title: Barriers and opportunities for return-to-work of cancer survivors: time for action--rapid review and expert consultation.
abstract: BACKGROUND
  The spread of early detection and the improvement of cancer treatment have led to an increased prevalence of cancer survivors, including in the working age population. Return-to-work (RTW) of cancer survivors has become a key issue for national cancer control plans. This study aims (1) to identify the factors that have an impact on RTW of cancer survivors and to draw a risk profile supporting health professionals in the screening of those at risk for barriers of RTW and (2) to sharpen these results with input from health, social security and academic Belgian experts and to provide evidence-based recommendations that facilitate RTW of cancer survivors.
  
  
  METHODS
  A rapid review was conducted, based on the methodology elaborated by The Knowledge to Action Research Programme and researchers from the University of York, including a quality assessment of retained studies. Next, the Delphi method was used to organize a consultation with experts in order to discuss, validate and complement the results.
  
  
  RESULTS
  Forty-three out of 1860 studies were included. We identified nine risk factors grouped into four categories: socio-demographic, disease and treatment-related, work-related, and personal and subjective factors. Experts suggested dividing them into two even groups: factors which are modifiable and those which are not. The awareness of health professionals regarding the identified factors, a better assessment of work capacities, clarity on the rights and obligations of employers and workers alike, and the setup of a positive discrimination employment policy for cancer survivors were acknowledged as factors facilitating RTW of cancer survivors.
  
  
  CONCLUSIONS
  The awareness of health professionals regarding barriers of RTW may improve the early identification of cancer survivors at risk for prolonged time to RTW and may allow early supportive intervention. Social and employment policies should be better tailored to support both employers and cancer survivors in the RTW process, providing incentives to positively discriminate cancer survivors on prolonged sick leave.
authors.affiliation: Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. regine.kiasuwambengi@wiv-isp.be.|Belgian Cancer Center, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium. regine.kiasuwambengi@wiv-isp.be.
authors.forename: Régine
authors.initials: R
authors.lastname: Kiasuwa Mbengi
authors.affiliation: Belgian Cancer Center, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium. Renee.otter@gmail.com.
authors.forename: Renée
authors.initials: R
authors.lastname: Otter
authors.affiliation: Department of Research and Development, Mensura, Antwerp, Belgium. Katrien.mortelmans@mensura.be.
authors.forename: Katrien
authors.initials: K
authors.lastname: Mortelmans
authors.affiliation: Belgian Cancer Center, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium. Marc.arbyn@wiv-isp.be.|Unit of Cancer Epidemiology, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium. Marc.arbyn@wiv-isp.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Arbyn
authors.affiliation: Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium. Herman.vanoyen@wiv-isp.be.
authors.forename: Herman
authors.initials: H
authors.lastname: Van Oyen
authors.affiliation: Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. Catherine.bouland@ulb.ac.be.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bouland
authors.affiliation: Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. De.brouwer.christophe@ulb.ac.be.
authors.forename: Christophe
authors.initials: C
authors.lastname: de Brouwer
mesh_terms: D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005221:Fatigue / Q000453:epidemiology; D006801:Humans; D007182:Income; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000628:therapy; D010146:Pain / Q000453:epidemiology; D065840:Protective Factors; D012017:Referral and Consultation; D062707:Return to Work / Q000706:statistics & numerical data*; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D012944:Social Support; D017741:Survivors / Q000706:statistics & numerical data*; D016526:Workload
chemical_list: D000970:Antineoplastic Agents