Returning to work after sick leave due to cancer: a 365-day cohort study of Japanese cancer survivors

PURPOSE More employees are experiencing a cancer diagnosis during their working-age years, yet there have been no large-scale Japanese studies investigating sick leave due to cancer. We clarified differences in the cumulative partial and full return to work (RTW) rates between different cancer types among Japanese cancer survivors. METHODS Data on Japanese employees who experienced an episode of sick leave due to clinically certified cancer diagnosed between 1 January 2000 and 31 December 2011 were obtained from an occupational health register. Subject outcomes within the 365-day period following their initial day of sick leave were utilized for this study. We investigated the cumulative partial/full and full RTW rates by using survival analysis with competing risks and predictors of time to RTW by a Fine-Gray proportional hazard regression model. RESULTS One thousand two hundred seventy-eight subjects (1033 males and 245 females) experienced their first episode of sick leave due to cancer during the 12-year follow-up period. Of the subjects, 47.1% returned to work full time within 6 months of their initial day of sick leave absence, and 62.3% by 12 months. The cumulative RTW rate varied significantly by cancer type. There were considerable differences in the range of cumulative full RTW rates between the two categories ("lower full RTW rate" groups ("lung," "hepatic, pancreatic," "esophageal," and "blood" cancer groups) vs. "higher full RTW rate" groups ("gastric," "intestinal," "breast," "female genital," "male genital," "urinary"): 6.3 to 14.3% vs. 11.4 to 28.3% at 60 days, 10.6 to 22.4% vs. 27.0 to 50.0% at 120 days, 21.3 to 34.7% vs. 38.5 to 65.4% at 180 days, 34.3 to 42.9% vs. 66.0 to 79.5% at 365 days). Additionally, older age may be associated with a longer time to full RTW. CONCLUSIONS More than half of the subjects returned to work full-time within the 365-day period following their initial day of sick leave, with cumulative RTW rates varying by cancer type. Older employees may require a longer time to full RTW. IMPLICATIONS OF CANCER SURVIVORS It is very important for companies (especially small- and medium-sized companies) to establish and improve their RTW support system for cancer survivors, with knowledge that the median time to RTW is expected to be at least a few months.