Return to work in elderly population with cancer

As survival following cancer diagnosis continues to improve, supporting functional recovery and social participation among older cancer survivors has become an important public health priority. This retrospective cohort study examined return-to-work (RTW) trajectories among older cancer survivors and explored the association between RTW and long-term survival.

Older workers diagnosed with cancer between 2004 and 2015 were identified from nationwide population-based databases in Taiwan. Cox proportional hazards models were used to examine sociodemographic, clinical, and work-related factors associated with RTW. Survival differences between survivors with and without RTW were assessed using Kaplan-Meier analyses.

Older age, male sex, selected comorbidities, receipt of chemotherapy or radiotherapy, higher income, and engagement in physically demanding occupations were associated with a lower cause-specific hazard of RTW during follow-up. Survivors diagnosed at earlier cancer stages and those with colorectal, breast, or prostate cancer had a higher cause-specific hazard of RTW compared with the corresponding reference groups. Survival differed significantly between survivors with and without RTW across all cancer stages, with more pronounced separation of the survival curves among those with stage III or IV disease. RTW was independently associated with a reduced risk of all-cause mortality.

RTW among older cancer survivors reflects both clinical recovery and broader social reintegration. Survivors who returned to work experienced more favorable survival outcomes, highlighting the importance of supportive, survivorship-focused interventions that facilitate sustained work participation among older adults.