gms | German Medical Science

Background: A cancer diagnosis means a major disruption in the daily life of those affected. It often leads to a withdrawal from work due to treatment and its side effects. According to the WHO, approximately 4.4 million people in Europe were newly diagnosed with cancer in 2020, about 36% of those between 20 and 64 years old at diagnosis [1]. Studies in Europe show different return-to-work (RTW) rates, but methods and quality vary. Predictors of RTW include disease-, psychosocial and work-related as well as sociodemographic and social system predictors. The results of a systematic review on predictors of RTW in European cancer survivors show the need of addressing RTW in the whole patient pathway of cancer survivors [2]. To better understand the process of RTW in Europe and to subsequently support cancer survivors’ RTW in the patient pathway, looking at the individual health and social systems in European countries is critical.

Objective: To address this research gap, this work examines the following research question: When, where and by whom is the RTW process addressed in the patient pathway, and which support measures are available across different health and social systems in European countries? The aim is to describe RTW processes and regulations in health and social systems and to identify timepoints for addressing RTW in the patient pathway.

Methods: The research question will be addressed with a qualitative design. Based on the systematic review on predictors of RTW in Europe (2) and an exploratory literature review on social systems, an interview guideline for collecting RTW processes and regulations was developed. After a pilot phase in two European countries, stakeholders in eight European countries will be contacted for the interview. Interview participants will be experts on the health and social system of the respective country. Recruitment will take place through the Patient Support Working Group of the European Cancer League which consists of, among others, social workers, psychologists, and legal experts from different member states. Expert interviews will be conducted via Microsoft Teams and additionally recorded with an analog recorder. During the interviews, the table created to map the RTW processes will be filled in together with the expert. Written consent will be obtained from all participants.

Results: Results will be available for the DKVF. The results will be used to create a table of RTW processes and regulations in each country considering the phases of the patient pathway. Aspects of the table will include information on the type of support provided to the cancer survivor, involved providers, regulations anchored in law, benefit payments and requirements for RTW support within the patient pathway.

Implication for (healthcare) practice: The mapping of the existing RTW processes and regulations can help identify gaps in the care of cancer survivors. Knowledge about these gaps can contribute to developing cancer survivorship programs according to the goal of Europe’s Beating Cancer Plan to improve RTW processes for cancer survivors [3].

Funding: Other funding; Project name: CraNE; Grant number: 101075284