癌の生存者と失業:メタ解析とメタ回帰

Angela G E M de Boer¹, Taina Taskila, Anneli Ojajärvi

¹Coronel Institute of Occupational Health, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands. a.g.deboer@amc.uva.nl

JAMA

|February 20, 2009

まとめ

癌の生存者は,健康な人よりも高い失業率に直面しています. この研究では36の研究を分析し,がんの生存率と雇用喪失の有意な関連性を特定した.

科学分野:

腫瘍学腫瘍学
公衆衛生は公衆衛生である.
エピデミオロジーエピデミオロジー

背景:

大人のがんの生存者のほぼ半分は65歳未満です.
癌の生存率が雇用状態に与える影響は,依然としてほとんど不明である.
癌の生存者の雇用課題を理解することは,公衆衛生のイニシアチブにとって極めて重要です.

研究の目的:

癌の生存率と失業率との関連を判断する.
がんの生存者における失業率を,健康な対照群と比較するために.
癌の生存者における失業に影響を与える要因を特定する.

主な方法:

1966年から2008年6月までの間,複数のデータベース (MEDLINE,CINAHL,EMBASE,PsycINFO,OSH-ROM) の体系的な文献検索を行った.
成人がん生存者と対照群を対象とした研究を含み,就職成果に焦点を当てた.
メタアナリシスとベイジアン・メタレグレッションで,相対リスクのプールを計算し,影響因子を評価します.

主要な成果:

20,366人のがん生存者と157,603人の対照群を対象とした36件の研究が分析されました.
癌の生存者は,対照群 (15.2%) に比べて著しく高い失業率 (33.8%) を有しており,相対リスク (RR) は1.37.
高い失業率は,乳がん,胃腸がん,女性生殖器官がんの生存者の間で観察されました. 米国の生存者は,初期失業リスクが高く,調整後に失踪した.

結論:

癌の生存率は,失業率の増加と有意に関連しています.
特定の癌のタイプは,生存者の失業リスクが高くなります.
癌の生存者の雇用格差については,さらなる調査と標的型の支援が必要である.

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