Background: Pediatric, adolescent, and young adult (PAYA) cancer survivors suffer from multiple domains of adverse psychosocial and behavioral outcomes during and after their cancer treatment. This study conducted a systematic review and metaanalysis of psychosocial, behavioral, and supportive interventions for PAYA cancer survivors. Methods: We searched 11 electronic databases, 4 professional websites, and manual search of reference lists in existing reviews. We selected randomized controlled trials and controlled trials without randomization focusing on PAYA cancer survivors across six outcome domains. Results: We included 61 studies (4,402 participants) published between 1987 and 2020. Overall risk of bias across studies was low. We identified an overall moderate and statistically significant treatment effect size for PAYA cancer survivors across six outcome domains. Conclusion: psychosocial, behavioral, and supportive interventions were overall effective for PAYA cancer survivors. However, interventions were not effective for certain outcome domains, and less effective among AYA versus pediatric cancer survivors.

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e24175 Background: Body image is a major psychosocial concern for all cancer patients but can affect the adolescent and young adult (AYA) population in distinct ways. Similarly, the prospect of infertility and the fertility preservation process can create additional stress during cancer treatment. Discussions regarding infertility inherently implicate the body and its reproductive function, but downstream effects on self-perception have not been previously described. The aim of this study was to better elucidate the relationship between oncofertility discussions and body image disturbances in the AYA cancer population. Methods: AYA cancer patients (n = 27) aged 12-25 years whose cancer treatment conferred the risk of infertility were recruited through electronic health record query at an NCI-Designated Comprehensive Cancer Center. Participants completed semi-structured interviews which were recorded, transcribed, and deductively coded for themes related to information needs, knowledge of treatment effects on fertility, and reproductive concerns after cancer. Emergent, inductive themes related to body image were identified. Results: Body image concerns, including those related to both physical appearance and body functioning, emerged as common themes. Specific concerns included 1) anticipating and coping with body changes, 2) discomfort in experiencing and discussing one’s own body, 3) fear of judgement, and 4) failing to meet both internal and external expectations of the body. Some participants expressed a sense of loss when learning about infertility risk and the emotional challenges associated with accepting this risk. Several respondents worried that they would be negatively judged by their peers for a perceived defect of the body. Still others struggled with facing the unknown regarding fertility preservation and the difficulty in sharing this information with loved ones and future romantic partners. Conclusions: AYA cancer patients experience a multitude of body image related disturbances when faced with the possibility of infertility and decisions regarding fertility preservation. In identifying and exploring these themes, future opportunities, and novel interventions for improving oncofertility practice and discussions among AYAs with a focus on body image positivity emerge. These include the dual involvement of multidisciplinary teams (oncology and reproductive medicine) at initial clinical consultation and frequent follow-up contact; AYA and oncofertility-specific peer support programs, both in-person and virtual; and early, frequent involvement of social workers and mental health providers experienced in both cancer care and reproductive medicine.