An overview is provided of research into the return to work of cancer survivors, examining both the rate of return to work and factors impacting this return. A series of literature searches was conducted on MEDLINE and PSYCLIT databases for the years 1985-1999. Studies had to focus on the patient's perspective and had to include either the percentage of return to work or factors associated with return to work. Case studies and studies of cancer as an occupational disease were excluded. The search identified 14 studies. The mean rate of return to work was 62% (range 30-93%). The following factors were negatively associated with return to work: a non-supportive work environment, manual labour, and having head and neck cancer. Sociodemographic characteristics were not associated with return to work. For increasing age, associations were mixed. The increased survival rate of cancer patients warrants attention to the problems survivors may encounter upon their return to work. More systematic research is needed to establish more clearly the relative importance of factors associated with return to work of cancer survivors, which, in turn, would contribute to an increase in the labour-participation of cancer survivors.

Ongoing physical and/or psychosocial problems are present in occupationally active cancer survivors, which may cause serious difficulties at work. The results of this study may be used as input for developing supportive interventions for these survivors.

The extent to which self-assessed work ability collected during treatment can predict return-to-work in cancer patients is unknown. In this prospective study, we consecutively included employed cancer patients who underwent treatment with curative intent at 6 months following the first day of sick leave. Work ability data (scores 0 -10), clinical and sociodemographic data were collected at 6 months, while return-to-work was measured at 6, 12 and 18 months. Most of the 195 patients had been diagnosed with breast cancer (26%), cancer of the female genitals (22%) or genitourological cancer (22%). Mean current work ability scores improved significantly over time from 4.6 at 6 months to 6.3 and 6.7 at 12 and 18 months, respectively. Patients with haematological cancers and those who received chemotherapy showed the lowest work ability scores, while patients with cancer of urogenital tract or with gastrointestinal cancer had the highest scores. Work ability at 6 months strongly predicted return-to-work at 18 months, after correction for the influence of age and treatment (hazard ratio ¼ 1.37, CI 1.27 -1.48). We conclude that self-assessed work ability is an important factor in the return-to-work process of cancer patients independent of age and clinical factors.