Trajectories of sickness absence and disability pension in the 2 years before and 3 years after breast cancer diagnosis: A Swedish longitudinal population‐based cohort study

Background After breast cancer (BC) diagnosis, work incapacity often occurs among working‐age women. We investigated the trajectories of previous and subsequent sickness absence and/or disability pension (SA/DP) days, and risk factors for consistently high levels of future SA/DP among these women. Methods This longitudinal cohort study included all 3536 women in Sweden aged 19‐64 years who received a first BC diagnosis in 2010. Their annual SA/DP net days from 2 years before to 3 years after diagnosis were calculated. SA/DP patterns were depicted by a group‐based trajectory model. Logistic regressions were used to calculate odds ratios (ORs) with 95% CIs of >90 or >180 SA/DP days/year. Results Three trajectories of SA/DP days/year were identified: increasing only in year+1 (61% of all), increasing then decreasing in year+3 (30%), and constantly very high (9%). The risk factors associated with annual SA/DP days >90 (long) and >180 days (extreme long) were similar. Factors associated with having >90 SA/DP days for years 1‐3 were: stage II (OR, 4.59; 95% CI, 2.98‐7.07), stage III+IV (OR, 26.57; 95% CI, 13.52‐52.22), prediagnosis SA 1‐30 days (OR, 2.73; 95% CI, 1.30‐5.70), prediagnosis SA >90 days (OR, 24.52; 95% CI, 12.25‐49.08), and prediagnosis DP (OR, 659.97; 95% CI, 292.52‐>999.99). Conversely, adjusting for prediagnosis SA/DP and stage, sociodemographic factors were not associated with high levels of SA/DP. Conclusion After BC diagnosis, SA/DP increased significantly but then decreased. The absolute majority had no SA/DP during year 3. Advanced cancer stage and previous high SA/DP rendered the greatest risk for future high SA/DP. More knowledge is needed for applying the information in rehabilitation and return‐to‐work planning. This study examines different sickness absence and disability pension trajectories after breast cancer diagnosis and highlights the risk factors associated with continuous high levels of sickness absence and disability pension.