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Return to work in head and neck cancer survivors: a systematic review

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Abstract

Purpose

Cancer survivors face higher rates of unemployment compared with individuals without a history of cancer. Compared to other cancer types, head and neck cancer (HNC) survivors face unique disease and treatment-specific issues that may limit return to work (RTW). This review aimed to determine employment outcomes of HNC survivors post-treatment and identify factors associated with RTW.

Methods

A systematic search was conducted in MEDLINE, CINAHL and PsycINFO in December 2021. Inclusion criteria included adults (≥ 18 years); completed treatment for HNC; data available on RTW post-treatment. Both quantitative and qualitative studies were considered. Studies were critically appraised and data synthesised narratively.

Results

Twenty-nine publications were included: 22 quantitative, four qualitative and three mixed methods. The proportion of HNC survivors who RTW ranged from 32 to 90%, with participants taking 3.6–11 months to RTW. Working in a professional role and having a supportive work environment were positively associated with RTW.

Conclusions

The proportion of HNC survivors who RTW varies significantly which may be due to the heterogeneity between the studies including difference in clinical characteristics of the participants and/or sample size. Future studies that are longitudinal, adequately powered and measure a range of clinical and demographic variables are needed to better understand the RTW experience and assist development of effective RTW strategies.

Implications for Cancer Survivors

This review suggests potential areas for intervention, including enhanced symptom management and engaging with employers to foster supportive work environments to support RTW of HNC survivors.

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Authors and Affiliations

  1. Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia

    Claudia Zecena Morales, Karolina Lisy & Michael Jefford

  2. Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia

    Karolina Lisy, Amanda Piper & Michael Jefford

  3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia

    Karolina Lisy & Michael Jefford

  4. Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia

    Lachlan McDowell

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Claudia Zecena Morales. The first draft of the manuscript was written by Claudia Zecena Morales and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Zecena Morales, C., Lisy, K., McDowell, L. et al. Return to work in head and neck cancer survivors: a systematic review. J Cancer Surviv 17, 468–483 (2023). https://doi.org/10.1007/s11764-022-01298-6

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