结肠癌和直肠癌后的收入和工作损失:瑞典全国范围内的匹配队列研究。

IF 9.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2024-08-06 eCollection Date: 2024-09-01 DOI:10.1016/j.eclinm.2024.102770
S E Boman, I Hed Myrberg, G Bruze, A Martling, C Nordenvall, P J Nilsson
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引用次数: 0

摘要

背景:结肠直肠癌很常见,预后正在改善。因此,治疗幸存者的状况(包括经济后果)非常重要。本研究的目的是量化结肠癌和直肠癌适龄工作患者相对于匹配比较者的收入损失和工作损失:研究利用了 CRCBaSe 数据库中的数据,该数据库由瑞典全国结肠直肠癌登记册生成,并包含瑞典多个全国性登记册中的数据。直肠癌患者的研究时间为 1995-2020 年,结肠癌患者的研究时间为 2007-2020 年。该研究以人口为基础,在全国范围内对接受过 I-III 期结直肠癌治疗的幸存者的收入、可支配收入和工作损失进行了回顾性队列研究。研究采用中位数回归分析收入和可支配收入,采用逻辑回归分析失去工作的概率:研究分析了 8863 名在 2017 年前确诊的结直肠癌幸存者和 52514 名根据出生年份、法定性别和居住地匹配的比较者。结肠癌患者在确诊前一个日历年和确诊后一个日历年之间的收入明显减少,从31319欧元减少到23924欧元,直肠癌患者从32636欧元减少到22647欧元。可支配收入几乎没有变化。结肠癌和直肠癌患者在确诊当年失去工作的几率增加,分别从上一年的 29.8% 和 25.3% 增加到 83.3% 和 84.4%,而且从未完全恢复。结肠癌和直肠癌幸存者的失业概率相似,但接受过新辅助治疗的直肠癌患者的失业概率更高:这项研究表明,尽管广泛的福利制度提供了可维持的可支配收入,但结肠直肠癌幸存者仍有经济负担,表现为失业风险增加和收入减少:这项研究得到了瑞典癌症协会、瑞典癌症和过敏基金会以及斯德哥尔摩癌症协会的支持,并得到了斯德哥尔摩县议会和卡罗林斯卡医学院之间的医学培训和临床研究地区协议(ALF)的资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Earnings and work loss after colon and rectal cancer: a Swedish nationwide matched cohort study.

Background: Colorectal cancer is common and prognosis is improving. The conditions of survivors of treatment, including financial consequences, are thus important. The aim of this study was to quantify loss of earnings and work loss in working-age patients with colon and rectal cancer relative to matched comparators.

Methods: The study utilised data from the CRCBaSe database that is generated from the nationwide Swedish ColoRectal Cancer Register and includes data from several Swedish nationwide registers. The study period was 1995-2020 for rectal cancer patients and 2007-2020 for colon cancer patients. A retrospective population-based nationwide cohort study on earnings, disposable income, and work loss, in survivors of stage I-III colorectal cancer treatment was undertaken. Median regression was used to analyse earnings and disposable income, and logistic regression to analyse the probability of work loss.

Findings: A cohort of 8863 colorectal cancer survivors diagnosed before 2017 and 52,514 comparators matched on birth year, legal sex, and county of residence, was analysed. There was a clear reduction in earnings between the calendar year prior to and the calendar year after diagnosis, from € 31,319 to € 23,924 for colon cancer patients and from € 32,636 to € 22,647 for rectal cancer patients, and earnings never fully recovered during the 5-year follow-up. Disposable income was practically unaltered. The probability of work loss increased in the calendar year of diagnosis, from 29.8% to 25.3% the previous year to 83.3% and 84.4% for colon and rectal cancer patients respectively, and never fully recovered. The probability of work loss was similar between colon and rectal cancer survivors, but was higher among patients with rectal cancer who had received neoadjuvant therapy.

Interpretation: This study shows that despite an extensive welfare system providing maintained disposable income, there is a financial burden in the form of increased risk of work loss and a reduction in earnings among survivors of colorectal cancer.

Funding: The study was supported by the Swedish Cancer Society, the Swedish Cancer and Allergy Foundation, and the Stockholm Cancer Society, and supported by grants provided by the Regional Agreement on Medical Training and Clinical Research (ALF) between the Stockholm County Council and Karolinska Institutet.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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