People who have taken sick leave due to cancer continue to work in a lower proportion than employees who have not suffered from the disease and they also have a less stable career, according to a new study by researchers at the Center for Research in Occupational Health (CiSAL), Pompeu Fabra University (UPF), Hospital del Mar Medical Research Institute (IMIM), and the CIBER for Epidemiology and Public Health (CIBERESP). The article, coordinated by Fernando G. Benavides, head of the CIBERESP group at UPF, has been published in the journal Scientific Reports and enjoys the participation of the University of Girona.
Cancer incidence and survival rates have increased in recent decades, and as a result, so has the number of working-age people diagnosed with cancer who return to work. Even so, cancer survivors often suffer chronic symptoms due to the disease and also its treatment. This affects all aspects of their life, and they may experience limitations in their future working life.
This new study evaluates the career paths of a sample of salaried workers in Catalonia who had taken sick leave due to cancer. This group has been compared to working people that have not taken sick leave or who had done so due to other illnesses. “We have obtained our data from a longitudinal cohort formed from the working life of salaried people facilitated by the Spanish Social Security, with a long follow-up period that allows us to appreciate long-term differences”, explains Amaya Ayala García, first author of the study and researcher of the CIBERESP in the CiSAL.
Returning to work could benefit the health of cancer patients due to a greater sense of purpose, greater self-confidence, and a greater sense of social belonging associated with employment. But a successful return process is influenced by factors related to the disease and treatment, sociodemographic variables, and working and employment conditions.
“To eliminate bias, each individual taking sick leave due to cancer between 2012 and 2015 was matched for age, sex and date of entry to the cohort with a worker taking sick leave due to another diagnosis and another worker who had not taken sick leave”, she adds.
The results show that employees taking leave due to cancer continue to work after being absent less frequently than those not taking leave. In addition, they do so with a less stable career path. Specifically, men and women not taking sick leave or taking sick leave due to another diagnosis were at least 9% more likely to continue in employment compared to employees who had taken sick leave due to cancer.
“These differences may lead to significant social inequalities, since losing employment leads to a decrease in income. Let us recall that for the vast majority of citizens, their salary is the main, if not the only, source of economic income. Moreover, not being able to work when you can and want to leads to a loss of self-esteem and social relations, which can make it psychologically difficult to recover from cancer”, points out Fernando G. Benavides, full professor of Public Health at UPF and CIBERESP researcher.
The need for a new study with a gender perspective
“Regarding differences by sex, we have found more differences in men who have cancer compared to those who have no diagnosis than in women, contrary to what the literature says. Although there are contradictory results”, Amaya Ayala comments. She adds that “gender is a transversal axis of inequalities and the gender gap is reflected in the Spanish labour market where participation by women is lower than in other countries, where most of the literature comes from. In addition, marital status or having children or dependents have been seen to be prognostic factors for women returning to work. This year, we are going to carry out a study with a qualitative methodology that we hope will clarify some of these results”, she concludes.
Health and social protection systems must guarantee people who have suffered from cancer the opportunity to continue their voluntary participation in the labour market.
“This study represents a step towards a better understanding of the relationship between cancer and long-term employment and encourages future research in this area”, Fernando G. Benavides explains. Returning to work could benefit the health of cancer patients due to a greater sense of purpose, greater self-confidence, and a greater sense of social belonging associated with employment. But a successful return process is influenced by factors related to the disease and treatment, sociodemographic variables, and working and employment conditions.
Hence, health and social protection systems must guarantee people who have suffered from cancer the opportunity to continue their voluntary participation in the labour market. “In Spain, studies concerning the return to work and the consequences of cancer on working life are very scarce. Hence the need to continue researching in this area, as is being done in other European countries, and to take into account in the studies the location and stage of the cancer, as well as the treatment, since they are important determinants of the adverse effects that will mark the individual’s future working life”, Amaya Ayala comments.
“We recommend working on programmes for the gradual return to employment and the adaptation of job posts, always with the consent of the employee, as is done, for example, in Scandinavia, the Netherlands, the United Kingdom, Canada and the USA”, Fernando G. Benavides concludes.
Ayala-Garcia A, Serra L, Hernando-Rodriguez JC, Benavides FG. Returning to work after a sickness absence due to cancer: a cohort study of salaried workers in Catalonia (Spain). Sci Rep, Dec 2021. DOI: 10.1038/s41598-021-03368-8.
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Returning to work after a sickness absence due to cancer: a cohort study of salaried workers in Catalonia (Spain)
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