9588 Background: Infertility and sexual dysfunction can result from many cancer treatments and may become a source of significant distress for young adult cancer survivors. Our aims were to 1) characterize the frequency in which reproductive and sexual health discussions occur in a population-based cohort of young cancer patients and 2) identify clinical factors associated with such discussions. Methods: Patients aged 20 to 39 years who were diagnosed with solid tumors from 2006 to 2008, evaluated at any 1 of 5 regional cancer centers in British Columbia, Canada and alive at 2 or more years after their initial diagnosis were included. Demographics, tumor and treatment characteristics, and information on patient-physician conversations were analyzed. Using regression models, we explored the relationships between clinical factors and whether or not discussions had occurred. Results: A total of 397 patients were identified: median age was 35 years (IQR 31-38), 28% were men, 88% had ECOG 0, and 73% reported being in a relationship. Tumor sites included breast (50%), testicular (27%), gynecological (17%), and colorectal (6%). A significant proportion of patients received chemotherapy and radiation that posed the potential risk of infertility or sexual dysfunction. However, only 224 (56%) and 24 (6%) of individuals had a discussion about reproductive and sexual health, respectively, within the first month of their diagnosis. At 6 months, an additional 25 (6%) and 16 (4%) patients had discussed these concerns with their physicians. Age, gender, ECOG, relationship status, and type of chemotherapy and radiation were not correlated with whether or not discussions had occurred (all p>0.05). In regression models, tumor site was associated with differences in reproductive and sexual health discussions between patients and physicians (Table). Conclusions: Among young adult survivors of cancer, fertility and particularly sexual function are inadequately addressed during discussions near the time of initial cancer diagnosis. [Table: see text]