Ph.D. thesis carried out at Uppsala University: Health-Related Quality of Life and Return to Work following Breast Cancer

Background, aim and relevance

An increasing prevalence of breast cancer and continuous developments within breast cancer management emphasise the importance of improved knowledge about recovery following this disease. The overall aim of the thesis was to study health-related quality of life (HRQoL) and return to work in the first three years following a breast cancer diagnosis, and to identify clinical and contextual factors associated with these outcomes.

Methods

All four papers in the thesis were part of a population-based cohort study including women registered in the Breast Cancer Quality Register in central Sweden. A total of 1,573 women were asked to participate in a questionnaire study with a baseline assessment (response rate 69%) and two follow-ups (response rates 62% and 54%, respectively). Women participating in the 2^nd follow-up were individually matched to five breast-cancer-free controls. Questionnaire data on HRQoL, socio-demographics and work-related variables were combined with clinical register, normative and social insurance data.

Results

Following deteriorations within eight months post-diagnosis, HRQoL generally improved during the three years studied. The majority of women returned to work and sickness absence steadily decreased, but, compared with the controls, the odds of being on sick leave were increased all three years post-diagnosis. Chemotherapy, young age and sick leave/disability pension pre-diagnosis were associated with poorer HRQoL, decreased working time/job discontinuation and sickness absence post-diagnosis.

Conclusions

Most women with breast cancer gradually recover. In a clinical setting, increased attention should be directed towards vulnerable subgroups identified in this thesis.