Purpose The study aims to describe work status at diagnosis and 8 years post-diagnosis in a nationwide sample of breast cancer survivors (BCSs), and investigate associated and self-reported factors of reduced work status. Methods Women aged 20–65 years when diagnosed with stage I–III breast cancer (BC) in 2011 or 2012 were invited to participate in a questionnaire study in 2019 ( n = 2803), of whom 49% ( n = 1361) responded. For this sub-study, we included 974 BCSs below the legal retirement age in Norway (< 67 years) at survey and with complete work status data. Reduced work status was defined as being in paid work at BC diagnosis and not working at time of survey. Logistic regression analyses were applied to identify factors associated with reduced work status. Results Of BCSs who were in paid work at diagnosis ( n = 845), 63% maintained their work status to 8 years later. Reduced work status was associated with not living with children (OR .44, 95% CI .24–.82), age (OR 1.16, 95% CI 1.11–1.21), chemotherapy (OR 2.83, 95% CI 1.24–6.61), > 2 comorbid conditions (OR 2.27, 95% CI 1.16–4.32), cognitive function (OR .99, 95% CI .98–.99), fatigue (OR 1.02, 95% CI 1.01–1.03), and neuroticism (OR 1.57, 95% CI 1.00–2.46). BC and late effects were reported as reasons for reduced work status and disability. Conclusions The majority of BCSs who were in paid work at diagnosis were working 8 years later. Implications for Cancer Survivors Our results suggest a need to focus on fatigue and reduced cognitive function among long-term BCSs, with the ultimate aim of improving work sustainability.

Study ObjectiveTo investigate the long term oncological follow up results and the relevant clinicopathologic prognostic factors for early stage (St IB1) cervical carcinoma patients who were surgically treated with Robot Assisted Radical Hysterectomy (RARH) or Open Radical Hysterectomy (ORH) from 2005 to 2012 at The Norwegian Radium Hospital.DesignProspectively collected and non-randomized retrospective controlled study.SettingSingle institution (A university teaching hospital).Patients or ParticipantsAll early-stage cervical cancer patients who underwent radical hysterectomy at the Norwegian Radium Hospital within that time period.InterventionsPatients underwent RARH or ORH.Measurements and Main Results193 stage IB1 patients were identified within the study period. None of the RARH cases was converted either conventional laparoscopy or laparotomy. 19 cases were excluded due to preoperative neoadjuvant chemotherapy and total 174 patients were included. 110 patients underwent ORH and 64 patients RARH. RARH were performed with using the first generation da Vinci surgical platform by the same surgeon (MBS). The two groups were comparable in terms of age, body mass index (BMI) and follow-up time. The ORH group had shorter mean operation time (p<0.001) while RARH group have less estimated mean blood loss (<0.001) and shorter mean length of hospital stay (LOS) (p<0.001). The tumor size, positive lymph-vascular space invasion (LVSI), positive surgical margins were comparable between the groups. The frequency of perioperative complications were similar, but post- operative complications were higher in the ORH group (p<0.005). Recurrence rate 12% in the RARH group and 9% in the ORH group (p:0.48). Mean recurrence-free interval and 5 years survival rate were comparable in the both groups even-thought hematogenous metastasis was more likely (5.4%) in RARH group.ConclusionThis long follow up study provides that RARH reduces EBL and LOS and post-operative complications without significant poorer oncological outcomes even-thought distant organ metastasis were almost double in the RARH arm which should be further investigated with larger prospective randomized clinical studies.

Dank moderner onkologischer Behandlungen ist Hodenkrebs („testicular cancer“, TC) inzwischen heilbar. Doch für die Überlebenden ergeben sich aus langfristigen nachteiligen Folgen für ihre Gesundheit („adverse health outcomes“, AHOs) Risiken für eine höhere Mortalität und eine beeinträchtigte gesundheitsbezogene Lebensqualität („health-related quality of life“, HR-QoL).

