Predictive factors for prolonged sick leave in breast cancer patients treated with adjuvant therapies: a retrospective registry study

Abstract

Background

Being able to work during and after breast cancer treatments is important for patients to have a sense of normalcy, financial security, and improved quality of life, and for society due to the economic burden of sick leave. Factors influencing the length of sick leave can be sociodemographic factors, workplace adaptations, recurrences, symptoms, and type of treatment. The aim of this study is to analyse factors associated with prolonged sick leave after adjuvant breast cancer treatments.

Methods

The population of this registry study consists of 1333 early breast cancer patients diagnosed and treated in Helsinki University Hospital between 2016 and 2018. Data on patient demographics, disease characteristics, treatment, and healthcare resource utilization were obtained from Helsinki University Hospital and data on income level and sick leave were obtained from Kela sickness benefits registry. Prolonged sick leave was determined as the patient accumulating 30 or more reimbursed sick leave days during a 60-day follow-up period after the end of active oncological treatment. Univariate analysis and multivariate analysis were conducted.

Results

A total of 26% of the patients in this study were on sick leave for 30 or more days after the active treatments ended. Study findings show that chemotherapy, triple-negative breast cancer, reconstructive surgery, amount of outpatient visits, and income are associated with prolonged sick leave. Independent predictors of prolonged sick leave were treatment line, number of outpatient contacts, reconstruction, and triple-negative breast cancer.

Conclusions

Our study shows that prolonged sick leave affects a substantial number of working-age women with early breast cancer. Independent predictors for prolonged sick leave were all treatment-related. Targeted support for treatment-related side-effects already during the treatment period could lead to better recovery and earlier return to work.

Keywords:

• Breast cancer
• treatment
• prolonged sick-leave
• return-to-work
• predictive
• registry study

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Paula Pennanen], [Mari Lahelma]. All authors participated in the writing of the manuscript. All authors have read and approved the final manuscript.”

Ethics approval

This received a study permit from the Helsinki University hospital (10.12.2020) HUS/175/2020.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available on request from the corresponding author PPS. The data are not publicly available due to restrictions e.g., their containing information that could compromise the privacy of research participants.

Additional information

Funding

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 777167.