87 Residual work capacity and (in)ability to work fulltime among applicants with cancer INTRODUCTION In Europe, each year 3.5 million persons are newly diagnosed with cancer [1]. Of these, 40 to 50% are of working age at time of diagnosis [2, 3]. Due to early diagnostic methods and effective treatment strategies, individuals are more likely to survive a cancer diagnosis. As a result, an increasing part of the cancer patients is able to return to work, or to (partly) stay at work during treatment [4]. A systematic literature review by Mehnert shows that about two-thirds of the people diagnosed with cancer return to work at some point after diagnosis [5]. Twelve months after diagnosis, approximately 60% of the working patients had returned to work or stayed at work; 24 months after diagnosis, this percentage increased up to 89% [5]. For people diagnosed with cancer, being able to work is central to their quality of life and is associated with multifaceted psychological, social, and economic benefits. Besides financial necessity, work resumption also reestablishes identity and the former structure of everyday life [6–8]. In cancer patients, it has been found that the disease and its treatment frequently led to health worries and distress, fatigue, cognitive problems, and other health problems which can persist for years after treatment [9–13]. Some of these health problems, such as fatigue and pain, are related to all types of cancer. Other health problems such as lymphedema, dyspnea, and depression usually occur with specific types of cancer, like breast and lung cancer, or with specific treatment options (neuropathy as a result of chemotherapy) [14]. These health problems interfere negatively with the ability to work (fulltime) and may result in poor work outcomes, such as prolonged sick leave, job loss, and long-term work disability [9, 10, 15]. Once returned to work, it might cause lower levels of work functioning [16]. A growing number of studies have documented the impact of cancer on employment outcomes [16–20]. These studies included populations of workers during the onset of a sick leave period [21, 22], or after people returned to work [16, 21, 23] or from the first day of sick leave until they applied for a disability benefit [24]. The majority of these study samples consisted of (female) patients with breast cancer, and no comparison between cancer diagnosis groups was made. In the Netherlands, long-term sick-listed employees may apply for disability benefit to compensate for income loss after 2 years of sick leave. The insurance physician of the Dutch Social Security Institute: the Institute for Employee Benefits Schemes (UWV) assesses the health situation of an applicant and whether the applicant has residual work capacity [25]. When applicants are assessed with no residual work capacity, they have no possibilities to perform in any work at all. If the applicant is assessed with residual work capacity, the insurance physician also assesses the applicant’s (in)ability to work fulltime. The assessment of (in) ability to work fulltime is expressed by the 5
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