Survivor-informed recommendations to improve workplace support for young adult cancer survivors.

333 Background: Young adult cancer survivors (YACS) face unique challenges navigating the intersection of cancer care and employment. This study identified actionable, YACS-informed recommendations for employers and workplace systems to support YACS employment. Methods: We conducted in-depth interviews with employed YACS (N = 23) across the US, recruited through social media and snowball sampling. Questions addressed workplace support and employment needs during and after treatment. Using thematic content analysis, we identified YACS-derived recommendations for employers. Themes were clustered by common structural, psychosocial, and logistical concerns. Results: Five themes emerged from the data (Table 1). Recommendations included: 1) Provide accessible information for streamlining and simplifying leave and disability navigation; 2) Offer flexible, graduated work plans; 3) Ensure job protections; 4) Normalize disclosure in the workplace; and 5) Create workplace support systems. Conclusions: YACS’ recommendations highlight a pressing need within cancer care delivery: to establish transparent pathways to access employment benefits, foster psychological safety around diagnosis disclosure, and design flexible work models that adapt to YACS’ changing capacities. Findings reflect the urgency of structural reforms that protect YACS’ job security, and support sustained employment reintegration. YACS' recommendations to improve workplace support. Recommendation Exemplar Quote 1. Streamline and simplify leave and disability navigation: Implement centralized, clearly communicated leave and disability pathways. “someone who could be…that go-between between all of the different HR, insurance, and doctors, and get all of this figured out while I’m just trying to keep my job at work” 2. Offer flexible, graduated work & return-to-work plans: Develop tiered reintegration options including telemedicine, part-time roles, and non-clinical duties where applicable. “I did telemedicine for about 12 hours a week from home through my cancer treatment…I couldn’t have done full-time right away.” 3. Ensure job protections: Extend job security policies for employees undergoing critical illness. “Technically, they didn’t have to hold my job... I’ve heard of places that say, ‘If you can’t come back full time, we’ll replace you.’" 4. Normalize cancer disclosure and reduce stigma in the workplace: Educate managers and colleagues on respectful disclosure protocols. “building that community would…help bridge that gap from people feeling isolated to…here’s this little work community." 5. Create emotional and practical support systems at work: Establish workplace-based peer mentoring, counseling referrals, or survivor networks to reduce isolation and emotional burden. “There needs to be educational resources, seminars…for leaders who have employees that are going through traumatic experiences.”