Understanding the impact of an established oncology program for adolescents and young adults: The role of school and work transitions counseling.

Abstract

e24111 Background: Adolescent and young adult (AYA) oncology programs provide tailored, multidisciplinary care addressing concerns common to this population, including fertility, sexual health, body image, mental health, peer support, and wellness. Many AYAs experience cancer during critical educational or career transitions, making school and work transition (SWT) counseling an important component of supportive care. At Princess Margaret Cancer Centre (PM), AYAs are defined as individuals aged ≤39 years. This study examines the utilization and role of SWT counseling within an established AYA oncology program. Methods: All patients referred to the PM-AYA program between January 1 and June 30, 2025, were identified. Demographic and clinical characteristics were summarized descriptively. Associations between patient characteristics and receipt of SWT counseling were assessed using chi-square tests for categorical variables and ANOVA for continuous variables. Multivariable logistic regression was used to evaluate associations between SWT counseling and additional supportive care services, adjusting for age, gender, and diagnosis. Results: Among 229 patients included, median age at diagnosis was 29 years (IQR 23–35), and 133 (58%) were female. At referral, 96 (46%) were employed, 58 (28%) were students, and 55 (26%) were unemployed. Although SWT prompted referral in only 22 (9.6%) patients, 77 (34%) ultimately received SWT counseling. Compared with employed patients, students (RR 3.59, 95% CI 2.14–6.03) and unemployed patients (RR 2.96, 95% CI 1.72–5.12) were more likely to receive SWT counseling. Younger age was also associated with receiving SWT support (χ² = 16.152, p < 0.0001). After adjusting for age, gender, and diagnosis, SWT counseling was not associated with receiving palliative care or advanced practice nursing support. Conclusions: SWT counseling is a key component of comprehensive AYA oncology care and addresses needs that may arise beyond the initial referral reason. SWT services are reaching patients at highest risk of educational and employment disruption, particularly students and unemployed individuals. Lower uptake among employed patients may reflect under-recognition of work-related challenges. Continued investment in systematic SWT support is warranted to optimize AYA cancer care.