Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, Mexico City, Mexico.
Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, Mexico City, Mexico.
J Cancer Educ. 2022 Feb;37(1):10-15. doi: 10.1007/s13187-020-01771-9.
Guidelines recommend discussing fertility preservation with patients with cancer. In Mexico, internists frequently are the primary care provider (PCP) for adults in reproductive age. The knowledge of oncofertility among PCPs in low and middle income countries is poorly known. Internal medicine residents in a tertiary care hospital in Mexico City participated in a survey regarding fertility concepts in cancer patients. Sixty-three residents participated; their median age was 27. Thirty percent reported 0% self-perceived confidence for providing counseling about fertility issues, and 26% reported more than 50% self-perceived confidence. Twenty-eight percent reported not asking patients in reproductive age about satisfied parity/paternity. Eighty-one percent correctly identified patients that should receive fertility counseling, and 68% identified alkylating chemotherapy as having the highest risk of infertility. Fifty-four percent were able to name at least one fertility preservation (FP) strategy for males, whereas 49% were able to name at least one strategy in females. Residents who reported at least 50% self-perceived confidence for providing fertility counseling were more likely to name at least one FP strategy for men (64.7%) versus those who reported less than 50% self-perceived confidence (52.1%), but this result was not statistically significant (p = 0.378). This was similar for FP strategies in women, with 64.7% of more confident residents naming at least one, compared with 43.4% of less confident residents (p = 0.134). Knowledge of FP in patients with cancer is insufficient among internal medicine residents in our institution. Inclusion of oncofertility concepts in the internal medicine program is needed.
指南建议与癌症患者讨论生育力保留问题。在墨西哥，内科医生经常是生育年龄成人的初级保健提供者（PCP）。在中低收入国家，PCP 对肿瘤生育力的了解甚少。墨西哥城一家三级保健医院的内科住院医师参与了一项关于癌症患者生育概念的调查。63 名住院医师参加了调查；他们的中位年龄为 27 岁。30%的人报告对提供生育问题咨询的自我感知信心为 0%，26%的人报告自我感知信心超过 50%。28%的人报告没有询问生育年龄的患者对满意的生育/育儿的看法。81%的人正确识别出需要接受生育咨询的患者，68%的人识别出烷化剂化疗具有最高的不孕风险。54%的人能够至少说出一种男性生育力保存（FP）策略，而 49%的人能够至少说出一种女性 FP 策略。报告自我感知信心至少为 50%的住院医师更有可能说出至少一种男性 FP 策略（64.7%），而报告自我感知信心低于 50%的住院医师则为 52.1%，但这一结果没有统计学意义（p=0.378）。对于女性的 FP 策略也是如此，更有信心的 64.7%的住院医师至少能说出一种，而不太有信心的 43.4%的住院医师则为 43.4%（p=0.134）。我们机构的内科住院医师对癌症患者的 FP 知识不足。需要将肿瘤生育力概念纳入内科课程。
