The role of neuropsychological functioning in cancer survivors' return to work one year after diagnosis

OBJECTIVE: The objective of this study was to investigate the relationship between neuropsychological functioning and the ability to work in cancer survivors. METHODS: The study involved a consecutive cohort of 45 patients who had received a primary diagnosis of cancer, were gainfully employed at baseline, and had been treated with curative intent. Twelve months after the first day of sick leave, they underwent a neuropsychological assessment that included executive function and verbal memory tests. Other clinical, person-related, and work-related factors were also assessed by questionnaire at this time. Ability to work was measured as perceived workability (0-10) and work status at 12 months of sick leave. RESULTS: Fifteen participants (33%) showed neuropsychological impairments covering various domains. The mean workability score of cancer survivors with neuropsychological impairment was 4.9, whereas those without impairments had a mean score of 6.0 (raw beta = -0.19: 95% CI = -2.9 to 0.7; adjusted beta = -0.15; 95% CI = -2.5 to 0.8). More cancer survivors with neuropsychological impairments (7/15, 47%) than without (9/30, 30%) had not yet returned to work (raw OR 0.5: 95% CI: 0.1-1.8; adjusted OR 0.5; 95% CI: 0.1-2.1). CONCLUSIONS: To date, this is the largest study to assess neuropsychological functioning objectively in combination with perceived workability and work status. Impaired neuropsychological functioning was found in one-third of the cancer survivors and was related to a lower vocational functioning, but the relationship was not statistically significant. More research is needed to test the relevance of neuropsychological impairments for vocational functioning.