Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15–39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.

Objective: This review explores the impact of cancer on adolescents' and young adults' (AYAs) romantic and sexual relationships, examining both challenges and opportunities. Methods: Qualitative studies on AYAs with cancer and/or their partners were searched based on a sub‐set of studies identified in a previous literature review within the EU Horizon STRONG‐AYA project, and supplemented with an additional search on romantic/sexual relationships. Articles were screened, reviewed in Rayyan and data extracted using a structured framework. Study quality was appraised, and findings were synthesised thematically. Results: Twenty studies were included. Findings revealed how cancer altered AYAs' sense of self, affecting the navigation of romantic relationships and sexual intimacy across four themes: (1) Romantic relationship development‐connection, isolation and changing priorities : Disrupted romantic trajectories and fears of being undesirable hindered relationship formation, though some re‐evaluated priorities, deepening emotional connections, (2) The disclosure dance: Finding the right time and way : AYAs struggled with when and how to disclose their diagnosis, with anxiety about burdening partners or altering dynamics. Open and honest communication fostered intimacy, (3) Body image, sexuality, intimacy, and fertility : Challenges in these areas impacted self‐worth, but also led to sexual empowerment and adapted intimacy, (4) Partnerships and social support during cancer : Unsupportive partners heightened isolation, while supportive partners reinforced self‐worth. Many AYAs experienced growth, resilience and a deeper understanding of themselves/their relationships. Conclusion: Results may inform age‐appropriate interventions to adequately address the unique challenges AYAs with cancer face in navigating romantic relationships and sexual intimacy.

Background: Adolescents and young adults (AYAs) are diagnosed with cancer during a challenging period of life. We aimed to (1) describe positive changes (posttraumatic growth; PTG) and illness perception, and (2) determine associations between PTG and illness perception, sociodemographic, and cancer-related characteristics in Swiss AYA cancer survivors. Methods: We conducted a population-based survey among AYA cancer survivors diagnosed 1990–2005 at age 16–25 years, who had survived ≥ 5 years. We used the Posttraumatic Growth Inventory (PTGI) and the Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using descriptive statistics and linear regressions. Results: Among 389 contacted survivors, 160 responded (61.3% male; mean age = 34 years, SD = 5.8). The mean PTG sum score was 54.63 (SD = 20.24; range: 8–101). Survivors reported high PTG especially in the domains Appreciation of life (mean = 3.23; 95% confidence interval, 3.05–3.40), Personal strength (2.94; 2.77–3.12), and Relating to others (2.57; 2.40–2.74). Neither sociodemographic nor cancer-related characteristics were associated with PTG. Survivors who perceived follow-up care as helpful (p < 0.001) and those with high concerns about the consequences of the illness (p < 0.001) reported higher PTG. Conclusions: Finding ways to promote PTG and to identify and address maladaptive illness perceptions may help survivors transform their experience into something meaningful for their future life.

Background: A cancer diagnosis early in life can leave a legacy in terms of compromised Quality of Life (QoL). There is a lack of clarity regarding the impact on QoL according to age at diagnosis, with childhood cancer survivors (CCS) and adolescents and young adult cancer survivors (AYACS) often combined. As part of an EORTC Quality of Life Group study, this umbrella review aims to (1) identify the QoL outcomes reported in the literature for both CCS and AYACS, and (2) investigate the similarities and differences in QoL challenges between both groups. Methods: A systematic literature search of systematic reviews and meta-analyses was conducted in December 2023 using PubMed, PsychInfo, and CINAHL. Methodological quality was evaluated using the AMSTAR tool. Results: Overall, 1457 articles were assessed, and 39 systematic reviews and meta-analyses met the inclusion criteria. QoL outcomes were categorized into eight QoL domains, all of which were reported in both groups of young survivors. However, reviews on CCS often focused on outcomes relating to emotional functioning, cognitive difficulties, social challenges, school functioning, body image and overall happiness, whereas AYACS reviews had a greater focus on depressive symptoms, outcomes related to sexual health and reproductive health, employment, financial difficulties, self-image and identity and the impact of cancer. Conclusion: This umbrella review comprehensively explores QoL outcomes among CCS and AYACS, revealing both shared and distinct challenges. Future research should focus on developing tailored questionnaires, emphasizing transition periods and incorporating a life perspective to capture unique developmental tasks of young survivors.

