Labor market affiliation of patients with myeloproliferative neoplasms: a population-based matched cohort study

Patients with myeloproliferative neoplasms (MPNs) suffer from substantial symptoms and risk of debilitating complications, yet observational data on their labor market affiliation are scarce. We conducted a descriptive cohort study using data from Danish nationwide registries, including patients diagnosed with MPN in 2010-2016. Each patient was matched with up to ten comparators without MPN on age, sex, level of education, and region of residence. We assessed pre- and post-diagnosis labor market affiliation, defined as working, unemployed, or receiving sickness benefit, disability pension, retirement pension, or other health-related benefits. Labor market affiliation was assessed weekly from two years pre-diagnosis until death, emigration, or 31 December 2018. For patients and comparators, we reported percentage point (pp) changes in labor market affiliation cross-sectionally from week −104 pre-diagnosis to week 104 post-diagnosis. The study included 3,342 patients with MPN and 32,737 comparators. From two years pre-diagnosis until two years post-diagnosis, a larger reduction in the proportion working was observed among patients than comparators (essential thrombocythemia: 10.2 [95% CI: 6.3–14.1] vs. 6.8 [95% CI: 5.5–8.0] pp; polycythemia vera: 9.6 [95% CI: 5.9–13.2] vs. 7.4 [95% CI: 6.2–8.7] pp; myelofibrosis: 8.1 [95% CI: 3.0–13.2] vs. 5.8 [95% CI: 4.2–7.5] pp; and unclassifiable MPN: 8.0 [95% CI: 3.0–13.0] vs. 7.4 [95% CI: 5.7–9.1] pp). Correspondingly, an increase in the proportion of patients receiving sickness benefits including other health-related benefits was evident around the time of diagnosis. Overall, we found that Danish patients with essential thrombocythemia, polycythemia vera, myelofibrosis, and unclassifiable MPN had slightly impaired labor market affiliation compared with a population of the same age and sex. From two years pre-diagnosis to two years post-diagnosis, we observed a larger reduction in the proportion of patients with MPN working and a greater proportion receiving sickness benefits compared with matched individuals.

患有髓增生性肿瘤（MPN）的患者承受着显著的病状和致残并发症的风险，然而关于他们在劳动力市场中的关联的观察性数据却极为匮乏。本研究采用丹麦克隆国家登记处的数据，对2010-2016年间被诊断为MPN的患者进行了一项描述性队列研究。每位患者均与最多十个未患有MPN的对照者进行匹配，匹配条件包括年龄、性别、教育水平和居住地区。我们评估了诊断前后在劳动力市场中的关联，该关联被定义为工作、失业或领取疾病津贴、残疾养老金、退休养老金或其他与健康相关的福利。从诊断前两年开始，每周对劳动力市场关联进行评估，直至死亡、移民或2018年12月31日。对于患者和对照者，我们从诊断前104周至诊断后104周，跨截面报告了劳动力市场关联的百分点（pp）变化。本研究纳入了3,342名MPN患者和32,737名对照者。从诊断前两年至诊断后两年，患者在劳动参与比例上的下降幅度大于对照者（特发性血小板增多症：10.2 [95% CI: 6.3–14.1] pp vs. 6.8 [95% CI: 5.5–8.0] pp；真性红细胞增多症：9.6 [95% CI: 5.9–13.2] pp vs. 7.4 [95% CI: 6.2–8.7] pp；骨髓纤维化：8.1 [95% CI: 3.0–13.2] pp vs. 5.8 [95% CI: 4.2–7.5] pp；以及不可分类的MPN：8.0 [95% CI: 3.0–13.0] pp vs. 7.4 [95% CI: 5.7–9.1] pp）。相应地，在诊断期间，接受疾病津贴及其他健康相关福利的患者比例有所增加。总体而言，我们发现，与同龄、同性别的普通人群相比，丹麦患有特发性血小板增多症、真性红细胞增多症、骨髓纤维化以及不可分类的MPN的患者在劳动力市场中的关联略有受损。从诊断前两年至诊断后两年，我们观察到MPN患者的劳动参与比例下降幅度较大，而领取疾病津贴的比例则高于匹配的个体。