Work absence after breast cancer diagnosis:: a population-based study

Background: Absence from work after breast cancer diagnosis may be part of the burden of disease for women with cancer, but little research has addressed this. We examined work absences of 4 weeks or more among women who had had breast cancer during the 3 years after diagnosis and compared their absences with those of women who had never had cancer. Methods: Our 2 target study groups were women in Quebec 18 - 59 years of age who were working when they first received therapy for breast cancer between November 1996 and August 1997 and similarly aged women randomly selected from provincial health care files who had never had cancer and were working at the time of diagnosis in women who had cancer. We interviewed 646 women who had had breast cancer ( 73% of those eligible) and 890 women in the comparison group ( 51% of those eligible) by telephone 3 years after first diagnosis. Results: One year after diagnosis, 85% ( 459/ 541) of breast cancer survivors who remained free of disease during the 3- year study period were absent from work for 4 weeks or more compared with 18% ( 156/ 881) of healthy women ( geometric mean total duration 5.6 v. 1.7 months, p< 0.001). By the third year, disease-free women were not absent more than women in the comparison group; however, more women who had experienced any new cancer event continued to be absent from work and to be absent from work for longer periods of time. Receiving adjuvant chemotherapy prolonged absence duration ( 9.5 v. 5.4 months among women not receiving chemotherapy). Compared with survivors belonging to a union, those who did not belong to a union ( multivariate relative risk [ RR] 7.54, 95% confidence interval [ CI] 3.02 - 18.83) and those who were self- employed ( RR 13.95, 95% CI 5.53 - 35.21) were more likely to report no work absence. Interpretation: Most of the women with breast cancer took time off work ( almost 6 months on average) after receiving the diagnosis. Three years after diagnosis, breast cancer survivors who remained disease- free - a large proportion of women with non-metastatic breast cancer - were not absent from work more often or for longer periods of time than other working women.