Work Disability and Return to Work After Lymphoma: A Danish Nationwide Cohort Study

Abstract

Purpose

Many patients diagnosed with lymphoma are of working age. Cancer patients are known to have a higher risk of sick leave and disability pension, but this has only been delineated for certain subtypes of lymphoma. Therefore, this study aimed at investigating the overall risk of disability pension for all lymphoma subtypes and at quantifying return to work for patients with lymphoma in work before diagnosis.

Patients and Methods

Patients aged 18–60 years with lymphoma in complete remission (CR) diagnosed between 2000 and 2019 were included in the study. Using national registers, each patient was matched with five comparators from the general population with same sex, birth year, and level of Charlson Comorbidity Index. Risk of disability pension was calculated from 90 days after CR or end of treatment with competing events (death, retirement pension, early retirement pension, relapse for patients, or lymphoma diagnosis for comparators). Return to work for patients was calculated annually until 5 years after diagnosis for patients employed before diagnosis.

Results

In total, 4072 patients and 20,360 comparators were included. There was a significant increased risk of disability pension for patients with all types of lymphoma compared to the general population (5-year risk difference: 5.3 (95% confidence interval (CI): 4.4;6.2)). Patients with non-Hodgkin lymphoma were more likely to get disability pension than patients with Hodgkin lymphoma (sex- and age-adjusted 10-year risk difference: 2.9 (95% CI: 0.3;5.5)). One year after diagnosis, 24.5% of the relapse-free patients were on sick leave. Return to work was highest 2 years after diagnosis (82.1%).

Conclusion

Patients with lymphoma across all subtypes have a significantly higher risk of disability pension. Return to work peaks at 2 years after diagnosis.

Keywords:

• lymphoma
• disability pension
• return to work

Acknowledgments

The authors want to thank Andreas Kiesbye Øvlisen and Peter Enemark Lund for help with data management in SAS, and all the clinical staff who provided data for Danish National Lymphoma Registry (LYFO).

Disclosure

E.F.M.: Grants from Dagmar Marshalls Foundation, grants from Master Carpenter Jørgen Holm and wife Elisa born Hansen’s memorial trust, during the conduct of the study.

L.H.J.: Lecture fee from Roche (2021)

J.B.: Research funding from Gilead Sciences Denmark

J.M.J.: Consulting: Gilead, Novartis, Roche, Incyte, BMS, Orion

M.R.C.: Consulting, speaker fee or advisory role: AbbVie, Janssen, Genmab, Incyte, Nordea

T.S.L.: Consulting or Advisory Role: Roche, Bristol Myers Squibb, Novartis, Gilead; Research Funding: Genentech

A.O.G.: Lecture fee from Roche (2022)

P.B.: Consulting or Advisory Role: Roche, Incyte, Novartis, Gilead

T.C.E-G.: former employee by Roche; speakers fee from AbbVie (2021)

The authors report no other conflicts of interest in this work.

Additional information

Funding

The study is supported by Dagmar Marshalls Foundation (E.F.M), Master Carpenter Jørgen Holm and wife Elisa born Hansen’s memorial trust (E.F.M), the Karen Elise Jensen Foundation (L.H.J), Gilead Science Denmark (J.B) and the Danish Cancer Society (T.C.E-G, J.B). No sponsors have been involved in any part of the study or its publication.