Systematic Review and Meta-Analysis of Labor and Productivity Outcomes Caused by Cancer

Cancer imposes substantial economic burden through indirect costs associated with labor outcomes and productivity loss. This systematic review and meta-analysis quantifies labor and productivity outcomes among patients with cancer and survivors to inform economic evaluations and policy development.

We systematically searched PubMed, EconLit, and Web of Science databases in June 2025 using cancer, productivity loss, and labor outcomes terminology. Peer-reviewed studies reporting eight outcomes were included. Following screening of 6,239 abstracts and full-text review of 358 articles, 144 studies from 27 countries met inclusion criteria for meta-analysis.

The available evidence skews strongly toward formal employment situations in high-income, Western countries. We estimate a 25% productivity loss due to absenteeism (95% CI, 18 to 32) and a 23% productivity loss due to presenteeism (95% CI, 21 to 26); working hours are reduced by 19% (95% CI, 14 to 24); the return-to-work rate is 47% (95% CI, 39 to 54) with a median time of 239 days for full return; the overall job loss rate is 9% (95% CI, 8 to 11; 35% for advanced cancer; 95% CI, 22 to 48); the unemployment rate is 29% (95% CI, 22 to 36); the long-term disability/pension use is 11% (95% CI, 0 to 22); and the early retirement rate is 14% (95% CI, 8 to 20). For each reported outcome, cancer's productivity costs are observed to be more severe among women than men.

This represents the largest comprehensive meta-analysis of cancer-related labor outcomes to date. Estimated labor and productivity consequences are in line with previous research, but outcomes varied significantly by gender, cancer stage, geographic region, and time since diagnosis. Subgroup analysis provides nuanced insight into how these factors influence labor and productivity outcomes. These evidence-based estimates provide critical inputs for economic evaluations and support development of policies to maintain professional productivity among patients with cancer and survivors.