Facilitators and barriers associated with returning to work for cancer survivors: A systematic review

Abstract

Objective: To analyze facilitators and barriers affecting cancer survivors' return to work based on the views of survivors and various stakeholders, using the social ecological model.

Methods: Five electronic databases were searched in April 2025. Relevant studies and extracted data were selected by two researchers independently. Qualitative synthesis followed the Joanna Briggs Institute three-step process and drew on the five interrelated layers of the social ecological model.

Results: Of 5535 initial studies, 13 qualitative studies were included. Intrapersonal factors consisted of personal characteristics, disease diagnosis, post-treatment physical symptoms, post-treatment emotional states, the perceived impacts of the disease and treatments on work, understanding of and attitudes toward work, and strategies for coping with return-to-work issues. Interpersonal factors included the opinions of employers and interpersonal relations at work, as well as interpersonal support. Organizational factors consisted of occupational return-to-work arrangements and occupational support. Community factors included community support and public cognition and atmosphere. Public policy factors included the dissemination of related policies, the deficiency of related legislation, and the impacts and implementation criteria of welfare policies. The differences between cancer survivors' and stakeholders' perspectives were compared.

Conclusions: Multiple factors directly or indirectly influence cancer survivors' return-to-work decisions and experience. Cancer survivors should develop their awareness and learn more strategies in dealing with return-to-work problems. Stakeholders should care about the health status of cancer survivors, offering increased understanding and collaboration. Further studies should explore the relationships among the factors. Multi-component interventions are recommended to address return-to-work issues.

Systematic review registration: PROSPERO CRD42024555929.

Keywords: Cancer survivors; Return to work; Social ecological model; Systematic review.

Fig. 1

Flow diagram of the review process.

Fig. 2

Social ecological model describing cancer survivors return-to-work.