Employment and social benefits up to 10 years after breast cancer diagnosis

A population-based study

C. H. Paalman, F. E. van Leeuwen, N. K. Aaronson, A. G. E. M. de Boer, L.V. van de Poll-Franse, H. S. A. Oldenburg, M. Schaapveld

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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.
Keywords: breast cancer; work; employment; disability benefits; long term effects
Original languageEnglish
Pages (from-to)81-87
JournalThe British Journal of Cancer
Volume114
Issue number1
DOIs
Publication statusPublished - 2016

Keywords

  • breast cancer
  • work
  • employment
  • disability benefits
  • long term effects

Cite this

Paalman, C. H., van Leeuwen, F. E., Aaronson, N. K., de Boer, A. G. E. M., van de Poll-Franse, L. V., Oldenburg, H. S. A., & Schaapveld, M. (2016). Employment and social benefits up to 10 years after breast cancer diagnosis: A population-based study. The British Journal of Cancer, 114(1), 81-87. https://doi.org/10.1038/bjc.2015.431
Paalman, C. H. ; van Leeuwen, F. E. ; Aaronson, N. K. ; de Boer, A. G. E. M. ; van de Poll-Franse, L.V. ; Oldenburg, H. S. A. ; Schaapveld, M. / Employment and social benefits up to 10 years after breast cancer diagnosis : A population-based study. In: The British Journal of Cancer. 2016 ; Vol. 114, No. 1. pp. 81-87.
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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.Keywords: breast cancer; work; employment; disability benefits; long term effects",
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author = "Paalman, {C. H.} and {van Leeuwen}, {F. E.} and Aaronson, {N. K.} and {de Boer}, {A. G. E. M.} and {van de Poll-Franse}, L.V. and Oldenburg, {H. S. A.} and M. Schaapveld",
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Paalman, CH, van Leeuwen, FE, Aaronson, NK, de Boer, AGEM, van de Poll-Franse, LV, Oldenburg, HSA & Schaapveld, M 2016, 'Employment and social benefits up to 10 years after breast cancer diagnosis: A population-based study', The British Journal of Cancer, vol. 114, no. 1, pp. 81-87. https://doi.org/10.1038/bjc.2015.431

Employment and social benefits up to 10 years after breast cancer diagnosis : A population-based study. / Paalman, C. H.; van Leeuwen, F. E.; Aaronson, N. K.; de Boer, A. G. E. M.; van de Poll-Franse, L.V.; Oldenburg, H. S. A.; Schaapveld, M.

In: The British Journal of Cancer, Vol. 114, No. 1, 2016, p. 81-87.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Employment and social benefits up to 10 years after breast cancer diagnosis

T2 - A population-based study

AU - Paalman, C. H.

AU - van Leeuwen, F. E.

AU - Aaronson, N. K.

AU - de Boer, A. G. E. M.

AU - van de Poll-Franse, L.V.

AU - Oldenburg, H. S. A.

AU - Schaapveld, M.

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N2 - 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.Keywords: breast cancer; work; employment; disability benefits; long term effects

AB - 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.Keywords: breast cancer; work; employment; disability benefits; long term effects

KW - breast cancer

KW - work

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KW - disability benefits

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U2 - 10.1038/bjc.2015.431

DO - 10.1038/bjc.2015.431

M3 - Article

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EP - 87

JO - The British Journal of Cancer

JF - The British Journal of Cancer

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