Aim
The incidence of human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is increasing. It commonly affects people of working age. This study aimed to understand the return to work (RTW) experience of survivors, examining RTW rates following treatment completion, and the clinical, treatment and social factors associated with RTW.
Methods
A cross-sectional, single-institution study. Eligible patients were: (1) aged 18-65 years at diagnosis; (2) employed at or within three months of diagnosis; and (3) had completed curative intent treatment ≥ four months prior to enrolment. Clinical data was collected from records. Patients completed a questionnaire assessing RTW status and quality of life (QOL; FACT-HN). Open-ended questions explored the impact of treatment toxicity, workplace factors, financial issues and supportive care. Associations between RTW and baseline factors, as well as its impact on QOL, were examined. Responses to open-ended questions were analysed through thematic analysis.
Results
Of 86 patients approached, 68 responded (79%). Mean age was 54.1 years, 89.7% were male, and 5.9%/67.6% were treated with radiation alone and chemoradiation, respectively. Mean time since treatment completion was 2.6 years. Overall, 58/68 patients had RTW (85.3%). 45 (77.6%) returned to the same role and 35 (60.3%) to identical hours. 10 were not working: 3 were retired; 7 unemployed, of whom 5 cited ongoing treatment toxicity as precluding RTW. In those who did RTW, the mean time from treatment completion was 7.8 months. Survivors who RTW reported higher QOL (p=0.002, 95% CI=8.06-33.73). A supportive work environment, access to leave and support from treating doctors were facilitators of RTW, while fatigue was frequently reported as a major barrier.
Conclusions
The majority of patients with HPV-associated OPC RTW following treatment. Attention to symptom management and workplace support may enable more successful RTW