Background. Modern oncological treatment has rendered testicular cancer (TC) a curative malignant disease but there is a risk of decreasing survival and reduced healthrelated quality of life (HR-QoL) related to long-termadverse health outcomes (AHOs). Aim. To provide an overview on AHOs after oncological treatment of TC. Material and methods. Summary of published studies and previous reviews. Results. Relative survival rates decrease among TC survivors 25 years after diagnosis, mainly due to treatment-related second cancer and/or cardiovascular disease, the latter mediated by components of the metabolic syndrome. With increasing age cisplatin-induced ototoxicity becomes a clinical problem in patients, whereas reported peripheral neurotoxicity only exceptionally achieves major clinical relevance. Anxiety but not depression represents the dominating psychological problem. In most patients HR-QoL is good, but working abilitymay be reduced by very intensive treatment. Conclusion. Awareness of long-term AHOs among TC survivors and health professionals can contribute to reduce long-term morbidity and mortality and to improve QoL by initiating early preventive and therapeutic measures. Radiotherapy should be avoided as much as possible during risk-adapted treatment of TC. Existing data indicate premature aging among strongly treated TC survivors but larger studies and longer follow-up in longitudinal studies are required to confirm these preliminary observations.

Background: Young adulthood (19-39 years) is a phase of life focused on career development and establishment of a family. Cancer during these years may interfere considerably with solving these tasks. We examined factors associated with reduced work ability among cancer survivors treated in young adulthood (YACSs). Methods: The Cancer Registry of Norway identified 3,617 YACSs alive at September 1, 2015 and diagnosed with cancer from 1985 to 2009, who were mailed a questionnaire. The response rate was 41% and we included 1,198 YACSs (198 melanoma, 494 breast cancer, 148 colorectal cancer, 222 non-hodgkin lymphoma and 136 leukemia), excluding YACSs who were in treatment, did not report on treatment, or had their last cancer diagnosed < 2 years before survey. Self-reported treatment was categorized in 6 groups by increasing intensity from minor surgery to 4-6 treatment modalities. The dataset was analyzed with block-wise linear regression analysis with current work ability (0=none to 10=optimal) as dependent variable. Results: Mean age at diagnosis was 34 years, mean age at survey 50 years and 60% were in full time job. Our five steps block-wise model explained 54% of the variance in work ability. Late effects and cancer-related variables explained 16%, socio-demography 5%, self-reported health and somatic diseases 27%, mental distress 5%, and lifestyle 1%. Cancer diagnosis and treatment burden did not contribute significantly to the model, while cognitive problems, neuropathy, lymphedema, and radiation sequelae in skin, connective tissue and/or muscles contributed significantly to reduced work ability. The same was true for being female, having a low level of education, having poor self-rated health and cardiovascular disease including hypertension. Higher levels of anxiety, fatigue, depression and fear of recurrence were also significantly associated with poorer work ability. Drinking alcohol ≥ once a week was the only life-style variables with such association. Conclusions: Among YACSs many psychosocial and somatic features, but not cancer type or treatment intensity, were significantly associated with reduced work ability. Legal entity responsible for the study: National Advisory Unit for Late Effects Funding: None Disclosure: All authors have declared no conflicts of interest.

Background This study examined employment patterns and associated factors in lymphoma survivors treated with high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) from diagnosis to a follow-up survey at a mean of 10 years after HDT-ASCT.Patients and methods All lymphoma survivors aged18 years at HDT-ASCT in Norway from 1987 to 2008, and alive at the end of 2011 were eligible for this cross-sectional study performed in 2012/2013. Participants completed a mailed questionnaire. Job status was dichotomized as either employed (paid work) or not-employed (disability and retirement pension, on economic support, home-makers, or students).Results The response rate was 78%, and the sample (N=312) contained 60% men. Mean age at HDT-ASCT was 44.3 and at survey 54.0 years. At diagnosis 85% of survivors were employed, 77% before and 77% after HDT-ASCT, and 58% at follow-up. Forty seven percent of the survivors were employed at all time points. The not-employed group at survey was significantly older and included significantly more females than the employed group. No significant between-group differences were observed for lymphoma-related variables. Fatigue, mental distress and type D personality were significantly higher among those not-employed, while quality of life was significantly lower compared to the employed group. Older age at survey, being female, work ability and presence of type D personality remained significantly related to being not-employed at survey in the multivariable analysis.Conclusions Our findings show that not-employed long-term survivors after HDT-ASCT for lymphoma have more comorbidity, cognitive problems and higher levels of anxiety/depression than employed survivors. These factors should be checked and eventually treated in order to improve work ability.