Introduction.: The death of a child profoundly impacts parents, often leading to anxiety, depression, and posttraumatic stress. However, factors such as resilience—defined as the capacity to adapt to adversity—are less explored. Resilience may mitigate grief-related distress. This study aimed to: (a) describe and compare resilience levels between bereaved parents and parents of childhood cancer survivors (CCS parents), (b) identify sociodemographic and cancer-related determinants of resilience among bereaved parents, and (c) investigate resilience’s association with psychological distress and prolonged grief disorder. Methods.: This is a cross-sectional study done in Switzerland. Bereaved parents were recruited from three hospitals and through patient advocacy groups. CCS parents were taken from a nationwide, population-based study (Swiss Childhood Cancer Survivor Study-Parents). Resilience, psychological distress, and prolonged grief disorder were assessed using the Connor-Davidson Resilience Scale (CD-RISC 10), Brief Symptom Inventory-18 (BSI-18), and Prolonged Grief 13 (PG-13), respectively. Regression analysis (linear and logistic) was used to identify factors associated with resilience, and the association of resilience with psychological distress and prolonged grief disorder (adjusted for age, sex, and time since death). Results.: We included 103 bereaved parents and 345 CCS parents in the analysis. Bereaved parents were younger compared to CCS parents (mean 53.7, SD 8.3 vs. 62.5, SD 6.7 years, p < 0.001), with both groups predominantly female (66% and 58%). Bereaved parents reported higher resilience scores than CCS parents (crude mean: 29.8 vs. 27.9; p = 0.005), with adjusted analyses confirming this finding. High risk of poverty was the only significant determinant of lower resilience (adjusted β = -7.37, 95% CI: -11.21, -3.54; p < 0.001). Higher resilience was associated with lower likelihood to report psychological distress (adjusted OR = 0.83, 95% CI: 0.74, 0.93, p = 0.002) and prolonged grief disorder (adjusted OR = 0.73, 95% CI: 0.58, 0.92, p = 0.008). Conclusion.: Bereaved parents exhibited higher resilience than CCS parents. Resilience in bereaved parents was strongly associated with reduced psychological distress and lower likelihood of having prolonged grief disorder. Targeting modifiable factors such as poverty may enhance resilience and thereby help to improve mental health outcomes for bereaved parents.

Many survivors of childhood cancer suffer from psychological late effects. Therefore, regular psychological screening is strongly advised. Experts recommend screening for mental disorders and symptoms for all survivors at every follow-up visit, regardless of age. However, there is little practical guidance on screening for mental health problems in childhood cancer survivorship care. The aims of this systematic review were to (a) collect comprehensive information on available screening tools, (b) determine which health care professionals performed the screening, and (c) identify practical considerations regarding the timing of screening. The databases PubMed, PsycINFO, and CINAHL were systematically searched for peer-reviewed publications concerning childhood cancer, mental health problems, survivorship, and screening published between January 1990 and January 2023. The search yielded 2268 potentially relevant articles, of which 32 were included in the narrative synthesis. We found that (a) many suitable screening tools are available for the target population, of which the Distress Thermometer, Brief Symptom Inventory-18, Symptom Checklist-90, and Pediatric Quality of Life Inventory were the most commonly used in all studies; (b) professionals of different disciplines were involved in screening, and examples include clinical nurse specialists and psychologists; and (c) early onset, regular, and long-term screening are recommended if resources are available. In conclusion, selecting a screening tool in a clinical setting depends on various factors such as time and cost. However, many brief screening tools can be easily implemented without a large investment of resources. Furthermore, professionals from various disciplines can perform the screening. If they have no background in psychology, training is recommended to give them confidence in dealing with mental health issues. In conclusion, consistent and regular mental health screening is crucial for childhood cancer survivors, and we believe that the benefits outweigh the costs.