Abstract

REGAL RAMOS, Raúl Jesús. Cancer patients with absolut permanent incapacity: epidemiology, survival and monitoring work disability. Med. segur. trab. [online]. 2011, vol.57, n.223, pp.121-133. ISSN 1989-7790.

Each year the incidence of cancer in Spain increases, as well as the survival, and at the same time the economic cost due to Absolute Permanent Disability (APD) caused by these diseases. Objective: Know the epidemiological characteristics of cancer patients with APD and what variables are associated to survival beyond 5 years, in order to establish criteria for the review of the working capacity of these patients. Method: We analyzed all patients evaluated in the Medical Unit of The National Institute of Social Security in Madrid in 2005, under 55 years of age, with the diagnosis of neoplasic disease and whose final evaluation was APD. We analyzed the following variables: age, sex, marital status, occupation, type of Social Security affiliation, type of cancer (distinguishing whether it was widespread and / or had had relapses), the presence of other associated diseases, the presence of other conditions which in themselves were constitutive of APD and finally the survival beyond 5 years. Among the patients who were alive in November 2010 we studied the relationship of variables with the survival and evolution of the degree of disability. Results: The total number of patients studied was 212. The most frequent type of tumors in women were breast and lung cancer and in men lung and colon-rectum. The 5-year survival was 30 %.This survival decreases with age, depending on the type of tumor, the presence of metastasis and / or relapses and the presence of comorbidity. Tumors that cause most number of deaths are lung cancer in men and breast cancer in women. Regarding the followup of disability, 54 % (35 of 64) of the survivors had not been reviewed and had no sequels or other conditions constituting APD. Conclusion: Medical evaluation must be adapted to changes in the evolution of these patients and must do so by updating oncological training and increasing medical reviews. These reviews may be established at the same time as the disability rating or later on, after selecting those cases where with a reasonable survival and age, do not exhibit other limitations constitutive of APD.

Keywords : Cancer; Disability; Neoplasia; Prognosis.

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