Explaining educational differences in return to work after early breast cancer: a mediation analysis.
BACKGROUND: The mechanisms behind the effect of education on the return to work (RTW) of survivors of breast cancer (BCS) are unknown. METHODS: We used data from 2461 BCS from the prospective cohort CANTO. Using inverse odds weights we studied the mediating effect of pre-existing comorbidities, clinical factors, post-treatment health related quality of life, working conditions and household composition in the association between education and non-RTW. We used education in three categories. All models were adjusted for age at diagnosis. RESULTS: Non-RTW increased at lower levels of education. Compared to high educated women, women with <high school education were more likely not to return to work (RR = 1.43, 95% CI 1.28-1.61). After accounting for all mediators, the direct effect of education on RTW remained elevated but was not statistically significant (RR = 1.18, 0.96-1.46). The association between
Authors
- Garazi Ruiz de Azua (ORCID: https://orcid.org/0000-0002-7784-7571)
- Claire Jouffroy-Zeller
- Sophie Guillermet
- Antonio Di Meglio (ORCID: https://orcid.org/0000-0002-0233-3189)
- Idlir Licaj (ORCID: https://orcid.org/0000-0003-3389-0735)
- Julie Havas (ORCID: https://orcid.org/0009-0001-5498-8574)
- Carole Tarpin (ORCID: https://orcid.org/0009-0003-9806-9662)
- Florence Dalenc (ORCID: https://orcid.org/0000-0002-9854-4182)
- Gwenn Menvielle (ORCID: https://orcid.org/0000-0002-3261-6366)
- I. M. V. D. Luis
- Olivier Rigal (ORCID: https://orcid.org/0000-0002-9206-847X)
- Mario Campone (ORCID: https://orcid.org/0000-0002-5196-5908)
- Marion Fournier
- Sylvie Giacchetti
- Agnès Dumas
- Marie-Ange Mouret-Reynier
- Koketso Ntobeng
- Anne-Laure Martin
- Thierry Petit
- Florence Lerebours
Institutions
- Inserm (FR)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Aix-Marseille Université (FR)
- Université Paris-Saclay (FR)
- Institut Gustave Roussy (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre de recherche en Epidémiologie et Santé des Populations (FR)
- Institut de Cancérologie de l'Ouest (FR)
- Levi Strauss (United States) (US)
- Centre Eugène Marquis (FR)
- Centre Jean Perrin (FR)
- Institut Claudius Regaud (FR)
- Institut Bergonié (FR)
- UniCancer Group (FR)
- Hôpital Saint-Louis (FR)
- Institut Paoli-Calmettes (FR)
- Economic & Social Sciences, Health Systems & Medical Informatics (FR)
- Institut de Recherche pour le Développement (FR)
- Centre Henri Becquerel
- UiT The Arctic University of Norway (NO)
- Institut Curie (FR)
Publication Details
- Journal
- PubMed
- Published
- 2026-09-29
- DOI
- https://doi.org/10.1093/jnci/djag350
- Primary Topic
- Cancer survivorship and care
- Type
- article
- Field-Weighted Citation Impact
- 0.00