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One-third of patients fail to return to work 1 year after surgery for colorectal cancer

Bhalla, Ashish; Williams, John P.; Hurst, N.G.; Speake, W.J.; Tierney, G.M.; Tou, S.; Lund, Jonathan N.


Ashish Bhalla

John P. Williams

N.G. Hurst

W.J. Speake

G.M. Tierney

S. Tou

Jonathan N. Lund



Achieving full recovery after colorectal cancer surgery means a return to normal physical and psychological health and to a normal social life. Recovery data focusses on time to discharge rather than longer term functionality including return to work (RTW). We aim to assess return to normal holistic function at 1 year after colorectal cancer surgery.

Questionnaires were created and dispatched to 204 patients who had undergone surgery with curative intent for colorectal cancer, in 2011–2012, in a single teaching hospital.

Response rate was 75 % (153/204), 82 % (129/157) for open surgery (OS) and 51 % (24/47) for laparoscopic surgery (LS). Median age was 68 (48–91) years for OS and 65 (36–84) for LS. Eighty-four per cent of patients felt ‘ready’ and 95 % had adequate pain control upon discharge (no difference between groups). LS reported earlier ‘return to full fitness’ (1–3 months) than OS (>6 months; Mann–Whitney U, p < 0.05). Recovery from LS was ‘better than expected’ compared to OS ‘worse than expected’ (Mann–Whitney U test, p < 0.05). Forty-nine patients were employed preoperatively and 61 % (n = 30) returned to work. RTW was more frequent after LS (Chi-square test, p < 0.05). Length of time to RTW was significantly less after LS [44 (6–84) days] than OS [71 (14–252) days] (t test, p < 0.05). Levels of self-employment were equal between groups.

One-third of patients failed to RTW at 1 year post-surgery. Patients having LS returned to full fitness faster, felt recovery was shorter and returned to work earlier than OS. We must invest more in managing expectations and provide better post-discharge support to improve RTW.


Bhalla, A., Williams, J. P., Hurst, N., Speake, W., Tierney, G., Tou, S., & Lund, J. N. (2014). One-third of patients fail to return to work 1 year after surgery for colorectal cancer. Techniques in Coloproctology, 18(12),

Journal Article Type Article
Acceptance Date Oct 27, 2014
Online Publication Date Nov 8, 2014
Publication Date Dec 1, 2014
Deposit Date Aug 1, 2017
Journal Techniques in Coloproctology
Print ISSN 1123-6337
Electronic ISSN 1128-045X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 18
Issue 12
Keywords Laparoscopic surgery; Return to work; Recovery; Colorectal cancer
Public URL
Publisher URL
Additional Information The final publication is available at Springer via
Contract Date Aug 1, 2017