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

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. 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 -tests (Hypothesis 1) and multiple regression with bootstrapping (Hypothesis 2). Both hypotheses were supported: participants were less likely to self-disclose at work/school than to friends/acquaintances ( < 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). 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.