Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Self-reported cognitive and educational impacts among survivors of child, adolescent and young adult cancer (146585)

Ursula M Sansom-Daly 1 2 3 , Joanna E Fardell 1 2 , Sophia Stanford 1 , Sarah J Ellis 1 2 , Clarissa Schilstra 1 2 , Abbie Lucien 1 , Thomas Walwyn 4 , Richard J Cohn 1 2 , Claire E Wakefield 1 5
  1. Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW, Australia
  2. Minderoo Children's Comprehensive Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
  3. Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospitals, Randwick, NSW, Australia
  4. Royal Hobart Hospital, Hobart, Tasmania, Australia
  5. Division of Quality of Life and Pediatric Palliative Care, Department of Pediatrics, Stanford University and Stanford Medicine Children's Health, Palo Alto, California, USA

Aims

Childhood cancer survivors often experience lasting neurocognitive and educational impacts that affect quality of life in persistent ways in survivorship. Neurocognitive difficulties—including memory, attention, and executive function challenges—can influence school participation, academic achievement, and longer‑term employment and wellbeing outcomes .

This study aimed to (1) document survivor and parent‑proxy reports of neurocognitive and educational impacts among childhood cancer survivors; and (2) examine risk factors associated with these neurocognitive outcomes.

Method

Survivors aged 8–17 years and parents of survivors aged 3–17 were recruited from a survivorship clinic. Measures included demographics, PROMIS Cognitive Function, school quality of life (KIDSCREEN‑52), school attendance, and school supports received. Mixed-effects regression analysis assessed predictors of cognitive symptoms and school quality of life.

Results

Fifty‑two survivors and 61 parents participated. At participation, survivors were on average: 11.9 years old, 7.6 years post-diagnosis, 46.2% female, and 46.7% diagnosed with  Leukaemia. Mean cognitive functioning scores were within normal limits for survivors (M=47.72, SD=7.83) and parents (M=47.32, SD=9.44). However, 38.5% of survivors and 37.7% of parents reported at least mild cognitive impairment. Parents reported substantial school absences during treatment (mean ~105 days, SD=188) and beyond; and 36.1% reported their child received no school-based educational support. Yet, school quality of life was comparable to population norms. While younger survivors’ and parents showed moderate-level agreement around the survivor’s cognitive functioning (Cohen’s κ=0.383, p=.003), adolescent-parent dyads showed less agreement about this (non-significant: Cohen’s κ=0.297, p=.079).

Conclusion

More than one-third of childhood cancer survivors and their parents reported cognitive difficulties. Subjective cognitive functioning was associated with school-related quality of life, highlighting the importance of routine cognitive screening and educational support within survivorship care.  We discuss current practice innovations to develop integrated survivorship care that routinely addresses mental health, sleep, and learning support to optimise young people’s longer‑term outcomes beyond cancer.