Social characteristics and social benefit use among premenopausal breast cancer survivors in Denmark: a population-based cohort study

J Cancer Surviv. 2024 Apr 22. doi: 10.1007/s11764-024-01598-z. Online ahead of print.

Abstract

Purpose: In 2020, one million women aged < 55 years were diagnosed with breast cancer globally. The impact of breast cancer and its treatments on these women's ability to work and need for social benefits may differ by social characteristics. We evaluated social benefit use following breast cancer by education and cohabitation.

Methods: We conducted a nationwide population-based cohort study, including women aged 18-55 years diagnosed with stage I-III breast cancer in Denmark during 2002-2011. Statistics Denmark provided information on cohabitation, education, and social benefit use from 1 year pre-diagnosis to 10 years post-diagnosis. We calculated weekly proportions of self-support, unemployment, disability pension, flexi jobs, and sick leave according to education and cohabitation.

Results: Of 5345 women, 81.8% were self-supporting, 4.5% received disability pensions, 1.6% had flexi jobs, 3.6% were on sick leave, and 5.5% were unemployed 1 year pre-diagnosis. Ten years post-diagnosis, the proportions were 69.0%, 13.0%, 10.5%, 3.4%, and 2.0% of 3663 survivors. Disability pensions and flexi jobs increased from 12.1 to 26.4% and 2.8 to 13.5% in women with short education, from 4.1 to 12.8% and 1.8 to 12.2% in women with medium education, and from 0.8 to 6.0% and 0.9 to 6.9% in longer educated. Disability pensions increased more in women living alone (7.8 to 19.9%), than in cohabiting women (3.6 to 11.3%).

Conclusions: Use of social benefits reflecting lost ability to work was highest in less educated women and in women living alone.

Implications for cancer survivors: Awareness of these groups is crucial when tailoring efforts to support work participation in cancer survivors.

Keywords: Breast neoplasms; Cohabitation; Cohort study; Educational status; Social benefits; Socioeconomic position.