Abstract P4-11-17: Return to work after breast cancer: Disparities among patients treated in public and private hospitals in Brazil
Authors: Landeiro Luciana , Barros Luciana Holtzde Camargo , Neumann Lycia TramujasVasconcellos , Santos André Marques , Siqueira Anna Carolina Arena , Kaliks Rafael 
Published: March 2022

Abstract
Background: In North America and Europe return to work (RTW) rates vary among breast cancer(BC) survivors from 24-66% and 53-82% after 06 and 36 months of diagnosis, respectively. In 2017an observational study evaluated return to work among Brazilian patients treated in one publichospital in São Paulo, and described RTW rates of 30.3 and 60.4%, after 12 and 24 months of BCdiagnosis, respectively. The aim of the present study was to evaluate RTW rates among a broaderpopulation of Brazilian patients with BC, including patients treated in private hospitals, and todescribe factors associated with this outcome.Patients and Methods: Patients with BC registered on the portal of the NGO Instituto Oncoguia, oneof the largest Brazilian cancer patient support organization, and patients treated in one of the cancercenters from the Oncoclínicas group in Bahia, Rio de Janeiro or São Paulo. Patients received anemail invitation to participate in this study by answering an online survey. Inclusion criteria:Women with BC, diagnosed with stage I-IV within 12 to 36 months from survey date, age 18-65,with paid work before BC, who answered question related to returning to work after the diagnosis.The Institutional Review Board (IRB) of the Hospital Santo Antônio/Obras Sociais Irmã Dulce, inSalvador- Bahia, approved the study.Results: 124 women fulfilled all inclusion criteria and agreed to participate on this online survey.Most patients were white (71.8%), had college degree or higher education (74.2%) and were fromthe southeast region in Brazil (67.7%). Overall, 70.2% of patients returned to work after BCdiagnosis; 21.8% stayed away from work for &lt; 6 months, 26.6% for 6-12 months, 22.6% for 12-24months, 19.3% for more than 24 months and 9.7% did not answer this question. Most participantswere treated in private hospitals/clinics (82%), reported they liked their job (64.5%) and receivedsupport from employer (56.4%), but only 33.1% indicated had been offered work adjustments aftercancer diagnosis. From the 29.8% that did not RTW, 78.4% declared they wished to return. Only19.3% said that they had no difficulties in returning to work. Most common difficulties to RTWwere difficulty concentrating (34.7%) and adjusting to working hours (19.3%). In the multivariateanalysis, factors associated with positive RTW outcomes included being treated in a private versuspublic hospital (OR: 13.74, CI95% 1.76-106.96; p = 0.012) and job satisfaction (OR: 4,69,CI95% 1.10-19.98; p = 0.036). Factors associated with negative RTW outcomes included &gt; 24. months away from work (OR: 0.02, IC95% 0.01-0.32; p = 0.004) and depression diagnosed afterBC (OR: 0.13, IC95% 0.01-0.91; p = 0.04). A limitation of this study is the use of a conveniencesample, thus, the associations found are limited to the participating women .Conclusion: Differences in RTW rates in private versus public hospitals may explain the betterRTW rate found in this cohort, in contrast with previous study conducted with Brazilian patientstreated in a public hospital in São Paulo. Ultimately, identifying patients who will likely experiencedifficulties to RTW (patients who developed depression after BC and those not satisfied with theirjobs) can hopefully trigger patient support strategies. Organizations and government should betterassist patients in the rehabilitation work process and with possible career transitions.
Citation Format: Luciana Landeiro, Luciana Holtzde Camargo Barros, Lycia TramujasVasconcellos Neumann, André Marques Santos, Anna Carolina Arena Siqueira, Rafael Kaliks. Return to work after breast cancer: Disparities among patients treated in public and private hospitals in Brazil [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-17.