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PURPOSE: Improved therapies for pediatric central nervous system (CNS) tumors have increased survival rates, however, many survivors experience significant long-term functional limitations. Survivors of pediatric CNS tumors can experience deficits in social attainment. The aim of this review was to systematically amalgamate findings pertaining to social attainment (i.e., educational attainment, marriage, employment outcomes) in survivors of pediatric CNS tumors. METHODS: PubMed(Web-based), PsycINFO(EBSCO), EMBASE(Ovid), and Web of Science(Thomson Reuters) were used to identify articles published between January 2011 and September 2018. Eligible studies reported outcomes for survivors of pediatric CNS tumors diagnosed before age 21 years, and >5 years from diagnosis and/or >2 years off therapy. All data were independently abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS: The search yielded 7,021 unique publications. Forty-six were included in the current review. Meta-analyses revealed survivors of CNS tumors were significantly more likely to have completed compulsory education only (OR = 1.87, 95% CI = 1.66, 2.12, p < 0.00001), less likely to be married (OR = 4.70, 95% CI = 3.89, 5.68, p

Introduction: Competent and socially responsible physicians require a range of abilities other than medical expertise to effectively meet the healthcare needs of the people they serve, including health advocacy skills. The CanMEDS framework for physician competency outlines that, as Health Advocates, physicians work to determine and understand patient and community needs, speak on behalf of others when required, and support the mobilization of resources to effect change. Although recognized as essential for medical trainees to develop, health advocacy is challenging to teach and assess. Here, we describe the development and evaluation of a workshop to support Canadian medical students to develop as health advocates through advancing health equity in blood product donation for gay, bisexual, and other men who have sex with men (gbMSM) in Canada. Methods: We developed a workshop for a Canadian medical student audience, "Building a more inclusive blood system in Canada", consisting of an online module followed by a virtual facilitated discussion group. The online module (available at stemcellclub.ca/training) outlined blood and stem cell donation in Canada for gbMSM, starting from the historical policies and the context in which they were first put in place, to today's policies and where future policies may lie (Fig. A). The module also presented content from a national campaign in Canada to engage gbMSM as stem cell donors (stemcellclub.ca/savingliveswithpride). The discussion group supported participants to reflect on donation policies for gbMSM and their consequences, and discuss how medical students can concurrently advocate for gbMSM and patients in need of blood products. A facilitator guide was developed and facilitator training was provided. A pre- and post- test was administered to participants to assess knowledge transfer. Quantitative and qualitative analyses were employed to evaluate participants' perspectives on the impact of the workshop on their development as health advocates. Results: From 10/2020-7/2021, workshops were hosted at 8 medical schools across Canada. 104 medical students from across Canada participated, of whom 65 (63% response rate) completed a pre- and post- workshop survey. 26 (40%) of survey respondents were male, 22 (34%) identified as LGBTQ+ (10 gay, 9 bisexual, 3 other), and 52% were non-Caucasian (from 9 different ancestral groups). 44 (68%) were in the first and 16 (25%) in second years of medical school. Post-workshop, mean scores on a 6-question stem cell donation knowledge test improved from 33% to 79% (p 98% strongly agreed/agreed the workshop supported their development as health advocates (Fig C), including the abilities to: advocate for patients beyond the clinical environment (83%); work with patients (88%) or communities and populations (74%) to address and identify determinants of health that affect them and their access to care; respond to the needs of communities or populations by advocating with them for system-level change (83%); improve clinical practice by applying a process of continuous quality improvement to disease prevention and health promotion activities (79%); and contribute to a process to improve the health of a community or population they will serve (90%). 94% felt that the workshop should be incorporated into medical curricula. 39 medical students participated in focus groups to share their perspectives on the workshop. (42% male, 37% LGBTQ+ identified, 76% non-Caucasian; 53% in first year of medical school). Qualitative analysis identified rich examples of participant development as health advocates through their participation in the workshop (Fig D). Conclusion: We present the perspective of a national cohort of medical students in Canada that their participation in a workshop on advancing health equity in blood product donation for gbMSM contributed to their development as health advocates. This workshop is a model for teaching health advocacy to medical students and is relevant to medical educators and curriculum developers. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Objectives Fear of cancer recurrence (FCR) has not been widely explored in survivors of childhood cancer. Yet, childhood survivors are at risk of experiencing late effects and may be especially vulnerable. The aims of the current study were to conduct a retrospective chart review to determine the prevalence and persistence of FCR among survivors of childhood cancer and to examine factors that may be related to FCR. Methods Survivors of childhood cancer (n = 228, mean attained age = 14.5 years [range = 4.7-21 years]; mean diagnosis age = 4.4 years [range = 0-16.5 years]; mean time off treatment = 8.7 years [range = 2.8-19.3 years]) seen in a Long-Term Survivor Clinic (LTSC) completed questionnaires at each clinic visit detailing their current health. FCR was measured with a single item. Data from questionnaires from 2011 to 2018 were analyzed retrospectively. Descriptive statistics and a random effects model were used to address study aims. Results FCR was reported in 43% (n = 98) of survivors at least once across all clinic visits. Among survivors reporting FCR at least once, 66% were diagnosed with cancer under the age of 5, and 64% were 13 years or older at their most recent follow-up. Twenty-one percent of survivors (n = 48/224) reported FCR during at least 50% of their visits. Survivors with a higher number of depressive symptoms were more likely to report FCR (OR = 1.66, P = .03). Conclusions FCR is prevalent among survivors of childhood cancer and is related to other health concerns. Research is needed to understand who is at risk and how to.