e15057 Background: Mental distress (MD) and chronic fatigue (CF) have been studied to some extent in prostate cancer patients (PCaPs), while that hardly is the case for the personality trait of neuroticism. We studied the above three factors as pre-treatment predictors of sexual, urinary and bowel bother in PCaPs 12 months after RP or RAD (>74Gy). Methods: The Extended UCLA Prostate Cancer Index form was completed pre-treatment and at 12 months post-treatment by patients treated with RP ( N:177) or RAD (N:116), none of them ever having radiotherapy or hormones after their local treatment. The primary outcome variables examined with logistic regression analyses was self-reported sexual, urinary, and bowel bothers at 12 month follow-up (present vs. absent). MD was defined as caseness by the Hospital Anxiety and Depression Scale, CF as caseness by the Fatigue Questionnaire, and neuroticism caseness by the Eysenck Personality Questionnaire. Other independent pre-treatment variables were demography, comorbidity, lifestyle and cancer-related parameters. Results: In univariate analyses within the combined RP/RAD group caseness of MD predicted both bowel (OR=4.66, p<0.001) and urinary bother (OR=5.04, p<0.001). Caseness of CF was associated with bowel (OR=12.40, p<0.001), sexual (OR=2.36, p=0.06) and urinary bother (OR=3.16, p=0.06). Caseness of neuroticism was associated with bowel (OR=6.53, p<0.001) and urinary bother (OR=3.58, p=0.007). In multivariate analyses, including treatment (RAD as reference), age, education, civil status, comorbidity and T-category, the associations between CF and bowel bother (OR=4.60, p=0.006) and neuroticism and bowel (OR=3.85, p=0.02) or urinary bother (OR=3.30, p=0.02) persisted. Further, compared to RAD significantly more patients reported sexual and urinary bother after RP, whereas the frequency of bowel bother was significantly decreased. Conclusions: Caseness of MD, CF and neuroticism significantly predicted side effects 12 months after curatively intended local treatment in PCaPs. Patient counselling before treatment should take these factors into account. No significant financial relationships to disclose.

5097 Background: Risk-reducing salpingo-oophorectomy effectively prevents ovarian cancer in women at risk for hereditary breast/ovarian cancer. Surgically induced menopause may affect sexual functi...

9510 Background: Sexual function in male lymphoma survivors (LS) was examined and compared to age-matched controls from the general population (CTR). Methods: The study includes 294 LSs, diagnosed 1980–2002, treated at the Norwegian Radium Hospital, ≤50 years at diagnosis, with recent gonadal hormone levels [testosterone (T), SHBG, LH, and FSH]. Sexual function was assessed using the Brief Male Sexual Function Inventory (BSFI) consisting of 11 self-report items covering five domains: sexual drive, erectile function, ejaculatory function, problem assessment and overall satisfaction. Lower scores indicate impaired sexual function. A total BSFI score (T-BSFI) was constructed by summing all items except overall satisfaction. Mean and median scores for the BSFI domains and T-BSFI were compared across age groups (21–39, 40–49, 50–59, 60–69 years at survey), gonadal hormone levels [normal (n=144), elevated FSH only (n=60), low T and/or elevated LH (n=90)], cancer treatment intensity, comorbidity, relationship status, fatigue score, mental distress (HADS) and quality of life (SF-36, mental and physical health components). Multivariate linear regression analysis was performed with T-BSFI as the dependent variable including independent variables significant in univariate analyses. Each LS was matched to two CTRs (n=506). Results: Valid T-BSFI scores were available for 253 LSs (86%). Median age at survey was 48 years, median duration of follow-up 15 years, and 78% were in a committed relationship. LSs aged 40–59 years had significantly lower T-BSFIs compared to their CTRs (p≤0.01). All BSFI domain scores and T-BSFI decreased significantly with ageing. LSs with low T and/or elevated LH had the lowest BSFI domain and T-BSFI scores. Survivors with normal hormone levels had the highest scores. Low T and/or elevated LH (p=0.03), age ≥50 years at survey (p≤ 0.001) and mental distress (p< 0.001) were significantly associated with male sexual dysfunction (T-BSFI) in the multivariate analysis. Conclusions: LSs aged 40–59 years reported poorer sexual function than age-matched CTRs. Impaired sexual function was significantly associated with age ≥ 50 years at survey, having low T and/or elevated LH and being distressed. No significant financial relationships to disclose.

Purpose: To explore the associations between the presence of personality problems and somatic morbidity and health care utilisation.Methods: The Iowa Personality Disorder Screen was administered in order to identify persons with personality problems in a Norwegian population survey (the Oslo Health Study - HUBRO). Cases consisted of 369 individuals, 30, 40 and 45 years of age with personality problems matched on age and gender with five controls each. Data on somatic morbidity and health care utilisation were collected by questionnaires.Results: The cases more frequently reported persistent muscular pain, asthma, fibromyalgia and alcohol problems than the controls. They also more often used nonprescribed analgesics and antidepressants. The cases more frequently had consulted a general practitioner (GP) in the last 12 months, less frequently got referral to somatic specialist care and were less satisfied with their last visit to a GP.Conclusion: In this population based study, personality problems in young adults based on DSM-IV personality disorder criteria were associated with increased occurrence of somatic morbidity and primary health care utilisation. The relevance for GP to take personality problems into account during consultations is underlined and a method for doing so is suggested. (C) 2009 Elsevier Masson SAS. All rights reserved.

