Papers

Population based case-control study of sick leave in postmenopausal women before diagnosis of hyperparathyroidism

Ewa Lundgren, consultant surgeon, ^a Eva Szabo, medical student, ^a Sverker Ljunghall, professor, ^b Reinhold Bergström, professor, ^c Lars Holmberg, associate professor, ^a Jonas Rastad, associate professor. ^a

^a Department of Surgery, Uppsala University, S-751 85 Uppsala, Sweden, ^b Department of Internal Medicine, Uppsala University, ^c Department of Statistics, Uppsala University

Correspondence to: Dr Lundgren ewa.lundgren{at}kirurgi.uu.se

Objective: To analyse sick leave in women at risk of primary hyperparathyroidism before its diagnosis.
Design: Case-control study nested within a screened cohort of postmenopausal women. Cases were women with hyperparathyroidism without prior knowledge of their disease and no traditional symptoms or complications. Controls were women from the screened population without hyperparathyroidism.
Setting: Population based screening within a Swedish community.
Subject: 48 case-control pairs of women aged 55-70 years.
Main outcome measure: Sick leave during the 5 years before diagnosis.
Results: Total duration of sickness benefits was longer in the cases than controls, and this discrepancy included sick leave on full time or half time and for periods of longer than a week. Cases had an increased risk of sick leave more than half of the investigated time compared with controls (odds ratio 12). Doctors' certificates showed that the overrepresented sick leave in the cases related mainly to cardiovascular diseases.
Conclusion: Asymptomatic mild primary hyperparathyroidism in postmenopausal women is accompanied by a previously unrecognised morbidity, which has consequences for clinical management of the disorder and its impact on the health economy.