# An Environmental Scan of Services for Adolescents and Young Adults Diagnosed with Cancer Across Canadian Pediatric and Adult Tertiary Care Centres

## TL;DR

This study finds that only half of Canadian hospitals offer specialized care for young cancer patients, with significant regional differences in service availability.

## Contribution

The study provides a comprehensive environmental scan of AYA-specific cancer services across Canadian hospitals, highlighting disparities and barriers.

## Key findings

- Only about half of surveyed pediatric and adult hospitals offer AYA-specific cancer services.
- Significant geographic disparities exist in the availability and range of AYA cancer services.
- Most AYA programs rely on private donations and face barriers like limited training and collaboration challenges.

## Abstract

Only about half of Canada’s major pediatric and adult cancer hospitals offer specialized programsfor young people with cancer. Available services include support for families and caregivers, guidance on returning to work or school, fertility and sexual health support, and palliative care. Some hospitals are developing programs, such as informational websites for young patients, education for healthcare providers, sexual health resources, and hiring staff trained in adolescent and young adult (AYA) care, though training and support remain limited. Collaboration between pediatric and adult hospitals occurs in some areas; however, it is often hindered by costs, limited training, challenges across multiple sites, and lack of management support. Most programsrely on private donations. The study highlights wide regional variation in service availability, meaning young people may have many, few, or no specialized support depending on where they live in Canada.

Adolescents and Young adults (AYAs: 15–39 years) diagnosed with cancer face unique medical and psychosocial challenges requiring specialized care. This study conducted an environmental scan of AYA-specific programming and services currently offered across Canadian tertiary care centres. Key informants from pediatric and adult cancer centres in Canada reported on program logistics, AYA specialized staff and training opportunities, and collaboration between centres, funding, and specific areas of interest for AYA care such as palliative care, fertility, fatigue, and sexual health. Surveys were completed by 13/16 (81%) pediatric sites and 19/23 (83%) adult sites. Only about half of pediatric sites (n = 8/13) and adult sites (n = 9/19) who responded reported offering any AYA-specific cancer services or programming. One third of centres without programming reported to be working on developing programming. Only 6 sites reported to offer specialized AYA training. Several barriers were reported, such as the need for collaboration among institutions and improvement of oncofertility services. Significant disparities exist regarding geographic availability of services, the range of services available, and the populations served. Findings will guide researchers, health professionals, and provincial health authorities in the development of highquality and equitable services and programs for AYAs diagnosed with cancer across Canada.