OnCo
ideasIdea

Vocational rehabilitation integrated into cancer care so survivors can return to work

Many survivors of working age lose their jobs or income after treatment, though they could work with the right support. Job-focused rehabilitation should be part of cancer care, as it is for stroke.

Cancer survivors are at substantially higher risk of unemployment than the general population, with large economic and psychological costs. Multidisciplinary vocational rehabilitation (fatigue management, cognitive strategies, employer liaison, phased return) has moderate evidence from trials, mostly in Europe, but is rarely funded within oncology. Integrating a return-to-work pathway from diagnosis, with a named coordinator, would address one of survivors' most reported unmet needs.

Hypothesis
Survivors offered integrated vocational rehabilitation will have return-to-work rates at 12 months at least 15 percentage points higher than usual care, with improved financial and quality-of-life outcomes.
Rationale
Return-to-work programmes are standard after stroke and cardiac events with demonstrated benefit; cancer survivors have similar functional barriers and a longer horizon of benefit.
What would test it
A randomised trial across four regions of working-age patients with employment status, income, and quality of life at 12 and 24 months as endpoints.
Maturity
early clinical
Who has to act
payer
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks

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