Chin Helen B, Howards Penelope P, Kramer Michael R, Mertens Ann C, Spencer Jessica B
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Fertil Steril. 2016 Dec;106(7):1763-1771.e1. doi: 10.1016/j.fertnstert.2016.08.034. Epub 2016 Sep 24.
To assess which characteristics are associated with failure to receive fertility counseling among a cohort of young women diagnosed with cancer.
Population-based cohort study.
Not applicable.
PATIENT(S): A total of 1,282 cancer survivors, of whom 1,116 met the inclusion criteria for the analysis.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): The main outcome in this study was whether or not women reported receiving any information at the time of their cancer diagnosis on how cancer treatment might affect their ability to become pregnant.
RESULT(S): Forty percent of cancer survivors reported that they did not receive fertility counseling at the time of cancer diagnosis. Women were more likely to fail to receive counseling if they had only a high school education or less or if they had given birth. Cancer-related variables that were associated with a lack of counseling included not receiving chemotherapy as part of treatment and diagnosis with certain cancer types.
CONCLUSION(S): Counseling about the risk of infertility and available fertility preservation options is important to cancer patients. Additionally, counseling can make women aware of other adverse reproductive outcomes, such as early menopause and its associated symptoms. Less-educated women and parous women are at particular risk of not getting fertility-related information. Programs that focus on training not just the oncologist, but also other health care providers involved with cancer care, to provide fertility counseling may help to expand access.
评估在一群被诊断患有癌症的年轻女性中,哪些特征与未接受生育咨询相关。
基于人群的队列研究。
不适用。
共有1282名癌症幸存者,其中1116名符合分析的纳入标准。
无。
本研究的主要观察指标是女性在癌症诊断时是否报告收到关于癌症治疗可能如何影响其怀孕能力的任何信息。
40%的癌症幸存者报告称,她们在癌症诊断时未接受生育咨询。如果女性只有高中及以下学历或已生育,则她们更有可能未接受咨询。与未接受咨询相关的癌症相关变量包括未接受化疗作为治疗的一部分以及被诊断患有某些癌症类型。
向癌症患者提供关于不孕风险和可用的生育力保存选择的咨询很重要。此外,咨询可以让女性了解其他不良生殖结局,如早期绝经及其相关症状。受教育程度较低的女性和已生育的女性尤其有得不到生育相关信息的风险。不仅专注于培训肿瘤学家,还包括培训参与癌症护理的其他医疗保健提供者以提供生育咨询的项目,可能有助于扩大咨询的可及性。