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Parambil NA, Kannan S. Work Ability, Anxiety, and Depression among Long-Term Breast Cancer Survivors of Northern Kerala, India; A Historical Cohort Study. Asian Pac J Cancer Prev 2024; 25:115-122. [PMID: 38285775 PMCID: PMC10911738 DOI: 10.31557/apjcp.2024.25.1.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Increasing number of breast cancer cases, and improved survival due to advancements in early detection, and treatment resulted in an increase in women living beyond a cancer diagnosis. Survivors have to face long-term physical effects as well as psychosocial issues post-treatment. This study aims to study survivourship in terms of work ability, anxiety and depression. METHODS Retrospective cohort study on female breast cancer survivors from Hospital Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC). Data from 2016 (n=534) were collected from the medical records, and a follow-up survey (n=209) was conducted in 2022 to study their survivorship issues. RESULTS In 2022, the mean age of the cohort (n=209) was 55.45 ± 9.36. The mean work ability score was 40.7±5.73 (95% CI 39.92 to 41.48). In the multivariate binary logistic regression model, those who were married (OR 7.15, 95%CI 2.61 to 19.55), disease-free (OR 15.27, 95% CI 2.36 to 98.7), employed (OR 9.09, 95%CI 1.12 to 73.5), having no fatigue (OR 2.6, 95% CI 1.05 to 6.48), no pain (OR 3.11, 95% CI 1.16 to 8.35), and no depression (OR 6.58, 95% CI 1.82-23.8) were found to have optimal work ability. Anxiety (OR 4.93, 95% CI 1.76 to 13.76), and sub-optimal work ability (OR 4.22, 95% CI 1.39 to 12.77) were predictors of depression among survivors. Disease status and fatigue were associated with all three dimensions of survivorship in our study. CONCLUSION Understanding survivorship will help improve health outcomes in this population. In our study, work ability, anxiety, depression, and their associated factors were found to be interrelated. Interventions in these areas can go a long way in improving breast cancer survivorship.
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Affiliation(s)
- Neethu Ambali Parambil
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
- Department of Community Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
| | - Srinivasan Kannan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
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Hallgren E, Ayers BL, Moore R, Purvis RS, McElfish PA, Maraboyina S, Bryant-Smith G. Facilitators and barriers to employment for rural women cancer survivors. J Cancer Surviv 2023; 17:1338-1346. [PMID: 35142993 DOI: 10.1007/s11764-022-01179-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Limited research exists on the employment experiences of rural women cancer survivors, yet this population may face unique barriers to employment following a cancer diagnosis. This study aims to identify facilitators and barriers to employment for rural women cancer survivors. METHODS We used a qualitative descriptive design to examine facilitators and barriers to employment for rural women cancer survivors. We conducted interviews with 33 rural women with cancer histories. RESULTS Facilitators of employment included paid time off, flexible work arrangements, and supportive workplace social networks, while barriers to employment included compromised immunity, long-term treatment effects, stigma and discrimination, and limited rural job markets. Rural women with secure employment histories generally experienced facilitators of employment, while rural women with insecure (e.g., temporary, informal, non-standard) employment histories generally faced barriers to retaining jobs and finding employment. CONCLUSIONS Formal and informal workplace support helped rural women retain their jobs during and following cancer treatment, especially those with secure employment. However, women with insecure employment histories generally faced multiple barriers to retaining and finding employment. More inclusive policies to support workers facing disabling illnesses, such as paid medical leave, are needed to ensure cancer survivors can maintain employment and/or financial security during and following their cancer treatment. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors with secure employment may benefit from formal and informal workplace support in retaining their employment. Those with insecure employment histories may benefit from access to job placement services and inclusive policies protecting employment for all workers experiencing disabling illness.
