Variability in higher-education support for adolescents and young adults with active cancer: A cross-sectional survey study.

Abstract

e23279 Background: Adolescents and young adults (AYA) with cancer frequently face disruptions to educational trajectories, yet limited data exist on how higher-education institutions accommodate students undergoing active cancer treatment. Understanding institutional support mechanisms is critical to improving academic continuity and psychosocial outcomes for this vulnerable population. Methods: We conducted a cross-sectional, survey-based study of undergraduate students aged 18–25 years enrolled in four-year U.S. colleges or universities who carried an active cancer diagnosis requiring ≥3 outpatient oncology visits within a 12-month period. Participants were recruited through online cancer advocacy networks on social media. The survey assessed institutional accommodations including exam rescheduling, assignment flexibility, attendance leniency, access to disability services, and administrative communication. Perceived institutional support was measured using a 5-point Likert scale. Outcomes were compared between public and private institutions using chi-square tests and multivariable logistic regression adjusting for cancer type, treatment intensity, and academic year. Results: A total of 122 students completed the survey (public institutions: 42%; private institutions: 58%). Overall, 62% reported needing to miss ≥2 weeks of coursework due to cancer-related care. Exam rescheduling was permitted in 42% of cases, while 58% were allowed assignment extensions without penalty or needing to repeat a module or semester. Students at private institutions reported higher rates of proactive administrative outreach (63% vs 37%, p < 0.05) and greater flexibility in exam rescheduling (82% vs 18%, p < 0.05) compared with public institutions. After adjustment, enrollment at a private institution was independently associated with higher perceived institutional support (adjusted OR 3.4, 95% CI 1.5–7.7). Inadequate academic accommodations were associated with consideration or initiation of withdrawal or leave of absence in 92% of respondents. Conclusions: Significant variability exists in institutional support for undergraduate students undergoing active cancer treatment, with private institutions demonstrating greater flexibility across multiple academic accommodations. These findings highlight the need for flexible academic policies within higher education to promote equity, retention, and well-being among AYA cancer patients.