Return to work and its determinants among head and neck cancer survivors: a cross-sectional study

Return to work is an important marker of rehabilitation. While many head and neck cancer survivors are motivated to resume work, they often face greater disability and reintegration challenges than other cancer survivors due to clinical and psychosocial factors. The objective of this study was to identify determinants of return to work and to explore barriers and facilitators to workforce reintegration among head and neck cancer survivors.

This cross-sectional study of 215 head and neck cancer survivors at two stomatology services used questionnaires to assess socioeconomic, clinical, illness-related, employment, and psychosocial factors. The statistical analysis evaluated correlations with return to work.

Among 215 participants, 137 (63.7%) returned to work. Smaller tumors (p < 0.0001), no lymph node (p = 0.0076), or distant metastases (p = 0.0122) positively influenced reintegration. Radiotherapy (p = 0.0005) and chemotherapy (p = 0.0001) negatively impacted. Completing treatment within six months improved reintegration (67.5%; p = 0.0004), while tracheostomy reduced it (12.5%; p = 0.0021). Neck hypersensitivity (p = 0.0009), paresthesia with incomplete eye closure (p = 0.0027), paresthesia of the corner of the mouth (p = 0.0098) and functional restrictions hindered reintegration. White-collar workers (75.0%) returned more often. Returning survivors had higher anxiety (69.3%; p = 0.0366), quality of life (89.1%; p < 0.0001), higher income (p = 0.0022), and education (p = 0.0110).

Socioeconomic status, education level, tumor characteristics, and treatment modalities significantly affect return to work rates. Physical and functional impairments, along with differences in occupational categories, further hinder reintegration, underscoring the importance of tailored strategies.