Return to work, after head and neck cancer: results from the French VICAN study

Returning to work after cancer is a major concern, particularly in the case of head and neck cancer (HNC). As the head and neck sphere is central to communication and appearance, it can be affected to varying degrees, which can be extremely disabling. Returning to work remains a challenge for this vulnerable population.

Using univariate and multivariate logistic regression analyses including 153 HNC survivors, we studied how different sociodemographic and clinical factors were associated with non-return to work in the VICAN national epidemiological survey set up in France. Eligible participants were aged between 18 and 60.

After 5 years, 48.4% of survivors had still not returned to work. Factors associated with non-return to work were age over 50 (p < 0.001), cancer recurrence (p = 0.015), lack of high school diploma (p = 0.002), pain preventing return to work (p = 0.002), and lower physical quality of life score (p = 0.031). For those under 50, older age (p < 0.001), single status (p = 0.042), recurrence (p = 0.004), manual occupation (p = 0.043), no high school diploma (p = 0.010), pain (p < 0.001), depression (p = 0.039), and impaired physical score (p = 0.009) were significantly associated with not returning to work.

Almost half of HNC survivors do not return to work following treatment. The return-to-work process is multifactorial and influenced by a wide range of medical, functional, and psychosocial variables. Our findings have identified specific patient-related risk factors, as well as key clinical and psychological determinants, which may facilitate the early identification of at-risk individuals and inform targeted interventions to optimize return-to-work outcomes.

The organization of a multidisciplinary post-treatment, "post-habilitation," cancer strategy seems increasingly inevitable, in order to plan a return to daily life (work, sociability, married life).