Risk of disability pension for patients diagnosed with haematological malignancies: a register-based cohort study.
Patients with haematological malignancies are at increased risk of experiencing work-related problems. The aims of this study were to compare the risk of disability pension (DP) among patients diagnosed with eight subtypes of haematological malignancies to a reference cohort, and to determine if relative risks differ between these subtypes; to evaluate the influence of socioeconomic factors, demographic factors, and clinical factors on the risk of DP; and to investigate if these associations differ between the reference cohort and the patient cohort.


METHODS
We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until DP, emigration, old age pension or anticipatory pension, death or 26 February 2012, whichever came first.


RESULTS
A total of 550 (17%) patients and 1511 (5%) reference individuals were granted DP. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies and ranged from 2.64 (95% CI 1.84-3.78) for patients with Hodgkin lymphoma to 12.53 (95% CI 10.57-14.85) for patients with multiple myeloma. In the patient cohort we found that gender, age, comorbidity, ethnicity, educational level, household income, history of long-term sick leave, and need of treatment with anxiolytics or antidepressants after diagnosis were associated with receiving DP. However, most of these associations were stronger in the reference cohort.


CONCLUSIONS
All eight subtypes of haematological malignancies were associated with an increased risk of DP compared to the reference cohort. The relative risks differed according to subtype, and patients with multiple myeloma had the highest risk of DP. Furthermore, most socioeconomic, demographic and clinical factors had a stronger impact on the risk of DP in the reference cohort than in the patient cohort.
Department of Haematology, Aarhus University Hospital , Denmark.
Trine A
TA
Horsboel
Claus V
CV
Nielsen
Niels T
NT
Andersen
Bendt
B
Nielsen
Annette
A
de Thurah
D000328:Adult; D000367:Age Factors; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology*; D006689:Hodgkin Disease / Q000453:epidemiology; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007945:Leukemia, Lymphoid / Q000453:epidemiology; D007951:Leukemia, Myeloid / Q000453:epidemiology; D008224:Lymphoma, Follicular / Q000453:epidemiology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology; D010415:Pensions / Q000706:statistics & numerical data*; D012042:Registries; D012179:Retirement / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents