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BMJ 2009; 338 doi: (Published 24 February 2009) Cite this as: BMJ 2009;338:b755

Cancer survivors are less likely to work

People who survive cancer are more likely to be unemployed than controls without a history of cancer, according to a meta-analysis of 36 observational studies. The overall relative risk for unemployment was 1.37 (95% CI 1.21 to 1.55) in an analysis that pooled data from more than 20 000 survivors and more than 150 000 controls. A breakdown of the risk associated with different cancers indicated that breast cancer, gastrointestinal cancers, and cancers of the female reproductive organs were associated with unemployment, whereas blood cancers, prostate cancers, and testicular cancers were not.

The researchers also found a hint that cancer was more strongly associated with unemployment in the US than in Europe, although this may have been an artefact caused by the high proportion of studies from the US that were of poor quality. Poor quality studies are notorious for producing spuriously positive results.

Most of the studies did not record why individual participants were unemployed, but those that did suggest that unemployment in cancer survivors is a product of poor health and disability. In one subanalysis of seven studies, survivors of cancer were nearly three times more likely to be unemployed because of disability than were controls (2.84, 1.91 to 4.20).

MRSA from central lines is declining in the US

A careful look at surveillance data sent to the US Centers for Disease Control and Prevention shows a clear fall in the incidence of meticillin resistant Staphylococcus aureus (MRSA) infections associated with central lines in intensive care units across the country. After an initial rise between 1997 and 2001, the aggregated incidence of MRSA bloodstream infections related to indwelling lines has been falling steadily, and by 2007 it had fallen by an estimated 49.6% (95% CI 43.2% to 55.4%) relative to 1997. Up to 518 non-neonatal units contributed to the analysis, which shows that line related infections …

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