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Affiliation(s)
- Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
| | - Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Sanjay Maraboyina
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W. Markham St., #771, Little Rock, AR, 72205, USA
| | - Gwendolyn Bryant-Smith
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham St. - Slot 556, Little Rock, AR, 72205, USA
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Corbière M, Charette-Dussault É, Larivière N. Recognition During the Return-to-Work Process in Workers with Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:486-505. [PMID: 36462069 DOI: 10.1007/s10926-022-10087-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Purpose Considering worker's perspective, the purpose of this study was twofold: (1) to document the meaning of the experience of recognition in the return to work (RTW) process of work after a sick leave due to a common mental disorder (CMD) and (2) to investigate the phenomenon of recognition for workers in the process of RTW after a sick leave due to a CMD, by evaluating the presence or absence of marks of recognition from salient RTW stakeholders stemming from different systems. Methods The Relational Caring Inquiry phenomenological method was used to explore the meaning of recognition during the return-to-work process and marks of recognition in a group of 20 workers who returned to their employment after a sick leave due to a CMD. In depth individual interviews were conducted with each participant. Results The definition of recognition that emerged from workers experiencing the RTW process is related to the behaviours and attitudes of various stakeholders, stemming from the work, health, insurance and social systems that allow them to feel appreciated, valued and respected, throughout the RTW process. Recognition was most often described as showing support, trust, respect for recovery and pace, and providing positive feedback. Conclusion The findings from this study could serve as guidelines in organizations regarding the RTW process, and in particular clarifying the roles and actions that different stakeholders could take in the workplace to stimulate expressions of meaningful recognition.
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Affiliation(s)
- Marc Corbière
- Department of Education and Pedagogy - Career Counseling, Université du Québec à Montréal, Montreal, QC, Canada.
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Élyse Charette-Dussault
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Nadine Larivière
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
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Sarfo MC, Bertels L, Frings-Dresen MHW, de Jong F, Blankenstein AH, van Asselt KM, de Boer AGEM. The role of general practitioners in the work guidance of cancer patients: views of general practitioners and occupational physicians. J Cancer Surviv 2023; 17:416-424. [PMID: 35469363 PMCID: PMC9038171 DOI: 10.1007/s11764-022-01211-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/10/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore views of general practitioners (GPs) and occupational physicians (OPs) on the role of GPs in work guidance of cancer patients. METHODS Between 2016 and 2019, two focus groups with GPs (N = 17) and two focus groups with OPs (N = 10) were conducted. Focus group discussions were audiotaped and transcribed verbatim. Transcripts were analysed by data-driven analysis. RESULTS GPs generally indicated that they inquire about patients' occupations but do not structurally document these. GPs described offering support and advice to patients regarding their work, while other GPs stated they do not interfere with their patients' work or return to work (RTW) process. In general, GPs stated that they do not aspire a professional role in the work guidance of patients, due to lack of expertise and not having sufficient knowledge in work regulations and legislation. In contrast, OPs anticipated a proactive role from GPs concerning work guidance in cancer patients, and they expected GPs to refer cancer patients to the OP, when required. Moreover, they emphasised the importance of communication between GPs and OPs about patients' work-related problems to achieve common goals. CONCLUSIONS GPs can contribute to cancer patients' RTW process by supporting patients, giving advice and providing referral to other health professionals. Better cooperation between GPs and OPs may improve work guidance in cancer patients. IMPLICATIONS FOR CANCER SURVIVORS When cancer patients with work-related issues get appropriate advice and support from GPs and referred in time to OPs, the RTW process and staying at work of cancer patients may be positively affected.
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Affiliation(s)
- Marie-Christine Sarfo
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucinda Bertels
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
| | - Femke de Jong
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette H Blankenstein
- Department of General Practice/Family Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands.
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Ghasempour M, purabdollah M, Rahmani A, dehghannezhad J, Mousavi S, Sattarpour S. The Relation of Work Ability and Return to Work Among Iranian Cancer Survivors. Asian Pac J Cancer Prev 2022; 23:3339-3346. [PMID: 36308357 PMCID: PMC9924310 DOI: 10.31557/apjcp.2022.23.10.3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Cancerous diseases are known to disrupt a person's ability and inflict physical, psychological, financial, and social complications on the person, thereby challenging an individual's returning to work. The aim of this study was to investigate the ability of cancer patients to work after returning to work. METHODS This descriptive-correlational study examined a total of 227 surviving cancer patients, having picked the participants through convenience sampling. Data were collected by the return to work and work ability index (WAI) questionnaires and analyzed by descriptive statistics and inferential statistics using SPSS software. RESULTS A total of 166 (73.2%) of the participants had returned to work after completing the basic treatment. The mean (standard deviation) of the work ability score was 29.52 (9.43), ranging from 9 to 43 while the average daily work hours dropped from 12.30 to 5.50. The chi-square test showed a significant relationship between the work ability score and the type of return to work. Moreover, the rank logistic regression analysis revealed that work ability was the most important predictor of return to work. CONCLUSION Survivors of cancer face reduced working hours and limited ability to work after returning to work, and it is possible to facilitate the return to work in these patients by identifying their job needs in relation to their abilities and barriers of returning to work through the appropriate interventions.
