With improvements in screening, diagnosis, and treatment, the number of persons surviving cancer and staying at or returning to work is increasing. While workplace accommodations optimize workers’ abilities to participate in the workforce, there has been little in-depth investigation of the types of accommodations reported to have been provided to cancer survivors and the processes relevant to ensuring their successful implementation.
We employed an exploratory qualitative method and conducted 40 semi-structured interviews with three groups: (i) cancers survivors (n = 16), (ii) health/vocational service providers (n = 16), and (iii) employer representatives (n = 8) to explore return to work and accommodation processes, successes, and challenges. An inductive thematic analysis approach was used to analyze the data.
Four types of accommodations were recommended: (1) graduated return to work plans and flexible scheduling, (2) modification of work duties and performance expectations, (3) retraining and supports at the workplace, and (4) modification of the physical work environment and/or the provision of adaptive aids/technologies. Processes relevant to ensuring effective accommodations included: (1) developing knowledge about accommodations, (2) employer’s ability to accommodate, (3) negotiating reasonable accommodations, (4) customizing accommodations, and (5) implementing and monitoring accommodation plans. Accommodation challenges included: (1) survivors’ fears requesting accommodations, (2) developing clear and specific accommodations, (3) difficult to accommodate jobs, and (4) workplace challenges, including strained pre-cancer workplace relationships, insufficient/inflexible workplace policies, employer concerns regarding productivity and precedent setting, and limited modified duties.
Accommodations need to be customized and clearly linked to survivors’ specific job demands, work context, and available workplace supports. Survivors need to feel comfortable disclosing the need for accommodations. Ongoing communication and monitoring are required to ensure accommodations are implemented and changes made to the return to work plan as required.
Implications for Cancer Survivors
The provision of appropriate workplace accommodations can enhance survivors’ abilities to stay or return to work.
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Under the Ontario Human Rights Code, undue hardship may be claimed by employers in situations where costs of accommodations may be excessive and when there are identified occupational health and safety risks 
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This study was supported by a Grant through the Dean’s Fund, Faculty of Medicine, University of Toronto. We would like to express our gratitude to the cancer survivors, service providers, and employer representative who gave of their time and shared their extensive expertise to assist us in developing a shared understanding of how we can facilitate workplace accommodations and support survivors with their work goals. We would also like to acknowledge the support of Holly Bradley and Well Spring in assisting us with participant recruitment.
All procedures performed in this study, involving human participants, were in accordance with the ethical standards and approval from the ethics review boards at the University of Toronto and the University Health Network, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
This study was supported by a grant through the Dean’s Fund, Faculty of Medicine, University of Toronto (Award #DF-2013-17).
Conflict of interest
All authors of this paper have no conflict of interest to declare.
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Stergiou-Kita, M., Pritlove, C., van Eerd, D. et al. The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives. J Cancer Surviv 10, 489–504 (2016). https://doi.org/10.1007/s11764-015-0492-5
- Cancer survivors
- Return to work
- Employment supports
- Workplace accommodations