Objectives This study aimed to (i) investigate cancer survivor’s employment status one year after the completion of a medical rehabilitation program and (ii) identify demographic, cancer, and psychosocial, treatment-, and work-related predictors of return to work (RTW) and time until RTW.

Methods A total of 1520 eligible patients were consecutively recruited on average 11 months post diagnosis and assessed at the beginning (t₀) (N=1148) and end of rehabilitation (t₁) (N=1060) and 12 months after rehabilitation (t₂) (N=750). Participants completed validated measures assessing functional impairments, pain, anxiety, depression, quality of life, social support, and work-related characteristics including work ability, sick leave absence, job requirements, work satisfaction, self-perceived employer accommodation, and perceived job loss. Physicians estimated the degree of cancer-entity-specific functional impairment.

Results In a mean time of six weeks after rehabilitation, 568 patients (76%) had returned to work. The multivariate hierarchical logistic regression analysis indicated that baseline RTW intention [odds ratio (OR) 6.22, 95% confidence interval (95% CI) 1.98–19.51], perceived employer accommodation (OR 1.93, 95% CI 0.33–0.99), high job requirements (OR=1.84, 95% CI 1.02–3.30), cancer recurrence or progression (OR=0.27, 95% CI 0.12 – 0.63), baseline sick leave absence (OR=0.26, 95% CI 0.09–0.77), and problematic social interactions (OR=0.58, 95% CI 0.33–0.99) emerged as significant predictors for RTW. The explained variance of the total model was Nagelkerke’s R^²=0.59 (P<0.001).

Conclusion Our findings emphasize the high relevance of motivational factors. Occupational motivation and skepticism towards returning to work should be carefully assessed at the planning of the rehabilitation program.

Key terms cancer; cancer survivor; cancer survivorship; employment; predictor; prospective study; psycho-oncology; rehabilitation; return to work; RTW