Objectives

Working-aged colorectal cancer (CRC) patients have a much better survival, indicating the importance of their future work situation. We investigated trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis, and risk factors associated with different trajectories.

Methods

A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19–62 when first diagnosed with CRC in 2008–2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi² test and multinomial logistic regression.

Results

Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level, Charlson’s Comorbidity Index, and prediagnostic mental disorders were the strongest factors determining the SADP trajectory groups. In references, three trajectories (“constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified.

Conclusion

Approximately 80% of CRC survivors return to a low level of SADP at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for them. CRC survivors will benefit from early rehabilitation programs with identified risk factors.

中文翻译：

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结直肠癌前后疾病缺席和伤残抚恤金的轨迹：一项基于瑞典纵向人群的配对队列研究

目标

适龄结直肠癌（CRC）患者的生存期要好得多，这表明他们未来的工作状况非常重要。我们调查了CRC诊断前后的疾病缺席和残障养老金（SADP）的轨迹，以及与不同轨迹相关的危险因素。

方法

一项纵向的，基于人群的配对队列研究对瑞典的4735名19-62岁的CRC幸存者进行了首次队列研究，这些幸存者于2008-2011年首次被诊断为CRC，并使用来自多个全国性登记簿的微数据进行了18230例匹配的参考文献。计算出诊断日期之前2年至诊断后5年的年度SADP净天数。基于组的轨迹模型用于描述SADP轨迹。通过chi ²检验和多项式logistic回归检验轨迹成员，社会人口统计学和临床​​变量之间的关联。

结果

CRC幸存者的SADP天/年的四个轨迹被确定为：“仅在诊断前后增加”（占总数的52％），“在诊断后略有增加”（27％），“在诊断后先升高然后适度下降”（13％），和“一直很高”（8％）。文化程度，查尔森合并症和诊断前精神障碍是决定SADP轨迹组的最强因素。在参考文献中，确定了三个轨迹（“恒定不变”（占总数的80％），“恒定适度并逐渐下降”（占12％）和“非常高然后逐渐下降”（占8％）。

结论

诊断后5年，大约80％的CRC幸存者恢复到SADP较低的水平。精神障碍的诊断前状态，躯体合并症和低学历水平是他们将来SADP高水平的良好指标。CRC幸存者将受益于已确定风险因素的早期康复计划。