Labour market participation after a sickness absence due to cancer: a dynamic cohort study in Catalonia (Spain)

Background: Consequences of cancer on working life until retirement age remain unclear. This study aimed to compare labour market participation patterns in workers with a sickness absence (SA) due to cancer versus those with no SA and those with SA due to other diseases. Methods: Registry-based cohort study of social security affiliates in Catalonia from 2012-2018. Cases consisted of workers with SA due to cancer between 2012-2015 (N=516) and were individually age- and sex-matched with an affiliate with SA due to other diagnoses and a worker without SA. All workers (N=1,548, 56% women) were followed-up until the end of 2018. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPP). All analyses were stratified by sex. Results: Compared with workers with SA due to cancer, male workers without SA and SA due to other causes showed lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00-0.16; aRRR 0.17, 95% CI: 0.06-0.46, respectively), and in women lower probability of increasing permanent disability and death (aRRR 0.24, 95% CI: 0.10-0.57; aRRR 0.39, 95% CI: 0.19-0.83). Compared to workers with SA due to cancer, risk of future retirement was lower in workers with no SA (women aRRR 0.60, 95% CI: 0.22-1.65; men aRRR 0.64, 95%CI: 0.27-1.52). Conclusions Workplaces should be modified to the needs of cancer survivors in order to prevent more frequent early exit of labour market due to retirement and permanent disability when possible.