102 Chapter 5 educational level. This might have impacted our outcomes, as the majority of the excluded cases had a normal ability to work fulltime, whereas in our study sample the majority of the applicants were assessed with an inability to work fulltime. Furthermore, because of the cross-sectional design we cannot draw conclusions about causal relationships. Implications for practice and future research The findings in the present study show that more than half of all applicants with cancer have abilities to work but often cannot work fulltime. This implies that (supporting) return to work is of great importance among cancer patients, and adjustments in work, like working hours, could be beneficial for their return to original or adapted work. Several studies have evaluated the effectiveness of intervention strategies to help people with cancer to return to work. For instance, Van Egmond et al. did not find a significant effect of a tailored return to work program carried out by reintegration coaches [37]. Furthermore, De Boer et al. evaluated in their review interventions to enhance return to work in cancer patients and found moderate-quality evidence that multidisciplinary interventions enhance the return to work of patient with cancer [38]. The findings among the different types of cancers and of the socio-demographic determinants could help to develop tailored interventions for enhancing work participation of specific cancer survivors. Furthermore, our findings can contribute to a more evidence-based assessment of residual work capacity and inability to work fulltime in disability claim assessments. Our study provides insight into which workers within specific cancer diagnosis groups are at risk for no residual work capacity and inability to work fulltime and can contribute to the development of interventions for work adjustments and reintegration. Our study aimed to explore two important work outcomes of the disability benefit assessment, using register data from the UWV. Future studies could focus on the effect of other indicators on no residual work capacity and inability to work fulltime, such as the individual diagnosis, treatment, and other personal and environmental factors. Additionally, future longitudinal studies should be conducted on the work trajectories from the onset of sick leave, or the date of diagnosis, until after the disability assessment of patients diagnosed with different types of cancer. Linkage of data from, for example, the National Cancer Registry and/or occupational health services, with data on disability benefit assessment, will provide insight into the ability to work of cancer patients before the disability benefit assessment, from the onset of the diagnosis, and compare return to work between different types of cancer on the short term. It also will provide insight into the effect of being assessed with (in)ability to work fulltime on actual (return to) work after the assessment.
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