Barriers and opportunities for return-to-work of cancer survivors: time for action—rapid review and expert consultation

Abstract

BackgroundThe spread of early detection and the improvement of cancer treatment have led to an increased prevalence of cancer survivors, including in the working age population. Return-to-work (RTW) of cancer survivors has become a key issue for national cancer control plans. This study aims (1) to identify the factors that have an impact on RTW of cancer survivors and to draw a risk profile supporting health professionals in the screening of those at risk for barriers of RTW and (2) to sharpen these results with input from health, social security and academic Belgian experts and to provide evidence-based recommendations that facilitate RTW of cancer survivors.MethodsA rapid review was conducted, based on the methodology elaborated by The Knowledge to Action Research Programme and researchers from the University of York, including a quality assessment of retained studies. Next, the Delphi method was used to organize a consultation with experts in order to discuss, validate and complement the results.ResultsForty-three out of 1860 studies were included. We identified nine risk factors grouped into four categories: socio-demographic, disease and treatment-related, work-related, and personal and subjective factors. Experts suggested dividing them into two even groups: factors which are modifiable and those which are not. The awareness of health professionals regarding the identified factors, a better assessment of work capacities, clarity on the rights and obligations of employers and workers alike, and the setup of a positive discrimination employment policy for cancer survivors were acknowledged as factors facilitating RTW of cancer survivors.ConclusionsThe awareness of health professionals regarding barriers of RTW may improve the early identification of cancer survivors at risk for prolonged time to RTW and may allow early supportive intervention. Social and employment policies should be better tailored to support both employers and cancer survivors in the RTW process, providing incentives to positively discriminate cancer survivors on prolonged sick leave.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0210-z) contains supplementary material, which is available to authorized users.

Return to work after breast cancer: The role of treatment‐related side effects and potential impact on quality of life

“…It was the most frequently self‐reported reason for impaired RTW, and fatigue persisting 1.5 years after end of therapy was a significant determinant for impaired RTW in the long run. Our results strengthen findings from previous trials that also found an influence of fatigue on RTW (Kiasuwa Mbengi et al, ; Mehnert, ; Porro et al, ; Wolvers, Leensen, Groeneveld, Frings‐Dresen, & Boer, ). Thus, health professionals' and the public's awareness needs to be raised that fatigue is a serious syndrome (and not just listlessness or moaning) that severely hampers general functioning and daily routine.…”

“…Memory and/or attention problems were another frequent selfreported reason for occupational changes, especially among women with no RTW 1 year after surgery (71%). Reduced cognitive ability has been emphasised by several previous studies as reason for impaired RTW but results are ambiguous (Bijker et al, 2017;Kiasuwa Mbengi et al, 2016). Subjective cognitive impairments are a frequently reported adverse effect during adjuvant therapy.…”

“…Likewise, barriers and facilitators for RTW might differ between countries. While overall there is a growing body of research on RTW (Bijker et al, ; Islam et al, ; Kiasuwa Mbengi et al, ; Paltrinieri et al, ; Sun et al, ; van Muijen et al, ), up‐to‐date information on the situation in Germany is scarce (Braybrooke et al, ; Heuser et al, ; Mehnert & Koch, , ; Noeres et al, ).…”

Return-to-work intervention during cancer treatment - The providers' experiences

“…Studies have argued that training in the use of validated tools for assessing work capacity and for identifying those at risk of problems in RTW is relevant to providers involved in cancer treatment (Egmond, Anema, Singh, van der Beek, & Duijts, 2016;Kiasuwa et al, 2016;Murphy et al, 2016). The RTW intervention was looked upon as either a disturbance or an integrated component of cancer treatment.…”

“…The provision of workplace support and plans for work accommodation during cancer treatment have shown to facilitate positive RTW outcomes and to enable cancer patients to remain at work (Kiasuwa et al, 2016;Lindbohm et al, 2011;Mehnert et al, 2013;Murphy et al, 2016). Screening of those at risk of encountering difficulties in RTW could help prevent inequality in this respect and could support the awareness of modifiable factors (Kiasuwa et al, 2016). Unfavorable work conditions, which typically affect lowincome and low-level educational jobs, are viewed as some of the factors explaining inequality in RTW (Amir & Brocky, 2009…”