Evaluation of the Socio-Medical Assessment of Work Capacity in Patients with Colorectal Cancer in German Rehabilitation Clinics: Its Diagnostic Accuracy for Actual Return to Work and the Physicians' Views on Potential Changes in Current Practice

Background/Objectives: Return to work (RTW) is a goal of many patients with colorectal cancer (PwCRC) attending inpatient rehabilitation. In German rehabilitation clinics, physicians conduct the socio-medical assessment of work capacity (SMWC) with the aim of assessing the current ability to work. We tested how well it also predicts the actual RTW of PwCRC. Methods: This study combined a nationwide physician survey (N = 38) with longitudinal data from a cohort study of PwCRC (N = 172) aged 65 or younger who were employed prior to CRC diagnosis. Physicians were asked about their use of validated tools for the SMWC and their attitudes towards a standardized assessment checklist. PwCRC completed baseline and 9-month follow-up questionnaires about their employment status. SMWC results of the cohort study's participants were extracted from rehabilitation discharge reports. Results: While 97% of PwCRC were predicted to be capable of working ≥6 hours/day, only 70% actually returned to work 9 months after rehabilitation. The SMWC showed high sensitivity (98%) but low specificity (6%) for predicting RTW, with a positive predictive value (PPV) of about 70%. Most physicians (73%) at least partly saw the need for an evidence-based structured checklist for an improved SMWC, and almost all (95%) would use it if it did not take more than 10 minutes to apply it. Conclusions: The SMWC for PwCRC in German rehabilitation clinics is not standardized and overestimates the return-to-work rate. There is a need for a standardized checklist, and most physicians would be willing to use it.