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
This was a cross sectional, single institution study. Eligible patients were aged 18-65 years at diagnosis, employed at or within three months of diagnosis, and had completed treatment with curative intent ≥ four months prior to study enrolment. Clinical data was collected from medical 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 on RTW. Associations between RTW and baseline factors, as well as correlation with QoL, were examined. Responses to open-ended questions were analysed using thematic analysis.
Results
The survey response rate was 79% (68/86). Mean age of participants was 54.1 years and 89.7% were male. Most participants received chemoradiation (85.3%), and mean time since treatment completion was 2.6 years. Overall, 58 participants had RTW (85.3%), 45 (77.6%) returned to the same role and 35 (60.3%) to identical hours. Ten were not working; of these, three were retired and seven unemployed, of whom five cited ongoing treatment toxicity preventing RTW. In those who did RTW, the mean time off work was 7.8 months. Survivors who RTW reported higher QoL (p=0.002, 95% CI=8.06-33.73) compared with those who had not RTW. A supportive work environment, access to leave and support from treating doctors were facilitators of RTW, and 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.