Abstract
PURPOSE: To longitudinally investigate overall and diagnosis-specific sickness absence (SA) and disability pension (DP) in colorectal cancer (CRC) survivors and references and to identify potential risk factors. METHODS: This longitudinal register-based cohort study included all patients living in Sweden, diagnosed with a first primary CRC in 2008-2011 when aged 18-62 (n=6679), and their matched references (n=26 716). Net days of SA (in SA spells >14 days) and DP were analyzed from 2 years before through 5 years after diagnosis, overall and by specific diagnoses. Among survivors, risk factors for future SADP were explored using logistic regression. RESULTS: In survivors, SA peaked in year 1 postdiagnosis, with 62.5% having at least some SA, and then gradually decreased to 20.1% in year 5. In the 2 years after diagnosis, CRC was the most common SA diagnosis in survivors, while SA due to mental diagnoses remained similar to the references. Notable risk factors for postdiagnostic SA or DP were rectal cancer diagnosis, advanced cancer stage at diagnosis, lower educational level, born outside of Sweden, and pre-diagnostic SA, mental morbidity, and comorbidities. CONCLUSION: During 5 years after a CRC diagnosis, CRC survivors had higher levels of postdiagnostic SA and DP than the references, which was mostly due to CRC diagnoses. Although their SA lowered gradually, it did not return to pre-diagnostic levels. IMPLICATIONS FOR CANCER SURVIVORS: Our results provide valuable information for patients with CRC diagnosis, especially that most have none or low levels of SA/DP after a few years.