Cancer-Related Self-Disclosure in the Workplace/School by Adolescent and Young Adult Cancer Survivors

Abstract

Purpose: Little is known about how survivors of adolescent and young adult (AYA) cancers navigate the process of communicating their cancer history to those at work/school. The purpose of this study was to evaluate the factors impacting workplace/school disclosure decisions among AYA survivors and strategies used for self-disclosure. Two hypotheses were tested: (1) survivors would be significantly less likely to disclose their cancer history and more likely to avoid cancer-related topics at work/school versus with friends/acquaintances; (2) survivors' satisfaction with previous cancer-related self-disclosures at work/school would mediate the relationship between the reactions of others to those disclosures and the likelihood of future work/school disclosures. Methods: Online survey data, including a measure of self-disclosure adapted from the Nebraska Outness Scale, were collected from 120 survivors (age = 15 to 39 years at diagnosis, 19 to 45 years when surveyed). Data were analyzed descriptively and study hypotheses were evaluated using paired t-tests (Hypothesis 1) and multiple regression with bootstrapping (Hypothesis 2). Results: Both hypotheses were supported: participants were less likely to self-disclose at work/school than to friends/acquaintances (p < 0.001) and satisfaction with previous self-disclosure at work/school mediated the relationship between reactions to previous disclosures and likelihood of future disclosures (95% confidence interval = 0.39-0.81). Descriptive analyses indicated that participants were guided by a variety of factors when making disclosure decisions (e.g., anticipated reactions) and used a range of strategies for disclosures (e.g., humor). Conclusions: AYA survivors are cautious in their approach to workplace/school disclosure. Employers and school administrators should create supportive and inclusive environments that facilitate self-disclosure for survivors who wish to self-disclose.