Absenteeism and indirect costs during the year following the diagnosis of an operable breast cancer

Introduction The consequences of disease on work for individual patients as well as the consequences of absenteeism from work are subjects of interest for decision-makers. Methods We analyzed duration of absenteeism and related indirect costs for patients with a paid job during the year following diagnosis of early-stage breast cancer in the prospective OPTISOINS01 cohort. A human capital and friction costs approaches were considered for evaluation of lost working days. For this analysis, the friction period was estimated from recent French data. Statistical analysis included simple and multiple linear regression to identify determinants of absenteeism and indirect costs. Results 93% of patients had at least one period of sick leave, with an average of 2 periods of sick leave and a mean total duration of 186 days. 24% of patients returned to work part-time after an average sick leave of 114 days (i.e. 41 LWD). Estimated indirect costs were €22,722.00 and €7,724.00 per patient, for the human capital and friction cost approaches, respectively. In the multiple linear regression model, factors associated with absenteeism were: invasive tumor (p=.043), mastectomy (p=.038), redo surgery (p=.002), chemotherapy (p=.027), being a manager (p=.025) or a craftsman (p=.005). Conclusion Breast cancer is associated with long periods of absenteeism during the year following diagnosis, but almost all patients were able to return to work. Major differences in the results were observed between the friction cost and human capital approaches, highlighting the importance of considering both approaches in such studies.