Seattle Children's Hospital, University of Washington, Seattle, Washington 98105-0371, USA.
J Natl Compr Canc Netw. 2013 Jan 1;11(1):71-7. doi: 10.6004/jnccn.2013.0010.
Most adolescents and young adults (AYAs) with cancer will survive their disease, and fertility issues are a major concern for this population. The ASCO and new NCCN Clinical Practice Guidelines in Oncology for Adolescent and Young Adult Oncology recommend that oncologists offer the option of fertility preservation to all postpubertal AYAs before the start of potentially gonadotoxic chemotherapy or radiotherapy, providing that the patient does not require emergent start of therapy. Despite the published practice guidelines, many AYAs diagnosed with cancer are still not offered fertility preservation, with oncologists citing lack of time, lack of knowledge, and discomfort in discussing fertility and sexuality with AYAs as reasons. Developing a systematic and coordinated multidisciplinary strategy for fertility preservation referrals within a practice site may streamline the referral process, off-loading some tasks from the oncologist and potentially increasing patient satisfaction, provider satisfaction, and compliance with the guidelines.
大多数患有癌症的青少年和年轻人 (AYAs) 能够存活下来，而生育问题是这一人群的主要关注点。ASCO 和新的 NCCN 肿瘤学青少年和年轻成人肿瘤学临床实践指南建议，肿瘤学家应在可能的性腺毒性化疗或放疗开始之前，向所有青春期后 AYA 提供生育力保存的选择，前提是患者不需要紧急开始治疗。尽管有已发布的实践指南，但许多被诊断患有癌症的 AYA 仍未被提供生育力保存，肿瘤学家引用缺乏时间、缺乏知识以及不愿与 AYA 讨论生育和性问题作为原因。在实践现场内制定一个系统的、协调的多学科生育力保存转诊策略，可能会简化转诊流程，减轻肿瘤学家的一些任务，从而提高患者满意度、提供者满意度和对指南的遵守程度。
