Association between patterns of return-to-work trajectories and long-term depressive symptoms among breast cancer survivors

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Rapicault, Clémence | Porro, Bertrand | Gilbert, Fabien | Roquelaure, Yves | Bertin, Mélanie

Edité par CCSD -

International audience. Background : Depressive symptoms and fatigue are well known factors affecting return-to-work (RTW) after breast cancer (BC). However, RTW is mainly assess using static measures that do not capture the dynamic and multi-phase process of RTW, while this diachronic process may in turn have an impact on later health and psychological well-being. Our aim was to identify RTW trajectories in breast cancer survivors (BCS) within the 5-years following their and assess their associations with long-term depressive symptoms. Methods: We used data from the French Constances cohort that included more than 200 000 participants from 2012 to 2020,. Our study relies on a sub-sample of women aged up to 55 years at the time of their diagnostic, who were working at the time of their diagnostic and for whom 5 years RTW trajectories could be collected based on the National Retirement Insurance system (CNAV) (n=381). Sequence analysis was used to identify RTW trajectories among BCS from their diagnosis up to 5 years later. Depressive symptoms were assessed using the 20-items CES-D scale. Adjusted logistic regression were performed to assess the association between RTW trajectories and depressive symptoms. Results: In our sample, 18 % of BCS suffered from depressive symptoms at their inclusion in the cohort. Four patterns of RTW trajectories were identified: Short sickness absence and RTW, long sickness absence and RTW (n=134), sickness absence and invalidity, Sickness absence and unemployment. BCS that had a late RTW or no RTW within their five years following their diagnostic were significantly associated with an increased risk of long-term depressive symptoms. Conclusion: This study shows the potential of using sequence analysis to capture the temporal and multi-state aspects of RTW trajectories and highlights the importance of work resumption after BC on long-term health and well-being. Main implication: This study highlights the importance of sustainable work resumption after BC on long-term patients’ well-being.

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