Sick leave and disability pension in Hodgkin lymphoma survivors by stage, treatment, and follow-up time-a population-based comparative study

• Purpose This study seeks to investigate the long-term public health burden of Hodgkin lymphoma (HL) in terms of work loss following contemporary treatment protocols and associations with established treatment complications and lymphoma relapse. Methods We identified 1,989 Swedish HL patients (1,082 with clinical information) aged 18-60 (median 33) years at diagnosis 1992-2009, and matched 1:4 to population comparators. Sick leave, disability pension (work loss), and comorbidity were retrieved through September 2013. Relative risks (RR) with 95 % confidence intervals (CI) were calculated using Poisson regression, and mean lost work days were estimated yearly during follow-up. Results The risk of annual work loss was elevated in HL survivors versus comparators up to the 15th year post-diagnosis (RR5th year 1.64, 95 % CI 1.46-1.84; RR10th year 1.33, 95 % CI 1.15-1.34; and RR15th year 1.30, 95 % CI 1.04-1.62). The risk remained elevated up to the 10th year after adjustment for secondary malignancies and cardiovascular disease (RR10th year 1.31, 95 % CI 1.13-1.52). Advanced-stage patients had more lost days than comparators (mean number(5th year) 66 versus 33, mean difference 34, 95 % CI 20-48) as did patients receiving 6-8 chemotherapy courses (62 versus 33, mean difference(5th year) 30, 95 % CI 17-43). Among patients in the first complete remission, a difference was still observed for advanced-stage (51 versus 33, mean difference(5th year) 19, 95 % CI 5-34) but not early-stage disease. Conclusions Advanced-stage HL survivors treated with full-dose chemotherapy were at increased risk of work loss, not only explained by relapse, secondary malignancies, or cardiovascular disease.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

Nyckelord

Work loss

survivorship

Cancer

Chemotherapy

Disability pension

Sick leave

Hodgkin lymphoma

Hodgkin lymphoma

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)