Social inequalities in return to work and social mobility after a cancer diagnosis: study protocol for a mixed-methods study in Central Germany

Introduction About one-third of all patients with cancer in Germany are still of working age at the time of diagnosis. Therefore, occupational reintegration is an important goal after the completion of the treatment. Compared with the general population, patients with cancer are more frequently affected by unemployment, early retirement and reduced earning capacity pensions. Yet, there are no robust results about which factors determine occupational reintegration, whether downward social mobility is associated with a cancer diagnosis and which groups are particularly at risk for not returning to work or the loss of their social position. The aim of this study is to analyse social inequalities in occupational reintegration, work-related changes and vertical social mobility processes, as well as to explore the role of rehabilitative measures and other intermediary influences in these processes. Methods and analysis Data are collected in a retrospective cross-sectional study with a qualitative in-depth sequential mixed-methods design. For this purpose, patients from three federal states in Central Germany who have been diagnosed with cancer between 2017 and 2022 and are between 18 and 60 years will be asked to participate in this study. Participants answer a standardised questionnaire (written or online). A subsample will subsequently be questioned in a qualitative interview. Analysis will be done by descriptive and multivariate methods as well as qualitative content analysis. Ethics and dissemination Ethics approval has been obtained from the Ethics Committee of the Medical Faculty at the Martin Luther University Halle-Wittenberg (reference number 2023-117). All research activities will be performed in accordance with the Declaration of Helsinki. Participants have to provide informed consent before enrolment. The study is registered at the German Clinical Trials Register. Results will be presented in peer-reviewed academic journals, at (international) conferences and on a joint workshop with stakeholders and patients. Study registration number DRKS00032076.