Factors influencing return to work of cancer survivors: a population-based study in Italy



Little is known about return to work (RTW) of cancer survivors (CSs) in Central and Southern Europe. This study investigates the RTW rate of Italian CSs, describes their sick leave (SL) pattern, and explores factors affecting their RTW process.


A population-based cross-sectional survey involving CSs registered at the Cancer Registry of Reggio Emilia Province (Italy) was launched in July 2016. Eligibility was restricted to individuals with first diagnosis of cancer in 2012 (stages I–III), aged 20–59, and employed at the time of diagnosis.


Of the 266 individuals interviewed, 140 (52.6%) were reintegrated without difficulty, 113 (42.5%) returned to work with some difficulty, and 13 did not RTW (4.9%). The majority of CSs (56%) took SL for some periods during treatment. Age > 50 years and higher income seemed to facilitate RTW (RR = 0.65, 95% CI 0.49–0.88 and RR = 0.72, 95% CI 0.54–0.97, respectively), while being divorced acted as a barrier compared to being married (RR = 1.45, 95% CI 1.04–2.01). Individuals uncertain about the type of company they were working for reported greater difficulty in RTW (RR = 1.68, 95% CI 1.03–2.72). Individuals who had undergone chemotherapy and those perceiving physical limitations had a higher risk of difficulty in the RTW process (RR = 1.79, 95% CI 1.42–2.24 and RR = 1.59, 95% CI 1.25–2.02, respectively).


Most CSs did RTW, with 2/3 combining work and treatment. However, almost half reported difficulty in RTW process. Factors affecting this process should be addressed throughout context-specific social and healthcare pathways aimed at preventing difficulties and potential job loss in this population.

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return to work


cancer survivors


sick leave


occupational therapist


relative risks


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We thank Jacqueline M. Costa for the English language editing.


This work was supported by the Chamber of Commerce of Reggio Emilia, the Foundation GRADE Onlus of Reggio Emilia, and the Local Health Authority-IRCCS of Reggio Emilia, Italy.

Author information

SP, MV, PM, PGR, and SC were responsible for the conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the initial manuscript, and revising it critically for important intellectual content; EM and SF were responsible for the conception and design of the study, analysis and interpretation of data collected, and critically revising the manuscript for important intellectual content; ER was responsible for analysis and interpretation of data collected, drafting the initial manuscript, and revising it critically for important intellectual content. All authors read and approved the final manuscript to be published.

All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Correspondence to Stefania Costi.

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Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Province of Reggio Emilia (2016/0014896). In accordance with the Italian law, the OT collected the informed consent to participate in this study, together with the consent to personal data processing.

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The authors declare that they have no conflict of interest.

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Additional file 1

– Questionnaire. The complete questionnaire used to collect data. (DOCX 110 kb)

Additional file 2

– The STROBE Checklist. The STROBE checklist of the report. (DOC 88 kb)

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Paltrinieri, S., Vicentini, M., Mazzini, E. et al. Factors influencing return to work of cancer survivors: a population-based study in Italy. Support Care Cancer 28, 701–712 (2020).

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  • Europe
  • Cancer survivors
  • Return to work
  • Epidemiology
  • Sick leave
  • Rehabilitation