Temporal Patterns of Breast Cancer-Related Sickness Absence and Social Insurance Expenditures Among Women in Poland, 2020-2024: A Nationwide Registry-Based Study.

Background/Objectives: Sickness absence due to breast cancer generates significant indirect costs. This nationwide registry-based study aimed to evaluate temporal patterns and the population-level burden of sickness absence, rehabilitation benefit utilization, and social insurance expenditures related to breast cancer among women in Poland between 2020 and 2024. Methods: This nationwide analysis is based on the Social Insurance Institution registry. Data on females unable to work due to breast cancer were analyzed (ICD-10: C50). Short-term sickness absence was analyzed. Results: The number of sick leave days due to breast cancer varied from 1,241,223 in 2021 to 1,444,863 in 2024. The number of sick leave certificates increased every year: from 55,732 in 2020 to 79,979 in 2024. The most dynamic growth between 2020 and 2024 occurred in the 45-49 group, where sick leave days increased +33.4% and certificates increased +70.6%. There were significant regional differences. The sickness absence days per certificate due to breast cancer decreased over time, from 23.5 days in 2020 to 18.1 days in 2024. The total number of medical certificates on rehabilitation benefit due to breast cancer varied from 4811 in 2021 to 5281 in 2024. Social insurance expenditures on sickness absence varied from 112,064.9 thousand PLN (approximately 25.24 million EUR) in 2020 to 207,687.9 thousand PLN (approximately 48.3 million EUR) in 2024 and expenditures on rehabilitation benefits varied from 56,812.8 thousand PLN (12.8 million EUR) in 2020 to 89,692.6 thousand PLN (20.83 million EUR) in 2024. Conclusions: This population-based registry study revealed a high economic burden of sickness absence due to breast cancer in Poland.