Return to Work After Adjuvant Chemotherapy for Colon Cancer: A Retrospective Study With Exploratory Occupational Analysis

BackgroundReturn to work is an important survivorship outcome for working-age cancer survivors.Still, occupational trajectories after adjuvant chemotherapy for colon cancer are not always systematically documented in routine oncology care.This study aimed to describe documented occupational trajectories after adjuvant chemotherapy for colon cancer and to explore occupation-level physical demand and break/restroom autonomy as descriptive occupational dimensions. MethodsThis single-centre retrospective observational study was based exclusively on routinely collected clinical records.Working-age patients with histologically confirmed colon adenocarcinoma, active work attachment before diagnosis, and completion of adjuvant chemotherapy between January 2024 and December 2025 were included.No questionnaire-derived data, Work Ability Index scores, or quality-of-life instruments were used.The primary analysis was descriptive and focused on ascertainable occupational trajectories documented in routine oncology records.Patients with return to work mentioned without an exact date, insufficient occupational information, disability retirement, unemployment, or documented recurrence before return were not treated as uniformly right-censored observations. ResultsAmong 62 eligible patients, two did not interrupt work during treatment and were described separately.Among the 60 patients who interrupted work, 34 had a documented return-to-work date.The observed median time from completion of adjuvant chemotherapy to documented dated return among these 34 patients was 115 days.Eight additional patients had return to work mentioned in the records without an exact date.Among the 26 patients without a dated return-to-work event, three were documented as still on medical leave or without return at the last occupational note, four entered disability retirement before documented return, eight were unemployed without documented return, eight had undated return mentioned, two had insufficient post-chemotherapy occupational information, and one had documented recurrence before return.Occupational coding was feasible in 45 patients; 26 of these had a documented return date.In descriptive exploratory analyses, 22 of 34 patients in higher-autonomy occupations and four of 11 patients in low-autonomy occupations had a documented dated return-to-work event. ConclusionsOccupational trajectories documented in routine oncology records after adjuvant chemotherapy for colon cancer were heterogeneous and incompletely captured.The absence of a dated return-to-work entry should not be interpreted as confirmed non-return in all patients.The exploratory occupational analysis did not establish physical demand or break/restroom autonomy as determinants of return to work.These findings support more systematic documentation of occupational status in survivorship care and prospective studies using validated individual-level occupational measures.