5164 Background: Chronic fatigue (CF) is frequent in cancer patients, but has been less studied in prostate cancer patients (PCPs). This study compares CF in PCPs treated with RP or RAD(≥70Gy), who have never received any hormonal therapy. Methods: In 2006 we addressed all Norwegian PCPs who had been diagnosed in 2004 and were alive (N = 2,997). Among the 2,194 PCPs (73%) responding we identified 332 patients with RP and 183 with RAD 12–32 months before our survey. The PCPs returned a mailed questionnaire covering fatigue, quality of life, urinary and bowel bother, sexual function, comorbidity, and lifestyle. Hormonal therapy identified by the national prescription database or self-report, lead to exclusion. Caseness of CF was based on the Fatigue Questionnaire. Results: Caseness of CF was observed in 13.6% of men with RP (95%CI 9.9–17.2%) and in 25.7% after RAD (95%CI 19.4–32.0%) (p = 0.001). The prevalence in the RP group was similar to the norm observed in Norwegian men >60 years. PCPs with RP or RAD had similar prevalence of bother regarding urinary symptoms (13 vs 16%, p = 0.13), while more RAD than RP patients reported bother due to bowel symptoms (24 vs 4%, p < 0.001). Sexual functioning showed a better score in the RAD versus the RP group (p < 0001). In multivariate regression analysis treatment modality did not show any significant association with CF (p = 0.25). In contrast, physical and mental quality of life (both p < 0.001) and bother due to bowel problems (p = 0.005) were associated with CF caseness. No significant associations were found between urinary bother, sexual function and CF caseness. Conclusions: This national study of PCP treated with curative intention showed a much higher prevalence of CF after RAD compared to RP. In multivariate analysis treatment modality was not significantly associated with CF caseness. Bowel bother was more common after RAD, and showed a significant association with CF caseness, however, with a wide confidence interval. No significant financial relationships to disclose.

The purpose of this study was to evaluate late effects and symptom complaints in long‐term survivors (>5 years) of Extremity Bone Sarcoma (EBS survivors). The results were compared with findings in age‐ and gender‐matched individuals from the general population (NORMs).

11048 Background: Risk-reducing salpingo-oophorectomy (RRSO) effectively prevents ovarian cancer in BRCA mutation carriers and in women at risk for hereditary breast-ovarian cancer. RRSO induces immediate menopause, which may increase the risk of coronary heart disease (CHD). Our aim was to determine CHD risk using Framingham risk score and examine factors associated with this risk in women who had undergone RRSO compared to population-based controls. Methods: A sample of 326 (65% of invited) women who underwent RRSO after genetic counseling from 1980–2005 provided completed questionnaires, physical measures, and blood samples. Controls were 1,630 age-matched controls from the Norwegian Nord-Trøndelag Health Study (HUNT-2) (1995- 97). Results: Mean age in both the RRSO and control groups at survey was 54.4 years. Mean follow-up after surgery was 6.5 years (SD 4.4). The RRSO group had a more favorable CHD risk profile (higher education, more physical activity, less smoking, lower total cholesterol, higher HDL cholesterol, lower systolic blood pressure and lower BMI) and lower Framingham total score compared to controls (p<0.05). In multiple logistic regression analyses RRSO was inversely associated with Framingham 10-year risk ≥5% (Odds Ratio 0.49, 95% CI [0.34, 0.71] p<0.001). Conclusions: In contrast to expectation, women at increased risk of hereditary breast ovarian cancer had a favorable CHD risk profile after RRSO compared to age-matched controls from the general population, and RRSO was associated with lower Framingham risk score. Follow-up time, self-selection of women seeking genetic counseling, changes in lifestyle after surgery and survival bias are possible explanations of this finding. No significant financial relationships to disclose.

Recent reviews indicate that the metabolic syndrome is a risk factor for cardiovascular disease and mortality, but evidence is scarce in elderly individuals. We therefore examined the relationship between the metabolic syndrome and mortality rates among individuals aged 40–59, 60–74 and 75–89 years. We also examined whether the syndrome was associated with mortality rates over and above the Framingham risk score.