Return to Work and Employment Outcomes in Survivors of Differentiated Thyroid Cancer: A Systematic Review

Differentiated thyroid cancer (DTC) predominantly affects individuals of working age and is characterized by excellent long-term survival. However, occupational recovery after treatment has received limited and fragmented attention in the literature. The objective is to systematically review the available evidence on return to work and employment-related outcomes among survivors of differentiated thyroid cancer.

PubMed/MEDLINE, Scopus, and Web of Science Core Collection were searched from database inception to December 2025 in accordance with PRISMA guidelines. Observational and qualitative studies reporting work- or employment-related outcomes in adult DTC survivors were included. Given the substantial heterogeneity of study designs and outcome measures, a narrative synthesis was performed.

Twenty-three studies met the inclusion criteria. Although many DTC survivors returned to work relatively early, incomplete occupational recovery was frequently reported, including reduced working hours, prolonged sick leave, income loss, or long-term employment difficulties. Work-related outcomes varied widely across studies and were influenced by nononcological factors such as fatigue, psychological distress, and sociodemographic characteristics. Importantly, several studies highlighted a mismatch between actual return to work and readiness to return to work, indicating that work resumption often occurred before full functional and psychological recovery.

Despite excellent oncological outcomes, survivors of differentiated thyroid cancer may experience persistent challenges in employment. Return to work should be regarded as a multidimensional process rather than a binary outcome, highlighting the need for standardized assessment and targeted vocational support in survivorship care.