Maslow Bat-Sheva L, Morse Christopher B, Schanne Allison, Loren Alison, Domchek Susan M, Gracia Clarisa R
Division of Reproductive Endocrinology and Infertility. Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, CT 06030, USA.
Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, WA 98195, USA.
Contraception. 2014 Jul;90(1):79-85. doi: 10.1016/j.contraception.2014.03.002. Epub 2014 Mar 11.
Few data on contraceptive choices in women with cancer exist. Contraception is challenging for women with cancer, particularly those with breast cancer, who are limited to nonhormonal methods. This study characterized contraceptive use during cancer treatment in a group of reproductive-aged women with a recent cancer diagnosis and assessed the impact of contraceptive counseling on the methods they selected.
Cross-sectional, survey study of reproductive-aged women at a large tertiary care health system with a recent cancer diagnosis.
A total of 107 women completed the survey. Eighty-two women reported 101 contraceptive choices. Twenty-seven percent (27/101) of all methods selected were Tier I/II, and 35% (35/101) were Tier III/IV. Only 4 used an intrauterine device (IUD). Among women reporting sexual activity after diagnosis, 19 (27%) of 71 reported using Tier I/II methods, 21 (30%) of 71 reported using Tier III/IV methods, 16 (23%) of 71 reported abstinence and 10 (14%) of 71 reported using no method. Factors significantly associated with Tier I/II use in the multivariable model included not having a college degree [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.05-0.92, p=.038], intercourse during treatment (OR 5.92, 95% CI 1.48-23.66, p=.012) and non-breast cancer (OR 3.60, 95% CI 1.03-12.64, p=.046). Report of contraceptive counseling was positively associated with Tier I/II contraceptive use during cancer treatment (OR 6.92, 95% CI 1.14-42.11, p=.036).
Reproductive-aged women diagnosed with cancer underutilized Tier I/II contraceptive agents, especially IUDs. Contraceptive counseling by physicians increases contraceptive use, particularly methods most effective at preventing pregnancy.
The study uniquely described the contraceptive practices of over 100 women with cancer. The study sample commonly reported abstinence and use of contraceptive methods with high failure rates. Our data suggest that contraceptive counseling from a health care provider may increase use of more effective methods among women with cancer.
关于癌症女性避孕选择的数据很少。对于癌症女性，尤其是乳腺癌患者，避孕颇具挑战性，她们只能选择非激素方法。本研究描述了一组近期被诊断患有癌症的育龄女性在癌症治疗期间的避孕情况，并评估了避孕咨询对她们所选方法的影响。
对一家大型三级医疗保健系统中近期被诊断患有癌症的育龄女性进行横断面调查研究。
共有107名女性完成了调查。82名女性报告了101种避孕选择。所有所选方法中，27%（27/101）为一级/二级，35%（35/101）为三级/四级。只有4人使用宫内节育器（IUD）。在诊断后有性行为的女性中，71人中有19人（27%）报告使用一级/二级方法，71人中有21人（30%）报告使用三级/四级方法，71人中有16人（23%）报告禁欲，71人中有10人（14%）报告未采取任何避孕措施。多变量模型中与使用一级/二级方法显著相关的因素包括没有大学学历[比值比（OR）0.21，95%置信区间（CI）0.05 - 0.92，p = 0.038]、治疗期间有性行为（OR 5.92，95% CI 1.48 - 23.66，p = 0.012）和非乳腺癌（OR 3.60，95% CI 1.03 - 12.64，p = 0.046）。避孕咨询报告与癌症治疗期间使用一级/二级避孕方法呈正相关（OR 6.92，95% CI 1.14 - 42.11，p = 0.036）。
被诊断患有癌症的育龄女性未充分利用一级/二级避孕药物，尤其是宫内节育器。医生进行避孕咨询可增加避孕措施的使用，特别是预防怀孕最有效的方法。
该研究独特地描述了100多名癌症女性的避孕行为。研究样本中普遍报告有禁欲情况且使用的避孕方法失败率高。我们的数据表明，医疗保健提供者提供的避孕咨询可能会增加癌症女性对更有效方法的使用。
