Return-to-work regulations for cancer survivors in Europe - A structured expert-description approach

Thirty-six percent of new cancer diagnoses in Europe in 2022 affected people of working age, potentially leading to substantial changes in their working lives, such as a withdrawal from work. Successful return to work has been found to be associated with several predictive factors, including health and social-system factors. The present study aimed to identify which policies and practices are in place on the health and social-system level to help cancer survivors return to work in selected European countries.

The present research project followed a qualitative approach. Return-to-work processes were assessed with experts from European countries, using a semistructured guideline. Processes were systematically assessed along the patient pathway using a prestructured grid. Two researchers then examined the grid independently and classified the processes into different approaches.

Experts from eight countries were recruited (from Germany, Belgium, the Netherlands, Finland, Ireland, Spain, Cyprus, Luxembourg). The results show "comprehensive" return-to-work approaches in Germany, Belgium, Netherlands, Ireland and Finland, "stepwise" approaches in Luxembourg and Spain, and an "ad-hoc" approach in Cyprus. We identified particular gaps in the provision of care in rural regions and for self-employed cancer survivors or cancer survivors who were already unemployed at the time of diagnosis. Assessment along the patient pathway revealed that return-to-work processes are unstructured, with varying contact persons in most of the European countries represented, making it difficult for cancer survivors to navigate.

In summary, the processes involved in cancer survivors' return to work vary along the patient pathway across European countries. Typically, these processes are not structured in a patient-friendly way, and successful uptake of available services depends on the patient's own initiative and willingness on the part of care professionals. Return-to-work processes for cancer survivors vary in European countries to an extent that is in conflict with European Union policy aims.