Labor market affiliation of patients with myeloproliferative neoplasms: a population-based matched cohort study

Abstract

Background

Patients with myeloproliferative neoplasms (MPNs) suffer from substantial symptoms and risk of debilitating complications, yet observational data on their labor market affiliation are scarce.

Material and methods

We conducted a descriptive cohort study using data from Danish nationwide registries, including patients diagnosed with MPN in 2010-2016. Each patient was matched with up to ten comparators without MPN on age, sex, level of education, and region of residence. We assessed pre- and post-diagnosis labor market affiliation, defined as working, unemployed, or receiving sickness benefit, disability pension, retirement pension, or other health-related benefits. Labor market affiliation was assessed weekly from two years pre-diagnosis until death, emigration, or 31 December 2018. For patients and comparators, we reported percentage point (pp) changes in labor market affiliation cross-sectionally from week −104 pre-diagnosis to week 104 post-diagnosis.

Results

The study included 3,342 patients with MPN and 32,737 comparators. From two years pre-diagnosis until two years post-diagnosis, a larger reduction in the proportion working was observed among patients than comparators (essential thrombocythemia: 10.2 [95% CI: 6.3–14.1] vs. 6.8 [95% CI: 5.5–8.0] pp; polycythemia vera: 9.6 [95% CI: 5.9–13.2] vs. 7.4 [95% CI: 6.2–8.7] pp; myelofibrosis: 8.1 [95% CI: 3.0–13.2] vs. 5.8 [95% CI: 4.2–7.5] pp; and unclassifiable MPN: 8.0 [95% CI: 3.0–13.0] vs. 7.4 [95% CI: 5.7–9.1] pp). Correspondingly, an increase in the proportion of patients receiving sickness benefits including other health-related benefits was evident around the time of diagnosis.

Conclusion

Overall, we found that Danish patients with essential thrombocythemia, polycythemia vera, myelofibrosis, and unclassifiable MPN had slightly impaired labor market affiliation compared with a population of the same age and sex. From two years pre-diagnosis to two years post-diagnosis, we observed a larger reduction in the proportion of patients with MPN working and a greater proportion receiving sickness benefits compared with matched individuals.

Keywords:

• Myeloproliferative disorder
• epidemiology
• cohort studies
• matched groups
• population characteristics
• employment

Acknowledgements

The authors would like to thank the Danish hematologists for their continued efforts in reporting MPN data to the Danish National Chronic Myeloid Neoplasia Registry.

Disclosure statement

Novartis funded the work done by the employees at Aarhus University. A.K., C.F.C., E.M.M., and L.S.S.: employees at Aarhus University/Aarhus University Hospital. A.S. and B.P.: employees at Novartis. H.C.H.: consultant for Novartis. All authors declare no personal conflicts of interests.

Data availability statement

Data presented in this study were obtained from Danish registries and handled remotely at secured servers at Statistics Denmark. Owing to the guidelines by Statistics Denmark, the authors are not allowed to share individual-level data. Anonymized data (including counts reported as '≤5' persons) are shared in the manuscript. Other researchers who fulfil the requirements set by the data providers could obtain similar data.