Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors

Background The number of breast cancer patients of working age is increasing in Japan . Consequently, there is a need for support for working individuals concomitantly undergoing breast cancer treatment. The present study aimed to clarify the risk factors for resignation and taking sick leave among breast cancer survivors in continued employment at the time of diagnosis. Methods As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2018. The investigators analyzed the risk factors for post-breast cancer diagnosis resignation and sick leave using a logistic regression model, including age at diagnosis, educational level, cancer stage, surgery, pharmacotherapy, radiotherapy, employment status, and occupational type. Results 40 of 269 breast cancer survivors (14.9%) quit their job after cancer diagnosis. Predictors of resignation included lower education level (odds ratio [OR]: 3.802; 95%CI: 1.233-11.729), taking sick leave (OR: 2.514; 95%CI: 1.202-5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221-0.998). Of 229 patients who continued working, sick leave was taken by 72 (31.4%); having surgery was a predictor for taking sick leave (OR: 8.311; 95%CI: 1.007-68.621). Conclusions 14.9% of Japanese employees quit their jobs after being diagnosed with breast cancer. Being younger at breast cancer diagnosis, having lower educational attainment level, and utilizing sick leave were identified as predictors of post-cancer diagnosis resignation. Surgery was associated with the highest risk of taking sick leave. Breast cancer survivors exhibit higher risks for resignation, and may require more carefully follow-up after diagnosis by healthcare providers and employers to protect work sustainability.