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Boelhouwer IG, Vermeer W, van Vuuren T. Late effects of cancer (treatment) and work ability: guidance by managers and professionals. BMC Public Health 2021; 21:1255. [PMID: 34187437 PMCID: PMC8240423 DOI: 10.1186/s12889-021-11261-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/10/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The prevalence of the group of workers that had a cancer diagnosis in the past is growing. These workers may still be confronted with late effects of cancer (treatment) possibly affecting their work ability. As little is known about the guidance of this group, the aim of this study was to explore the experiences and ideas of managers and professionals about the guidance of these workers in the case of late effects of cancer (treatment). Given the positive associations with work ability of the job resources autonomy, social support by colleagues and an open organisational culture found in several quantitative studies, these job resources were also discussed. Further ideas about the influences of other factors and points of attention in the guidance of this group of workers were explored. METHODS Semi-structured interviews were conducted with managers (n = 11) and professionals (n = 47). Data-collection was from November 2019 to June 2020. The data were coded and analysed using directed content analyses. RESULTS The late effects of cancer or cancer treatment discussed were physical problems, fatigue, cognitive problems, anxiety for cancer recurrence, and a different view of life. The self-employed have less options for guidance but may struggle with late effects affecting work ability in the same way as the salaried. Late effects may affect work ability and various approaches have been described. Autonomy, social support of colleagues and an open organisational culture were regarded as beneficial. It was indicated that interventions need to be tailor-made and created in dialogue with the worker. CONCLUSIONS Especially with respect to cognitive problems and fatigue, guidance sometimes turned out to be complicated. In general, the importance of psychological safety to be open about late effects that affect work ability was emphasized. Moreover, it is important to take the perspective of the worker as the starting point and explore the possibilities together with the worker. Autonomy is an important factor in general, and a factor that must always be monitored when adjustments in work are considered. There is a lot of experience, but there are still gaps in knowledge and opportunities for more knowledge sharing.
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Affiliation(s)
- Ingrid G Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands.
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Faculty of Management, Open University of The Netherlands, Heerlen, The Netherlands / Loyalis Knowledge & Consult, Heerlen, The Netherlands
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Mazzi MA, Perlini C, Deledda G, Ghilardi A, Buizza C, Bottacini A, Goss C, Del Piccolo L. Employment status and information needs of patients with breast cancer: a multicentre cross-sectional study of first oncology consultations. BMJ Open 2020; 10:e038543. [PMID: 32994250 PMCID: PMC7526300 DOI: 10.1136/bmjopen-2020-038543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To investigate the early information needs of women with a recent diagnosis of breast cancer (BC) according to their employment status. DESIGN Cross-sectional. SETTING Secondary-care patients attending three outpatient oncology clinics in northern Italy. PARTICIPANTS 377 women with a recent diagnosis of early-stage, non-metastatic BC aged 18-75 were recruited. Of them, 164 were employed, 103 non-employed and 110 retired. OUTCOME MEASURES The first consultation visit with an oncologist was audio-recorded and analysed for the number and type of questions asked. Linear regression models considering consultations' and patients' characteristics as confounding variables were applied. RESULTS Employed patients asked significantly more questions than non-employed and retired patients (17 vs 13 and 14; F=6.04; p<0.01). When age and education were included in the statistical model, the significance of employment status was rearranged among all the variables and was no more significant (b=1.2, p=0.44). Employed women asked more questions concerning disease prognosis (0.7 vs 0.4 and 0.6; F=3.5; p=0.03), prevention (1.4 vs 0.6 and 0.7; F=10.7; p<0.01), illness management (7.2 vs 6 and 5.4; F=3.8; p=0.02) and social functioning (37% vs 18% and 20%; χ2=14.3; p<0.01) compared with the other two groups. Finally, they attended more frequently the consultation alone (37% vs 18% and 25%; χ2=10.90, p<0.01), were younger (50 vs 58 and 67 years; F=63.8; p<0.01) and with a higher level of education (77% vs 27% and 45%; χ2=68.2; p<0.01). CONCLUSIONS Employment status is related to the type of questions asked during the first consultation. Also, it interrelates with other patients' characteristics like age and education in determining the number of questions asked. Patients' characteristics including employment status could be considered in tailoring work and social-related information provided during the first oncological consultation. Future studies could explore potential differences in information needs according to the different kinds of work.
