Purpose: Colorectal cancer (CRC) incidence is increasing among working-age adults. Survivors often encounter challenges in maintaining employment, leading to psychosocial and financial consequences. This study aimed to explore return-to-work (RTW) perceptions of CRC survivors and healthcare providers (HCPs), exploring barriers to work participation and comparing perspectives between survivors and HCPs.
Methods: A cross-sectional, mixed-methods study. CRC survivors aged 18 to 65 who had completed primary treatment and were in the paid workforce at diagnosis were recruited via clinics and community outreach to complete an investigator-developed survey or semi-structured telehealth interview. HCPs (surgeons/oncologists/nurses/allied health) involved in CRC care were recruited through snowball sampling for an interview.
Quantitative data were analysed using descriptive statistics, with an inductive thematic analysis guided by framework mapping for the interview data.
Results: 88 survivors completed the survey, 29 participated (20 HCPs and 9 survivors) an interview. Most survivors were female (61%), aged >40 (77%), and held professional or managerial roles (60%). Fatigue (64%), bowel issues (51%), concentration difficulties (59%), and neuropathy (41%) were the main barriers to work. Most participants took leave for surgery and chemotherapy, with only 6% working uninterrupted. Work was primarily valued for its income (84%). 25% received formal RTW preparation. 73% were unaware of their workplace rights.
Emerging themes from interviews with HCP and CRC survivors highlight a mismatch in perspectives regarding readiness to RTW (physical and psychological aspects) framed by the biopsychosocial and occupational health models. There were systemic gaps in care coordination and communication, and limited RTW knowledge among both groups.
Conclusions: The findings highlight mismatch in perception of RTW readiness between HCPs and survivors, and gaps in care coordination and knowledge. Aligning expectations, bridging knowledge gaps, promoting early integrated interdisciplinary planning, and fostering workplace policy awareness, are essential for facilitating a smooth transition back to work after CRC.