Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study
<h4>Background</h4> Childhood cancer survivors (CCS) are at high risk of chronic health conditions. We aimed to explore young adult CCS’ and matched references’ future diagnoses-specific healthcare use, sickness absence (SA), and disability pension (DP). <h4>Methods</h4> We p...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524675/?tool=EBI |
| _version_ | 1811229930972774400 |
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| author | Fredrik Baecklund Kristina Alexanderson Lingjing Chen |
| author_facet | Fredrik Baecklund Kristina Alexanderson Lingjing Chen |
| author_sort | Fredrik Baecklund |
| collection | DOAJ |
| description | <h4>Background</h4> Childhood cancer survivors (CCS) are at high risk of chronic health conditions. We aimed to explore young adult CCS’ and matched references’ future diagnoses-specific healthcare use, sickness absence (SA), and disability pension (DP). <h4>Methods</h4> We performed a prospective cohort study with microdata from seven nationwide Swedish registers. We included 1305 young adult CCS born 1983–1988 and living in Sweden in 2008 and 6430 matched references and followed them for ten years (2009–2018) regarding mean annual specialized outpatient visits, inpatient days, and SA (spells >14 days) and/or DP (SADP) days, overall and by eight diagnostic groups. Risk factors for >90 SADP days in 2018 were explored as odds ratios (OR) with 95% confidence intervals (CI) by adjusted logistic regression. <h4>Results</h4> Approximately 80% of CCS and 90% of references did not have SADP in the ten-year follow-up. Mean SADP days/year was higher among CCS (40–50 days/year), particularly in CNS tumor survivors (76–83 days/year), compared to references (12–18 days/year). Most SADP days were DP days. CCS had more mean outpatient visits (1.6–1.8 visits/year) and inpatient days (0.8–1.7 days/year) than references (0.8–1.2 visits/year and 0.6–0.75 days/year, respectively). The main healthcare use and SADP diagnoses were neoplasms and psychiatric disorders among all CCS, along with nervous system and endocrine conditions among CNS tumor survivors. The risk of SADP >90 days in 2018 was higher among female compared to male CCS (OR = 2.34, 95% CI 1.67–3.32), those with elementary schooling compared to high school/university education (OR = 6.52, 95% CI 4.49–9.49), and survivors of CNS tumors compared to other malignancies (OR hematological versus CNS = 2.88, 95% CI 1.95–4.28; OR hematological versus non-CNS solid tumors = 0.71, 95% CI 0.45–1.09). <h4>Conclusions</h4> Most CCS did not have SADP as young adults; nevertheless, their risk of SADP was higher than among matched references. CNS tumor survivors were at particularly high risk of SADP. |
| first_indexed | 2024-04-12T10:21:28Z |
| format | Article |
| id | doaj.art-6d2ec1a8266d4eaeab4bd349f4ffdf6d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T10:21:28Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-6d2ec1a8266d4eaeab4bd349f4ffdf6d2022-12-22T03:37:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort studyFredrik BaecklundKristina AlexandersonLingjing Chen<h4>Background</h4> Childhood cancer survivors (CCS) are at high risk of chronic health conditions. We aimed to explore young adult CCS’ and matched references’ future diagnoses-specific healthcare use, sickness absence (SA), and disability pension (DP). <h4>Methods</h4> We performed a prospective cohort study with microdata from seven nationwide Swedish registers. We included 1305 young adult CCS born 1983–1988 and living in Sweden in 2008 and 6430 matched references and followed them for ten years (2009–2018) regarding mean annual specialized outpatient visits, inpatient days, and SA (spells >14 days) and/or DP (SADP) days, overall and by eight diagnostic groups. Risk factors for >90 SADP days in 2018 were explored as odds ratios (OR) with 95% confidence intervals (CI) by adjusted logistic regression. <h4>Results</h4> Approximately 80% of CCS and 90% of references did not have SADP in the ten-year follow-up. Mean SADP days/year was higher among CCS (40–50 days/year), particularly in CNS tumor survivors (76–83 days/year), compared to references (12–18 days/year). Most SADP days were DP days. CCS had more mean outpatient visits (1.6–1.8 visits/year) and inpatient days (0.8–1.7 days/year) than references (0.8–1.2 visits/year and 0.6–0.75 days/year, respectively). The main healthcare use and SADP diagnoses were neoplasms and psychiatric disorders among all CCS, along with nervous system and endocrine conditions among CNS tumor survivors. The risk of SADP >90 days in 2018 was higher among female compared to male CCS (OR = 2.34, 95% CI 1.67–3.32), those with elementary schooling compared to high school/university education (OR = 6.52, 95% CI 4.49–9.49), and survivors of CNS tumors compared to other malignancies (OR hematological versus CNS = 2.88, 95% CI 1.95–4.28; OR hematological versus non-CNS solid tumors = 0.71, 95% CI 0.45–1.09). <h4>Conclusions</h4> Most CCS did not have SADP as young adults; nevertheless, their risk of SADP was higher than among matched references. CNS tumor survivors were at particularly high risk of SADP.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524675/?tool=EBI |
| spellingShingle | Fredrik Baecklund Kristina Alexanderson Lingjing Chen Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study PLoS ONE |
| title | Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study |
| title_full | Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study |
| title_fullStr | Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study |
| title_full_unstemmed | Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study |
| title_short | Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study |
| title_sort | long term diagnosis specific sickness absence disability pension and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references a swedish ten year prospective cohort study |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524675/?tool=EBI |
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