Factors associated with employment outcomes in cancer survivors: a systematic scoping review spanning a decade of international research

Purpose: Employment for cancer survivors impacts psychological, physical, and financial wellbeing. Existing systematic reviews of factors associated with employment outcomes are limited to specific cancer types, determinants, outcomes, and/or settings. This scoping review spanning one decade of international research aimed to provide a comprehensive overview of factors associated with employment outcomes in cancer survivors. Methods: Systematic scoping review methodology was used to identify primary studies conducting multivariate analysis of factors associated with any employment outcome (negative: reduced or less timely, productive, sustained, or satisfying employment or positive: maintained/return or more timely, productive, sustained, or satisfying employment) in adult cancer survivors (January 2014 to March 2024). Data were extracted on population, setting, outcomes, and associated factors. Results: Across 185 included studies, factors frequently associated with negative employment outcomes included older age, female sex, advanced cancer stage, some cancer types, and receipt of chemotherapy. Factors frequently associated with positive employment outcomes included higher education, more advantaged insurance status, some cancer types, and higher physical function. Research gaps were identified in specific populations/settings at risk of poorer outcomes. Conclusions: Modifiable and nonmodifiable factors associated with employment outcomes require screening and targeted interventions in clinical settings as well as the development of healthcare delivery, workplace, and national policies and resources. Future research should address gaps in people with advanced cancer, vulnerable groups, and lower resource settings. Implications for cancer survivors: Survivors at risk for negative outcomes should be identified and offered relevant, tailored information and resources regarding the impact of cancer and treatment on employment outcomes.