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25/01/2022 - General information

People who have been on sick leave due to cancer find it more difficult to continue working and have less job stability

· A study by CiSAL and CIBERESP shows that, once they have returned to work, they work at a lower rate than those who have not suffered from the disease.
· Men and women who had no sick leave or who were on sick leave for other illnesses were at least 9% more likely to continue working compared to workers who took cancer-related sick leave, according to this study carried out in Catalonia and published in 'Scientific Reports'.
· Not being able to work when you can and want to leads to a loss of self-esteem and social relationships, which can make recovering from cancer psychologically difficult", explains Fernando G. Benavides, the coordinator of the study.

People who have taken time off work due to cancer continue to work less than workers who have not suffered from the disease and also have a less stable employment history, according to a new study by researchers at the Centre for Research in Occupational Health (CiSAL), Pompeu Fabra University (UPF), the Hospital del Mar Medical Research Institute (IMIM), and the CIBER on Epidemiology and Public Health (CIBERESP). The article, coordinated by Fernando G. Benavides, head of the CIBERESP group at the UPF, has been published in the journal Scientific Reports and included the participation of the University of Girona.

Cancer incidence and survival rates have increased in recent decades and, as a result, the number of working-age people diagnosed with cancer who return to work has increased. However, cancer survivors often suffer from chronic symptoms due to the disease and its treatment. This affects all dimensions of their lives and may limit their future career path.

This new study looked at the employment trajectories of a sample of salaried workers in Catalonia who were on sick leave due to cancer. This group was compared with working people who did not take sick leave and people on sick leave for other illnesses. "We obtained data from a longitudinal cohort involving the working lives of salaried people according to the Social Security, with a long follow-up period that allows us to see any long-term differences", explains Amaya Ayala García, first author of the study and a CIBERESP researcher at CiSAL.

"To eliminate bias, each individual who took cancer-related sick leave between 2012 and 2015 was matched by age, sex and date of entry into the cohort with a working person on sick leave due to another condition, and another working person not on sick leave", she adds.

The results show that, after finishing their sick leave, workers who have had cancer continue to work less frequently than those who have not had time off. In addition, they have a less stable career path. Specifically, men and women who took no sick leave or were off work due to other diagnoses were at least 9% more likely to remain in employment than working people who were on sick leave due to cancer.

"These differences can generate important social inequalities, because losing one's job leads to a decrease in income. We must not forget that for the vast majority of people, their salary is the main, if not only, source of income. Moreover, not being able to work when you can and want to leads to a loss of self-esteem and social relationships, which can make recovering from cancer psychologically difficult", says Fernando G. Benavides, Professor of Public Health at the UPF and CIBERESP researcher.

Centre de Recerca en Salut Laboral – CISAL (UPF-IMIM)

The need for a new study with a gender perspective

"In terms of sex differences, we have found greater differences in men who have had cancer compared to men who have suffered no illness than in women. This is in contrast to the literature, although there are contradictory results", comments Amaya Ayala. She adds that "Gender is a transversal axis of inequality and this gender gap is reflected in the Spanish workforce, in which women's participation is lower than in other countries, where most of the literature comes from. In addition, marital status or having children or dependents have been found to be predictors of women's return to work. We will carry out a qualitative study this year that we hope will respond to some of these issues", she concludes.

"This study is a step towards a better understanding of the relationship between cancer and long-term employment, and encourages future research in this area", explains Fernando G. Benavides. Returning to work may be beneficial to the health of cancer patients due to a greater sense of purpose, increased self-confidence and the stronger sense of social belonging associated with employment. However, a successful return to work is influenced by disease- and treatment-related factors, socio-demographic variables, and work and employment conditions.

For this reason, health and social protection systems must guarantee that people who have suffered from cancer have the opportunity to continue their voluntary participation in the workforce. "In Spain, there are very few studies on the return to work and the consequences of cancer on working life. Further research in this area is therefore needed, as is being undertaken in other European countries, and studies should take into account the location and stage of the cancer, as well as the treatment, as these are important determinants of the adverse effects that will affect future working life", says Amaya Ayala.

"We recommend programmes involving a gradual return to employment and job adaptation, always with the consent of the worker, as happens, for example, in Scandinavian countries, the Netherlands, the UK, Canada and the USA", concludes Fernando G. Benavides.

Reference article:

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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