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Sick leave and disability pension among Swedish testicular cancer survivors according to clinical stage and treatment

Nord, Carina; Olofsson, Sven-Erik LU ; Glimelius, Ingrid; Cedermark, Gabriella Cohn; Ekberg, Sara; Cavallin-Ståhl, Eva LU ; Neovius, Martin; Jerkeman, Mats LU and Smedby, Karin E. (2015) In Acta Oncologica 54(10). p.1770-1780
Abstract
Purpose. To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse.Material and methods. A cohort of 2146 Swedish TCSs diagnosed 1995-2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The... (More)
Purpose. To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse.Material and methods. A cohort of 2146 Swedish TCSs diagnosed 1995-2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The mean number of annual work days lost was also estimated.Results. TCSs were at a modestly increased annual risk of work loss up to the third year of follow-up (RR3rd year 1.25, 95% CI 1.08, 1.43), attributed to a more pronounced risk among extensively treated patients (4 chemotherapy courses: RR3rd year 1.60, 95% CI 1.19, 2.15; > 4 courses: RR3rd year 3.70, 95% CI 2.25, 6.11). Patients on surveillance or limited treatment (radiotherapy, 1-3 chemotherapy courses) did not have an increased risk of work loss beyond the first year. TCSs receiving > 4 chemotherapy courses had higher mean number of annual days of work loss up to the 10th year post-diagnosis, and a five-fold risk of disability pension (RR 5.16, 95% CI 2.00, 10.3).Conclusion. Extensively treated TCSs, but not those on surveillance or limited treatment, are at increased risk of work loss long-term, not explained by relapse. These patients may benefit from early rehabilitation initiatives. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Oncologica
volume
54
issue
10
pages
1770 - 1780
publisher
Taylor & Francis
external identifiers
  • wos:000366669900010
  • scopus:84946203417
ISSN
1651-226X
DOI
10.3109/0284186X.2015.1020967
language
English
LU publication?
yes
id
9d446c58-f49d-420d-8243-efc33e25965c (old id 8555592)
date added to LUP
2016-02-08 07:21:31
date last changed
2017-11-05 03:51:20
@article{9d446c58-f49d-420d-8243-efc33e25965c,
  abstract     = {Purpose. To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse.Material and methods. A cohort of 2146 Swedish TCSs diagnosed 1995-2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The mean number of annual work days lost was also estimated.Results. TCSs were at a modestly increased annual risk of work loss up to the third year of follow-up (RR3rd year 1.25, 95% CI 1.08, 1.43), attributed to a more pronounced risk among extensively treated patients (4 chemotherapy courses: RR3rd year 1.60, 95% CI 1.19, 2.15; > 4 courses: RR3rd year 3.70, 95% CI 2.25, 6.11). Patients on surveillance or limited treatment (radiotherapy, 1-3 chemotherapy courses) did not have an increased risk of work loss beyond the first year. TCSs receiving > 4 chemotherapy courses had higher mean number of annual days of work loss up to the 10th year post-diagnosis, and a five-fold risk of disability pension (RR 5.16, 95% CI 2.00, 10.3).Conclusion. Extensively treated TCSs, but not those on surveillance or limited treatment, are at increased risk of work loss long-term, not explained by relapse. These patients may benefit from early rehabilitation initiatives.},
  author       = {Nord, Carina and Olofsson, Sven-Erik and Glimelius, Ingrid and Cedermark, Gabriella Cohn and Ekberg, Sara and Cavallin-Ståhl, Eva and Neovius, Martin and Jerkeman, Mats and Smedby, Karin E.},
  issn         = {1651-226X},
  language     = {eng},
  number       = {10},
  pages        = {1770--1780},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Sick leave and disability pension among Swedish testicular cancer survivors according to clinical stage and treatment},
  url          = {http://dx.doi.org/10.3109/0284186X.2015.1020967},
  volume       = {54},
  year         = {2015},
}