Communication Challenges and Strategies in Adolescent and Young Adult Cancer Survivorship Care: A Qualitative Study of Clinician Perspectives.

PURPOSE: Adolescent and young adult (AYA) cancer survivors treated in pediatric settings face long-term physical and psychosocial effects from cancer treatment, and lifelong specialized survivorship care is recommended. Prior research has focused on what survivors need to know about past cancer and future health, with less emphasis on how clinicians communicate with AYAs and families. This study evaluated effective communication strategies and challenges with survivorship-related communication according to experienced clinicians. METHODS: We conducted individual interviews with survivorship clinicians from diverse practice settings across the United States between November 2024 and February 2025. Interviews queried communication strategies, barriers, and recommendations for improving clinical interactions with AYA survivors. Qualitative analysis identified key themes and patterns. RESULTS: Clinicians (nine females and three males), in practice for 4-37 years, were physicians specializing in pediatric oncology (N = 7; two with med-peds training), primary care with a survivorship focus (N = 3), or nurse practitioners (N = 2). Barriers to effective communication included information complexity and volume, lack of time, and anxiety among AYA survivors and families. Effective communication strategies included building rapport, a mindset to "meet the patient where they're at," use of clear, accessible language with visual aids, and contextualizing information about health risks and associated uncertainty. Findings illustrated ways that clinician communication may promote or inhibit AYA engagement in survivorship care. CONCLUSION: Effective communication between clinicians and AYA cancer survivors may improve health outcomes by helping survivors understand health risks, managing associated uncertainty and anxiety, and promoting AYA engagement in survivorship care. This study will inform the development of communication interventions and training for clinicians.