Prevalence of work-related disabilities using the ICF definition in an employed cohort diagnosed with breast or prostate cancer.

摘要

Advances in cancer diagnosis and treatment have resulted in improved survival. Increasing emphasis on early detection has resulted in working individuals having to face the disease. Therefore, effects of cancer treatment may result in employed patients requiring workplace accommodations to minimize absenteeism. This investigation focuses on cognitive and physical disabilities reported at twelve and eighteen months following diagnosis by 447 breast and 267 prostate cancer patients recruited from the Metropolitan Detroit Cancer Surveillance System. Disability was defined to include activity limitation in specified job tasks with labor market participation restriction. Twelve and eighteen month disability prevalence estimates were calculated and compared. Furthermore, influences of personal and environmental factors on disability development in the breast cancer cohort were tested using logistic regression. Participants reported more cognitive work demands than physical demands at both time points. However, respondents reported significantly more physical disabilities compared to cognitive disabilities at twelve and eighteen months (p0.05); yet estimates were below national averages. Women experienced significant reduction in physical (17% to 10%) and cognitive disability (9% to 5%) prevalence estimates from twelve months to eighteen months (p0.05). Men did not enjoy significant changes in estimates of physical (8% to 5%) or cognitive (3% to 1%) disability during this time frame. Regression results indicated personal factors such as income or age were not significant predictors of disability in women. However, African-American women were at higher risk for cognitive disability. Much more important to the outcome of disability was cancer stage and treatment. Women diagnosed at later stages had significantly more disability. The most significant environmental factor associated with presence of disability was the absence of paid sick leave as a benefit. Since treatment is reflective of cancer stage, the importance of screening and early detection must be stressed to minimize disability. Also, adequate recovery time is necessary to adjust to the affects of cancer treatments. Individuals who cannot afford to take this time and work through treatment may experience longer lasting impacts. Employers may wish to consider the cost of paid sick leave versus the costs associated with lower productivity to re-evaluate their benefit packages. Limitations of this study included design as a secondary analysis, low power to detect small changes and lack of data regarding accommodation and rehabilitation available to participants. Also, future studies should include mechanisms to track the nature and intensity of limitations and restrictions.