfare. (E) Any work-related event.
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