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Results clearly indicate that young adult cancer patients have a reduced quality of life in comparison with the general population even long after the treatment of their disease is complete. Women had a lower quality of life than men. Age-specific interventions should be offered that lead to improvements in quality of life for this age group. And future studies should clarify what factors lead to women's quality of life being worse than men's.

Although they reported high satisfaction with their relationships, AYA patients experienced sexual problems and need support with sexual issues. As a substantial proportion of patients felt stressed because of sexual changes, communication and interventions addressing post-cancer sexuality, particularly in women, are indicated.

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Objective:The aim of this study was to compare the levels of anxiety and depression in cancer patients with those of the general population, to examine age and gender differences in anxiety and depression, to analyse the impact of several sociodemographic and clinical parameters on anxiety and depression, and to test the age and gender measurement invariance of the Hospital Anxiety and Depression Scale (HADS).Methods: A sample of 3,785 German patients with cancer and a sample of 2,747 people of the German general population were examined using the HADS. Results:Patients with cancer were more anxious but slightly less depressed than age-and gender-matched individuals of the general population. Young patients with cancer were particularly affected by anxiety. Measurement invariance across gender and age could be established. For all analysed clinical variables, including tumour site, tumour stage, metastases, setting and Eastern Cooperative Oncology Group (ECOG) performance status we found no significant interaction effects with gender that exceeded the 5% significance criterion. Conclusion:The HADS provides fair comparisons between age and gender groups.Gender differences in anxiety and depression can be generalised across the cancer sites and clinical subgroups. Young patients with cancer deserve special attention by the healthcare system.

Aim The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline. Methods This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40). Recommendations The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patientʼs personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities.

Over the last decade, fertility-related issues have come to the fore of clinical oncology. The majority of research though has focused on a medical perspective without considering reproductive motivations that influence decisions on fertility-preserving options. In order to identify specific parenthood motivations in young survivors of various types of cancer, a systematic review of the literature was conducted. Relevant literature was searched manually and using databases (Medline/PubMed, PsycInfo). Of 4848 articles retrieved, 20 studies met a priori defined inclusion criteria. Cancer was found to have a likely effect on reproductive intentions. All studies reported on specific reproductive concerns, mostly related to negative consequences for the patient or on the future child. Pregnancy concerns were overrepresented in breast cancer survivors. Practical barriers to post-cancer parenthood were financial or partner-referred. Overall, fewer incentives than disincentives for post-cancer parenthood were reported. They included the importance of parenthood, achieving normality and a desire to focus on the positive. As reproductive motivations and concerns affect the majority of cancer survivors of reproductive age, they should be assessed as early as possible post-diagnosis. While researchers should focus on the development of appropriate assessment methods, clinicians might address specific reproductive concerns.

Our findings may sensitize clinicians to the possible presence of mental disorders in AYA. The results indicate that there is a strong need for psycho-oncological interventions designed to improve mental health in AYAs with cancer at all stages of medical care.