癌症幸存者和失业:一个元分析和元回归
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
概括
癌症幸存者面临的失业率高于健康人群. 这项研究分析了36项研究,发现癌症存活率和失业率之间存在显著联系,特别是在某些癌症类型中.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 几乎一半的成年癌症幸存者在65岁以下.
- 癌症幸存者对就业状况的影响仍然在很大程度上是未知的.
- 了解癌症幸存者的就业挑战对于公共卫生倡议至关重要.
研究的目的:
- 确定癌症幸存率与失业率之间的关联.
- 为了比较癌症幸存者与健康对照者的失业率.
- 确定影响癌症幸存者失业的因素.
主要方法:
- 从1966年到2008年6月,对多个数据库 (MEDLINE,CINAHL,EMBASE,PsycINFO,OSH-ROM) 的系统文献搜索.
- 包括对成人癌症幸存者和对照组的研究,重点关注就业结果.
- 用元分析和贝叶斯元回归来计算聚合相对风险并评估影响因素.
主要成果:
- 分析了36项涉及20366名癌症幸存者和157603名对照者的研究.
- 与对照组 (15.2%) 相比,癌症幸存者失业率明显高 (33.8%),相对风险 (RR) 为1.37.
- 在乳腺癌,胃肠道癌和女性生殖器官癌症的幸存者中观察到更高的失业率. 美国幸存者最初的失业风险较高,在调整后消失了.
结论:
- 癌症幸存率与失业率的增加有很大关系.
- 特定的癌症类型为幸存者带来更高的失业风险.
- 癌症幸存者的就业差异需要进一步调查和有针对性的支持.
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