title: The transition between work, sickness absence and pension in a cohort of Danish colorectal cancer survivors.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of socioeconomic and clinical factors on the transitions between work, sickness absence and retirement in a cohort of Danish colorectal cancer survivors.
  
  
  METHODS
  Register-based cohort study with up to 10 years of follow-up.
  
  
  METHODS
  Population-based study with use of administrative health-related and socioeconomic registers.
  
  
  METHODS
  All persons (N=4343) diagnosed with colorectal cancer in Denmark during the years 2001-2009 while they were in their working age (18-63 years) and who were part of the labour force 1 year postdiagnosis.
  
  
  METHODS
  By the use of multistate models in Cox proportional hazards models, we analysed the HR for re-employment, sickness absence and retirement in models including clinical as well as health-related variables.
  
  
  RESULTS
  1 year after diagnosis, 62% were working and 58% continued until the end of follow-up. Socioeconomic factors were found to be associated with retirement but not with sickness absence and return to work. The risk for transition from work to sickness absence increased if the disease was diagnosed at a later stage (stage III) 1.52 (95% CI 1.21 to 1.91), not operated curatively 1.35 (95% CI 1.11 to 1.63) and with occurrence of postoperative complications 1.25 (95% CI 1.11 to 1.41). The opposite was found for the transition from sickness absence back to work.
  
  
  CONCLUSIONS
  This nationwide study of colorectal cancer patients who have survived 1 year shows that the stage of disease, general health condition of the individual, postoperative complications and the history of sickness absence and unemployment have an impact on the transition between work, sickness absence and disability pension. This leads to an increased focus on the rehabilitation process for the more vulnerable persons who have a combination of severe disease and a history of work-related problems with episodes outside the working market.
authors: Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup,  Denmark.
authors: Kathrine
authors: K
authors: Carlsen
authors: Henrik
authors: H
authors: Harling
authors: Jacob
authors: J
authors: Pedersen
authors: Karl Bang
authors: KB
authors: Christensen
authors: Merete
authors: M
authors: Osler