Department of Clinical Health Care, Oxford Brookes University, Jack Straws Lane, Oxford OX3 0FL, UK.
Br J Cancer. 2013 Apr 30;108(8):1602-15. doi: 10.1038/bjc.2013.139. Epub 2013 Apr 11.
Around 1 in 10 of all cancer cases occur in adults of reproductive age. Cancer and its treatments can cause long-term effects, such as loss of fertility, which can lead to poor emotional adjustment. Unmet information needs are associated with higher levels of anxiety. US research suggests that many oncologists do not discuss fertility. Very little research exists about fertility information provision in the United Kingdom. This study aimed to explore current knowledge, practice and attitudes among oncologists in the United Kingdom regarding fertility preservation in patients of child-bearing age.
A national online survey of 100 oncologists conducted online via medeconnect, a company which has exclusive access to the doctors.net.uk membership of GMC registered doctors.
Oncologists saw fertility preservation (FP) as mainly a women's issue, and yet only felt knowledgeable about sperm storage, not other methods of FP; 87% expressed a need for more information. Most reported discussing the impact of treatment on fertility with patients, but only 38% reported routinely providing patients with written information, and 1/3 reported they did not usually refer patients who had questions about fertility to a specialist fertility service. Twenty-three per cent had never consulted any FP guidelines. The main barriers to initiating discussions about FP were lack of time, lack of knowledge, perceived poor success rates of FP options, poor patient prognosis and, to a lesser extent, if the patient already had children, was single, or could not afford FP treatment.
The findings from this study suggest a deficiency in UK oncologist's knowledge about FP options and highlights that the provision of information to patients about FP may be sub-optimal. Oncologists may benefit from further education, and further research is required to establish if patients perceive a need for further information about FP options.
大约每 10 例癌症病例中就有 1 例发生在生殖年龄的成年人中。癌症及其治疗会导致长期影响,例如丧失生育能力,这可能导致情绪调整不良。未满足的信息需求与更高水平的焦虑相关。美国的研究表明,许多肿瘤学家并未讨论生育能力。关于英国肿瘤学家在生育力保护方面提供生育力信息的研究很少。本研究旨在探讨英国肿瘤学家目前在生育力保护方面的知识、实践和态度,这些知识、实践和态度适用于有生育能力的育龄患者。
通过 medeconnect 在线对 100 名肿瘤学家进行了一项全国性的在线调查,medeconnect 是一家拥有独家访问权限的公司,可访问 doctors.net.uk 上的 GMC 注册医生会员。
肿瘤学家认为生育力保护(FP)主要是女性的问题,但他们只对精子储存有了解,而对其他 FP 方法一无所知;87%的人表示需要更多的信息。大多数报告称与患者讨论治疗对生育力的影响,但只有 38%的人报告常规向患者提供书面信息,三分之一的人报告他们通常不会将对生育力有疑问的患者转介到专门的生育力服务机构。23%的人从未咨询过任何 FP 指南。启动有关 FP 讨论的主要障碍是缺乏时间、缺乏知识、认为 FP 选择的成功率低、患者预后差,在较小程度上,如果患者已经有孩子、单身或负担不起 FP 治疗。
本研究的结果表明,英国肿瘤学家对 FP 选择的知识存在不足,并强调向患者提供有关 FP 的信息可能不理想。肿瘤学家可能受益于进一步的教育,需要进一步研究以确定患者是否认为需要进一步了解 FP 选择的信息。