title: Cancer stage, comorbidity, and socioeconomic differences in the effect of cancer on labour market participation: a danish register-based follow-up study.
abstract: OBJECTIVE
  Socioeconomic inequality in return to work after cancer treatment and rehabilitation have been documented, but less is known about its causes. This paper investigates the role played by breast cancer stage at diagnosis and comorbidity.
  
  
  METHODS
  We used the comprehensive Danish Cancer Registry to follow 7372 women aged 30-60, who were in the labour force when diagnosed with breast cancer in 2000-06 and survived at least three years. Controls were 213,276 women without breast cancer. Inequalities in employment outlook were estimated as interaction effects in linear regression between educational attainment and disease on employment.
  
  
  RESULTS
  There is significant interaction between education and breast cancer, but it is only marginally affected by including stage and comorbidity in the regression models. Education, breast cancer stage, and comorbidity all have strong effects on later employment, and a considerable amount of the educational effect is mediated by comorbidity and pre-cancer labour market participation and income.
  
  
  CONCLUSIONS
  The result of the study is negative in the sense that the stronger effect of breast cancer on employment among low-educated compared to highly educated individuals is not explained by cancer stage or comorbidity. The fact that comorbidity has little impact on inequality may be due to a different social patterning of most comorbidity compared to breast cancer.
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen K, Denmark.
authors.forename: Karsten
authors.initials: K
authors.lastname: Thielen
authors.affiliation: KORA, Danish Institute for Local and Regional Government Research, Copenhagen K, Denmark.
authors.forename: Christophe
authors.initials: C
authors.lastname: Kolodziejczyk
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen K, Denmark.
authors.forename: Ingelise
authors.initials: I
authors.lastname: Andersen
authors.affiliation: Rockwool Foundation Research Unit, Copenhagen K, Denmark.
authors.forename: Eskil
authors.initials: E
authors.lastname: Heinesen
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen K, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D015897:Comorbidity; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D009367:Neoplasm Staging / Q000379:methods; D012042:Registries; D012923:Social Class; D012959:Socioeconomic Factors