New APOS Data Outline Barriers to AYA Developmentally Appropriate Care

For adolescent and young adult (AYA) cancer care, awareness alone was shown to be insufficient for developmentally appropriate care, with persistent training and workflow gaps noted across the psychosocial domains, according to findings from a poster presented at the 2026 American Psychosocial Oncology Society Conference.

The survey sample consisted of 50 oncologists, with 42% being pediatric providers only, 28% were adult only, and 30% were both. Additionally, 44% had 10 years or more of AYA experience, 36% practiced at National Cancer Institute–designated centers, and 90% treated all disease stages. The survey sample included members across the multidisciplinary team.

Across key AYA domains, there was high familiarity in 50% of responders for financial toxicity vs 14% who had sufficient training, 68% vs 34% were noted for fertility preservation, 84% vs 50% or adverse effects, 48% vs 20% for sexuality/gender identification, and 14% vs 0% for estate planning.

Additionally, needs of the AYA population emerged at different phases of care, with psychosocial concerns spanning the entire continuum. This included:

• Diagnosis
  • Fertility preservation
  • Autonomy and caregiver dynamics
• Early treatment
  • Financial toxicity
  • Adherence and adverse effects
• Survivorship
  • Identity and body image
  • School/work reintegration
• Later phases
  • End-of-life planning
  • Legacy building

The preferred formats for AYA tools were talking points and patient handouts at 72% each, videos at 66%, in-service training at 60%, and scripts at 24%.

There were multilevel barriers to addressing these gaps, including:

• Individual
  • Limited confidence and initiating sensitive conversations
  • Uneven training across disciplines
  • Difficulty locating age-appropriate resources
• Workflow
  • Time constrains during patients visits
  • Lack of standardized screening tools
  • Pediatric/adult care fragmentation
• Institutional
  • Limited formal AYA programs
  • Referral infrastructure gaps
  • Staffing/navigator shortages

The investigators also found that an awareness of AYA-specific needs were not always translating to a “structured preparedness.” Through the psychosocial and systems-level domains, training gaps were more pronounced. Importantly, an emphasis on structured tools was noted for providers trying to strengthen AYA care delivery.

“[These] findings will guide development of a paper-based ‘cheat sheet’ with prompts and resources for provider using during AYA clinical encounters,” Sarita P. Desai, MD, from Memorial Sloan Kettering Cancer Center, and co-authors wrote in the poster. “Structured tools and scalable education represent specific, actionable next steps for improving AYA care and empowering providers.”

The objective of this study was to assess provider-reported preparedness alongside barriers to delivering developmentally appropriate cancer care to the AYA population. Data were collected from a national provider survey and conducted by Stupid Cancer. There were 3 aims: identify gaps in familiarity and formal training across AYA-relevant domains, describe multi-level barriers that influence the delivery of AYA-focused care, and inform practical tools and training to enhance provider capacity for holistic AYA care.

The survey consisted of asking clinicians their familiarity of 24 AYA domains, if they had formal training or sufficiency, what the timing was across the cancer care continuum, if they had institutional resources, and what their desired tools for clinical practice were. Provider discussions were structured around facilitated discussion, if there were barriers to AYA care delivery, training and workflow gaps, multilevel implementation barriers, and the tools needed for support.

This analysis was quantitative for descriptive statistics and qualitative for directed content analysis and themes by implementation level. These findings were merged at interpretation to identify convergent and complementary themes.

Reference

Desai SP, Silberman A, Donahue C, Barnett ME. From barriers to priorities: provider perspectives on implementing age-appropriate care in AYA oncology. Presented at the 2026 American Psychosocial Oncology Society Annual Meeting; New Orleans, LA; March 18-20, 2026. Poster W5.