89 Residual work capacity and (in)ability to work fulltime among applicants with cancer well. This part of the assessment results in a conclusion about their (in)ability to work fulltime, reported as the number of hours one can sustain working activities per day. In these cases, an additional assessment by a labor expert follows to indicate whether the applicants are incentivized to continue in paid (part-time) employment at their current employer or should enroll in a new, more appropriate (part-time) job, according to their residual work capacity. Design and sample The study is a cross-sectional register-based cohort study among applicants for a long-term disability benefit according to the Work and Income Act, in the year 2016. Data were derived from the UWV register forms completed by the insurance physicians and labor experts at the time of assessment and anonymized by UWV. For this study, only applicants whose primary diagnosis was cancer (ICD-10 disease group Neoplasms, containing all cancer diagnoses) were included [32]. Subgroups of specific cancer diagnoses having less than 40 applicants, and other unspecified cancer diagnoses, were excluded from the data analyses. Approval by a Medical Ethical Committee was not necessary under Dutch law, as the study is a register-based study and therefore not subject to the Medical Research Involving Human Subjects Act (WMO). Outcome variables Residual work capacity (yes/no) was based on the insurance physicians’ assessment. The insurance physician assessed and registered the degree of (in)ability to work fulltime using 1 = at least 8 h per day; 2 = no more than 8 h per day; 3 = no more than roughly 6 h per day; 4 = no more than roughly 4 h per day; and 5 = no more than 2 h per day. Being able to work 8 or more hours per day (categories 1–2) was considered normal ability to work fulltime, all else (categories 3–5) was considered an inability to work fulltime, according to the guideline [33]. Independent variables Socio-demographic data included gender (male/female), age, and educational level. For educational level, three classes were differentiated based on the highest level of completed education: low (primary school, lower vocational education, lower secondary school), middle (intermediate vocational education, upper secondary school), and high (upper vocational education, university). Educational level is usually registered by the labor expert, and therefore only part of the assessment when an applicant has residual work capacity. As a consequence, educational level is often missing for applicants without residual work capacity, and therefore left out of the analyses on residual work capacity. Disease-related data included type of cancer and multi-morbidity. The type of cancer was determined using the first diagnosis code. Insurance 5
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