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

J Cancer Surviv. 2023 Apr;17(2):468-483. doi: 10.1007/s11764-022-01298-6. Epub 2022 Nov 17.

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.

Keywords: Head and neck cancer; Quality of life; Return to work; Survivorship.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Cancer Survivors*
  • Employment
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Return to Work
  • Survivors