Predicting Return to Work after Head and Neck Cancer Treatment Is Challenging Due to Factors That Affect Work Ability

SIMPLE SUMMARY: This prospective study examined the impact of various factors on return to work (RTW) for head and neck cancer (HNC) survivors at 3 and 12 months after treatment. The study included 227 participants aged 65 years or younger. Within 3 months, 92 participants RTW and 30 retired. At 12 months, 80 participants were still working and another 51 participants had RTW. Hindrances to RTW at 3 months were advanced tumour stage (stage III and IV), whereas hindrances at 12 months were oral and larynx cancer. Facilitators of RTW included having a white-collar job, living in a relationship and early tumour stages. The study underscored that disease stage significantly hindered RTW, and work type and having a spouse or partner were nonclinical factors influencing RTW. These findings offer valuable insights for healthcare professionals and policymakers, which can aid in the development of strategies and support systems to enhance the RTW experience for HNC survivors. ABSTRACT: Striving to return to work is of great importance to many cancer survivors. The purpose of the study is to prospectively investigate the factors that hinder and facilitate return to work (RTW) at 3 and 12 months after the end of treatment in head and neck cancer (HNC) survivors and whether these factors influence the ability to continue working after treatment. Participants (n = 227) aged ≤ 65 years at diagnosis with HNC were included. Data were collected before the start of treatment and at 3 and 12 months after the end of treatment. The Rubin causal model was used for statistical analysis. Within the 3-month follow-up period, 92 participants had RTW and 30 had retired. At the 12-month follow-up, 80 of these participants were still working, another 51 participants had RTW, and five participants working still suffered from cancer. The hindrance to RTW within 3 months was advanced tumour stage (stage III and IV) (p = 0.0038). Hindrances to RTW at the 12-month follow-up were oral cancer (p = 0.0210) and larynx cancer (p = 0.0041), and facilitators were living in a relationship (p = 0.0445) and a white-collar job (p = 0.00267). Participants with early tumour stage (stage I and II) (p = 0.0019) and a white-collar job (p = 0.0185) had earlier RTW. The conclusion is that disease factors were the most important hindrances to RTW, and type of work and living with a spouse or partner were nonclinical factors influencing RTW.