{"title":"慢性髓性白血病患者的工作能力:丹麦全国队列研究。","authors":"Eva Futtrup Maksten, Jonas Faartoft Jensen, Gitte Thomsen, Ditte Rechter Zenas, Maren Poulsgaard Jørgensen, Lene Udby, Kirsten Fonager, Marianne Tang Severinsen","doi":"10.3390/cancers17091585","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objectives</b>: Patients with chronic myeloid leukemia (CML) have a long life expectancy due to modern treatment. However, treatment may have adverse effects that hamper work ability. <b>Methods</b>: Patients aged 25-60 years diagnosed in 2002-2020 were included in this nationwide matched cohort study examining work ability from diagnosis (index date), including the need for permanent disability compensation (flexible job or disability pension). Each patient was matched 1:5 on sex, birth year, and level of comorbidity with citizens from the general Danish population without CML. The risks of requiring flexible job and disability pension were calculated by cause-specific hazard ratios (HRs) using Cox proportional hazards regression, and the Aalen-Johansen estimator was used to determine cumulative risks. <b>Results</b>: A total of 489 patients with CML and 2445 matched comparators were included. The median age was 46 years, and males comprised 59.5% of the cohort. Matched comparators were more likely to work at index date and 1, 3, 5, and 10 years after the index date (<i>p</i> < 0.001). The HRs of requiring both flexible job (HR 8.7 (95% confidence interval (CI): 6.1;12.2, <i>p</i> < 0.001)) and disability pension (HR 3.7 (95% CI: 2.8;4.9, <i>p</i> < 0.001)) were higher among patients diagnosed with CML compared to matched comparators. The cumulative risk of requiring flexible job and disability pension also increased in patients with CML compared to matched comparators (<i>p</i> < 0.001). <b>Conclusions</b>: Patients with CML have a reduced work ability compared to the general population. More research is needed to determine the cause of their loss of ability to work.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 9","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072068/pdf/","citationCount":"0","resultStr":"{\"title\":\"Work Ability in Patients with Chronic Myeloid Leukemia: A Danish Nationwide Cohort Study.\",\"authors\":\"Eva Futtrup Maksten, Jonas Faartoft Jensen, Gitte Thomsen, Ditte Rechter Zenas, Maren Poulsgaard Jørgensen, Lene Udby, Kirsten Fonager, Marianne Tang Severinsen\",\"doi\":\"10.3390/cancers17091585\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background/Objectives</b>: Patients with chronic myeloid leukemia (CML) have a long life expectancy due to modern treatment. However, treatment may have adverse effects that hamper work ability. <b>Methods</b>: Patients aged 25-60 years diagnosed in 2002-2020 were included in this nationwide matched cohort study examining work ability from diagnosis (index date), including the need for permanent disability compensation (flexible job or disability pension). Each patient was matched 1:5 on sex, birth year, and level of comorbidity with citizens from the general Danish population without CML. The risks of requiring flexible job and disability pension were calculated by cause-specific hazard ratios (HRs) using Cox proportional hazards regression, and the Aalen-Johansen estimator was used to determine cumulative risks. <b>Results</b>: A total of 489 patients with CML and 2445 matched comparators were included. The median age was 46 years, and males comprised 59.5% of the cohort. Matched comparators were more likely to work at index date and 1, 3, 5, and 10 years after the index date (<i>p</i> < 0.001). The HRs of requiring both flexible job (HR 8.7 (95% confidence interval (CI): 6.1;12.2, <i>p</i> < 0.001)) and disability pension (HR 3.7 (95% CI: 2.8;4.9, <i>p</i> < 0.001)) were higher among patients diagnosed with CML compared to matched comparators. The cumulative risk of requiring flexible job and disability pension also increased in patients with CML compared to matched comparators (<i>p</i> < 0.001). <b>Conclusions</b>: Patients with CML have a reduced work ability compared to the general population. More research is needed to determine the cause of their loss of ability to work.</p>\",\"PeriodicalId\":9681,\"journal\":{\"name\":\"Cancers\",\"volume\":\"17 9\",\"pages\":\"\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072068/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancers\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/cancers17091585\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancers","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/cancers17091585","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景/目的:由于现代治疗,慢性髓性白血病(CML)患者有较长的预期寿命。然而,治疗可能有不利影响,妨碍工作能力。方法:将2002-2020年诊断为25-60岁的患者纳入这项全国性匹配队列研究,从诊断(索引日期)开始检查工作能力,包括永久性残疾补偿(弹性工作或残疾养老金)的需求。每名患者在性别、出生年份和合并症水平上与没有CML的丹麦普通人群进行1:5匹配。采用Cox比例风险回归,通过因由风险比(hr)计算灵活就业和伤残养老金的风险,并采用aallen - johansen估计量确定累积风险。结果:共纳入489例CML患者和2445例匹配比较者。中位年龄为46岁,男性占队列的59.5%。匹配的比较者更有可能在索引日期和索引日期后的1,3,5和10年工作(p < 0.001)。诊断为CML的患者需要灵活工作的HR (HR 8.7(95%可信区间(CI): 6.1;12.2, p < 0.001))和残疾养老金(HR 3.7 (95% CI: 2.8;4.9, p < 0.001))比匹配的比较者更高。与匹配的比较者相比,CML患者需要灵活工作和残疾养老金的累积风险也增加(p < 0.001)。结论:与一般人群相比,CML患者的工作能力降低。需要更多的研究来确定他们丧失工作能力的原因。
Work Ability in Patients with Chronic Myeloid Leukemia: A Danish Nationwide Cohort Study.
Background/Objectives: Patients with chronic myeloid leukemia (CML) have a long life expectancy due to modern treatment. However, treatment may have adverse effects that hamper work ability. Methods: Patients aged 25-60 years diagnosed in 2002-2020 were included in this nationwide matched cohort study examining work ability from diagnosis (index date), including the need for permanent disability compensation (flexible job or disability pension). Each patient was matched 1:5 on sex, birth year, and level of comorbidity with citizens from the general Danish population without CML. The risks of requiring flexible job and disability pension were calculated by cause-specific hazard ratios (HRs) using Cox proportional hazards regression, and the Aalen-Johansen estimator was used to determine cumulative risks. Results: A total of 489 patients with CML and 2445 matched comparators were included. The median age was 46 years, and males comprised 59.5% of the cohort. Matched comparators were more likely to work at index date and 1, 3, 5, and 10 years after the index date (p < 0.001). The HRs of requiring both flexible job (HR 8.7 (95% confidence interval (CI): 6.1;12.2, p < 0.001)) and disability pension (HR 3.7 (95% CI: 2.8;4.9, p < 0.001)) were higher among patients diagnosed with CML compared to matched comparators. The cumulative risk of requiring flexible job and disability pension also increased in patients with CML compared to matched comparators (p < 0.001). Conclusions: Patients with CML have a reduced work ability compared to the general population. More research is needed to determine the cause of their loss of ability to work.
期刊介绍:
Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.