1 Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health , Washington, District of Columbia.
2 Lombardi Comprehensive Cancer Center, Georgetown University Medical Center , Washington, District of Columbia.
J Adolesc Young Adult Oncol. 2018 Aug;7(4):424-429. doi: 10.1089/jayao.2018.0014. Epub 2018 Apr 19.
Adolescent and young adult (AYA) cancer survivors experience fertility and childrearing challenges in adulthood, but there is limited evidence on awareness, beliefs, and concerns about oncofertility in this population, needs for supportive resources, and associations with quality of life (QoL).
Participants were 69 AYAs aged 12-25 who were diagnosed with cancer at age 18 years or younger and ≥1 year cancer free, recruited from childhood cancer clinical records and support organizations. Participants completed self-report assessment of oncofertility knowledge and beliefs, information needs, and measures of QoL. Analyses examined associations between oncofertility-related variables and QoL.
Knowledge and beliefs about oncofertility options were considerably low in the sample, and participants reported unmet oncofertility resource needs. In multivariable analyses, QoL was associated with beliefs valuing the importance of fertility in childhood cancer (β = 0.87, p = 0.01) and lower information needs (β = -1.19, p = 0.022).
Infertility is a well-documented effect of childhood cancer treatment. Our findings indicate that clinical providers are a preferred source of information for AYA patients, and there is a need to address oncofertility concerns and challenges in this group. Research is needed to examine barriers to addressing fertility issues in childhood cancer treatment and ways to promote dialogue between providers and patients and their families.
青少年和年轻成人（AYA）癌症幸存者在成年后会面临生育和育儿方面的挑战，但关于该人群对肿瘤生育能力的认识、信念和关注、对支持性资源的需求以及与生活质量（QoL）的关联，证据有限。
参与者为 69 名年龄在 12-25 岁之间的 AYA，他们在 18 岁或以下被诊断患有癌症且癌症已治愈至少 1 年，从儿童癌症临床记录和支持组织中招募。参与者完成了肿瘤生育能力知识和信念、信息需求以及生活质量测量的自我报告评估。分析了肿瘤生育相关变量与生活质量之间的关联。
该样本中对肿瘤生育选择的知识和信念相当低，且参与者报告了肿瘤生育资源需求未得到满足。在多变量分析中，生活质量与对儿童癌症生育重要性的信念（β=0.87，p=0.01）和较低的信息需求（β=-1.19，p=0.022）相关。
不孕是癌症治疗的一个公认后果。我们的研究结果表明，临床医生是 AYA 患者的首选信息来源，需要解决该群体的肿瘤生育能力问题和挑战。需要研究解决儿童癌症治疗中生育问题的障碍以及促进提供者、患者及其家属之间对话的方法。
