Premium
Fertility preservation knowledge, counseling, and actions among adolescent and young adult patients with cancer: A population‐based study
Author(s) -
Shnorhavorian Margarett,
Harlan Linda C.,
Smith Ashley Wilder,
Keegan Theresa H.M.,
Lynch Charles F.,
Prasad Pinki K.,
Cress Rosemary D.,
Wu XiaoCheng,
Hamilton Ann S.,
Parsons Helen M.,
Keel Gretchen,
Charlesworth Sarah E.,
Schwartz Stephen M.
Publication year - 2015
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29328
Subject(s) - fertility , medicine , fertility preservation , odds ratio , young adult , population , odds , confidence interval , demography , cancer , affect (linguistics) , family medicine , gynecology , gerontology , logistic regression , environmental health , psychology , communication , sociology
BACKGROUND The fertility of adolescent and young adult (AYA) patients with cancer can be threatened by treatments, but to the authors' knowledge little is known regarding the extent to which providers discuss this with patients or recommend fertility preservation, or the patient and physician characteristics associated with these interactions. METHODS Questionnaires from 459 AYA patients with cancer who were diagnosed between 2007 and 2008 and recruited through 7 US population‐based cancer registries were analyzed using sex‐specific multivariable models. The authors assessed characteristics associated with not discussing therapy effects on fertility or fertility preservation options, and not making fertility preservation arrangements. RESULTS Males without a medical oncologist were more likely not to be told that therapy might affect fertility than those with a medical oncologist (male odds ratio [OR], 2.28; 95% confidence interval [95% CI], 1.03‐5.00). Individuals without insurance (male OR, 2.91 [95% CI, 1.41‐5.91] and female OR, 5.46 [95% CI, 1.59‐18.72]); those raising children aged <18 years; and, among males only, those who received treatment posing no or a low fertility risk (OR, 3.39; 95% CI, 1.60‐7.16) were more likely not to discuss fertility preservation with providers. Finally, among males, those without a college degree (OR, 1.98; 95% CI, 1.00‐3.97), lacking private insurance (OR, 2.97; 95% CI, 1.16‐7.63), and raising children aged <18 years (OR, 3.53; 95% CI, 1.63‐7.65) were more likely to not make fertility preservation arrangements; too few females had made fertility preservation arrangements for similar analyses to be performed. CONCLUSIONS Discussion and action surrounding fertility preservation for AYA patients with cancer are associated with medical factors, patient socioeconomic data, and child‐rearing status. These results highlight the need for insurance coverage for fertility preservation and increased awareness of fertility preservation options. Cancer 2015;121:3435–43. © 2015 American Cancer Society .