Outcomes across the return-to-work process in PC survivors attending a rehabilitation measure-results from a prospective study

Abstract

Purpose: Approximately 60% of patients are able to work following a cancer diagnosis. The return-to-work (RTW) process after disability can be conceptualized as a multi-phase construct. This study investigated RTW outcomes throughout the RTW process among survivors of prostate cancer (PC) attending a cancer rehabilitation measure.

Methods: The study was based on a sample of 837 employed PC survivors enrolled in a longitudinal multicenter study. Data was collected at the beginning of the rehabilitation measure, at the end and at 12-month follow-up by means of self-report questionnaires. We compared outcomes with regard to age (<60 and ≥60 years) and socio-economic status (SES; lower, middle, higher) using t tests or univariate ANOVA for metrical and chi-square test or Fisher's exact test for categorical variables.

Results: In the off-work phase, most survivors reported positive expectations regarding future work, including responsiveness of their work environment. Nevertheless, one fourth intended to apply for a disability pension. At 12-month follow-up, the RTW rate was 87% and 62% when applying more conservative criteria of RTW. Among survivors who had returned to work, most reported stability of the work situation. Survivors with lower SES showed least favorable outcomes throughout the RTW process, while older age was less consistently of negative impact.

Conclusions: Survivors reported many favorable RTW outcomes, but low SES might be a barrier at various stages of the RTW process. Thus, special attention must be paid to the role of social inequalities during rehabilitation and work reintegration to help survivors managing the RTW process.

Keywords: Oncology; Prostate cancer; Psycho-oncology; Rehabilitation; Return-to-work; Social inequality.