Supportive Care in Cancer

, Volume 27, Issue 2, pp 539–546 | Cite as

The prevalence and determinants of return to work in head and neck cancer survivors

  • Meredith Giuliani
  • Janet Papadakos
  • Michaela Broadhurst
  • Jennifer Jones
  • Maurene McQuestion
  • Lisa W. Le
  • Lydia Beck
  • John Waldron
  • Jolie Ringash
Original Article



To determine the prevalence of and factors associated with the reduction or complete cessation of employment following treatment in head and neck cancer survivors.


This cross-sectional study was conducted among head and neck cancer survivors visiting outpatient clinics at the Princess Margaret Cancer Centre over a period of 18 months. Participants at any point along their survivorship course completed a survey that included demographic information, the Radiation Therapy Oncology Group (RTOG) Work Status Questionnaire, the Functional Assessment of Cancer Therapy–Head and Neck (FACT-HN), the M.D. Anderson Symptom Inventory–Head and Neck (MDASI-HN), the Cancer Survivors’ Unmet Needs Measure (CaSUN), and the EuroQol EQ-5D-5L utility scale.


Among 130 participants, 64 were employed at diagnosis. At the time of study, 31 (48%) had reduced their work, among whom, 21 (32.8%) had not returned to work at all following treatment. Pre-treatment employment status, cancer-related symptoms, quality of life, and health utility were associated with employment outcomes.


A high proportion of head and neck cancer survivors reduced their work capacity and many did not return following cancer treatment. Further research is needed to understand the barriers to work return in these survivors and to explore strategies to encourage resumption of employment and employment satisfaction.


Survivorship Return to work Insurance Unemployment Head and neck neoplasms 



The MDASI-HN, FACT-HN, EQ-5D, and CaSUN were used with permission. This work was supported by the Princess Margaret Foundation Discovery fund.


This study was funded by the Princess Margaret Cancer Center Discovery Grant.

Compliance with ethical standards

Conflict of interest

No financial relationship exists with the organization that sponsored this research.

We have full control of all primary data and agree to allow the journal to review the data if requested.

Meredith Giuliani declares that she has no conflict of interest.

Janet Papadakos declares that she has no conflict of interest.

Michaela Broadhurst declares that she has no conflict of interest.

Jennifer Jones declares that she has no conflict of interest.

Maurene McQuestion declares that she has no conflict of interest.

Lisa W Le declares that she has no conflict of interest.

Lydia Beck declares that she has no conflict of interest.

John Waldron declares that he has no conflict of interest.

Jolie Ringash declares that he has no conflict of interest.

Ethical approval

Research involving human participants and/or animals: all procedures performed in studies involving human participants were in accordance with the ethical standards of the Princess Margaret Cancer Center institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Results focusing on unmet needs from the overall cohort have been previously published (Giuliani, M. McQuestion, M. Jones, J. Papadakos, J. Le, LW. Alkazaz, N. Cheng, T. Waldron, J. Catton, P. Ringash, J. Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck. 2016;38(7): 1097-1103.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Meredith Giuliani
    • 1
    • 2
    • 3
  • Janet Papadakos
    • 2
    • 4
  • Michaela Broadhurst
    • 2
  • Jennifer Jones
    • 5
  • Maurene McQuestion
    • 3
  • Lisa W. Le
    • 6
  • Lydia Beck
    • 5
  • John Waldron
    • 1
    • 3
  • Jolie Ringash
    • 1
    • 3
  1. 1.Department of Radiation OncologyPrincess Margaret Cancer CentreTorontoCanada
  2. 2.Cancer EducationPrincess Margaret Cancer CentreTorontoCanada
  3. 3.Radiation Medicine ProgramPrincess Margaret Cancer CentreTorontoCanada
  4. 4.Patient EducationCancer Care OntarioTorontoCanada
  5. 5.Cancer Rehabilitation & Survivorship ProgramPrincess Margaret Cancer CentreTorontoCanada
  6. 6.Department of BiostatisticsPrincess Margaret Cancer CentreTorontoCanada

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