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Affiliation(s)
- Maria Angela Mazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Giuseppe Deledda
- Clinical Psychological Service, UO of Clinical Psychology, Scientific Institute for Research, Hospitalisation and Health Care (IRCCS) "Sacro Cuore - Don Calabria", Negrar di Valpolicella, Verona, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, Unit of Clinical Psychology, University of Brescia, Brescia, Italy
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, Unit of Clinical Psychology, University of Brescia, Brescia, Italy
| | - Alessandro Bottacini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Claudia Goss
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
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The associations between late effects of cancer treatment, work ability and job resources: a systematic review. Int Arch Occup Environ Health 2020; 94:147-189. [PMID: 32929528 PMCID: PMC7873002 DOI: 10.1007/s00420-020-01567-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/25/2020] [Indexed: 01/11/2023]
Abstract
Objective The aim of this review is to evaluate associations between possible late effects of cancer treatment (i.e. physical complaints, fatigue, or cognitive complaints) and work ability among workers beyond 2 years after cancer diagnosis who returned to work. The role of job resources (social support, autonomy, leadership style, coaching, and organizational culture) is also evaluated. Methods The search for studies was conducted in PsycINFO, Medline, Business Source Premier, ABI/Inform, CINAHL, Cochrane Library and Web of Science. A quality assessment was used to clarify the quality across studies. Results The searches included 2303 records. Finally, 36 studies were included. Work ability seemed to decline shortly after cancer treatment and recover in the first 2 years after diagnosis, although it might still be lower than among healthy workers. No data were available on the course of work ability beyond the first 2 years. Late physical complaints, fatigue and cognitive complaints were negatively related with work ability across all relevant studies. Furthermore, social support and autonomy were associated with higher work ability, but no data were available on a possible buffering effect of these job resources on the relationship between late effects and work ability. As far as reported, most research was carried out among salaried workers. Conclusion It is unknown if late effects of cancer treatment diminish work ability beyond two years after being diagnosed with cancer. Therefore, more longitudinal research into the associations between possible late effects of cancer treatment and work ability needs to be carried out. Moreover, research is needed on the buffering effect of job resources, both for salaried and self-employed workers. Electronic supplementary material The online version of this article (10.1007/s00420-020-01567-w) contains supplementary material, which is available to authorized users.
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Return to Work of Breast Cancer Survivors: Perspectives and Challenges for Occupational Physicians. Cancers (Basel) 2020; 12:cancers12020355. [PMID: 32033165 PMCID: PMC7072532 DOI: 10.3390/cancers12020355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 11/17/2022] Open
Abstract
Breast cancer is one of the most common diseases worldwide, mainly affecting the female gender. Considering the increase of breast cancer incidence and the decrease of mortality due to news diagnostic and therapeutic tools, the return to work issue after treatment is going to be very common in the next years. Occupational physicians therefore need to face the return to work and the fitness for work of workers previously diagnosed with breast cancer with a sufficient cultural and technical background. In addition to individual characteristics preceding the diagnosis, clinical outcome, lifestyles and occupational variables are the most impactful factors on return to work that need to be taken into account. The aim of this work is to analyze these factors and discuss the central role of occupational physicians in the decision-making process of returning to work in breast cancer survivors.
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