The Impact of Prostate Cancer Treatment on Work Participation: A Systematic Review

Prostate cancer is the most common cancer amongst men, yet how its treatment affects work participation remains poorly understood. This systematic review synthesised quantitative evidence on work participation following prostate cancer treatment, comparing treatments and identifying associated factors and evidence gaps.

Five databases (MEDLINE, Embase, PsycINFO, CINAHL, Google Scholar) were searched (May 2025) for English-language, peer-reviewed articles reporting treatment-specific work outcomes amongst men with prostate cancer. The review followed PRISMA and was registered with PROSPERO (CRD420251061347). Risk of bias was assessed using Joanna Briggs Institute tools, and certainty of evidence using GRADE.

Twenty-eight articles (24 studies, 39,966 men) were included. Most were cohort (n = 15) or cross-sectional (n = 6) studies; 15 compared ≥ 2 treatments. Median time to return to work (RTW) ranged from 14 to 56 days. Amongst low risk of bias studies reporting adjusted estimates, RTW was faster (adjusted hazard ratio 2.13, 95%CI 1.62-2.80) and long-term absenteeism less likely (adjusted odds ratio 0.53, 95%CI 0.42-0.68) after robot-assisted than open radical prostatectomy. Absenteeism ranged from < 14 to > 50 days and was longer with advanced disease and physically demanding work. The only randomised trial found no RTW difference between treatments (p = 0.49). No studies evaluated outcomes by occupation. Most used self-reported measures with limited confounder adjustment.

Very low-certainty evidence suggests that work participation after prostate cancer treatment varies by treatment type and disease severity, although heterogeneity and methodological limitations constrain interpretation. Standardised, validated measures and adequate confounder adjustment are needed to inform treatment decisions, survivorship care, and workplace support.