Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.
J Cancer Educ. 2023 Feb;38(1):106-114. doi: 10.1007/s13187-021-02084-1. Epub 2021 Oct 8.
Cancer diagnosis and treatment may influence reproductive planning and impact fertility in patients of reproductive age. Although guidelines have been established in the past decade, education, practice, and attitudes of medical oncologists regarding fertility preservation remain undecided. A nationwide survey was performed among members of the Dutch Society for Medical Oncology. Demographics, practice, knowledge, and barriers were measured regarding information provision of fertility preservation towards cancer patients of childbearing age. From 392 members, 120 oncologists completed the questionnaire (30.6%). Majority of oncologists was convinced it is their responsibility to discuss impact of cancer treatment to fertility (93.2%), yet 68.3% discussed the subject often or always (n = 82). Oncologists employed in district general hospitals were less likely to discuss fertility (p = 0.033). On average, 44.6% of reproductive men and 28.9% of reproductive women is referred to fertility specialists. Half of the respondents declared to possess sufficient knowledge regarding fertility preservation (n = 57, 47.5%). Poor prognosis (53%), unlikely survival (43.1%), and high chances on fertility recovery (28.7%) were identified as barriers to discussing fertility preservation. Among oncologists, impact of cancer treatment on fertility is a well-accepted responsibility to counsel. Despite, self-reported knowledge regarding fertility preservation is strongly varying. In practice, fertility is discussed to some extent, influenced by several barriers and depending on prognosis and type of hospital. Patients benefit from knowledge improvement among oncology care providers concerning fertility effects of cancer treatment. Education during medical school, residency, and among practicing oncologists may raise awareness, together with enhancement of referral possibilities.
癌症的诊断和治疗可能会影响到生殖计划，并影响到育龄患者的生育能力。尽管过去十年已经制定了指南，但医学肿瘤学家在生育力保护方面的教育、实践和态度仍存在争议。在荷兰医学肿瘤学会的成员中进行了一项全国性调查。调查了与生育力保护相关的信息提供情况，包括针对有生育能力的癌症患者的人口统计学、实践、知识和障碍。在 392 名成员中，有 120 名肿瘤学家完成了问卷调查（30.6%）。大多数肿瘤学家认为讨论癌症治疗对生育能力的影响是他们的责任（93.2%），但有 68.3%的人经常或总是讨论这个话题（n=82）。在地区综合医院工作的肿瘤学家不太可能讨论生育问题（p=0.033）。平均而言，44.6%的有生育能力的男性和 28.9%的有生育能力的女性被转介给生育专家。有一半的受访者表示对生育力保护有足够的了解（n=57，占 47.5%）。不良预后（53%）、存活可能性低（43.1%）和生育力恢复机会高（28.7%）被认为是讨论生育力保护的障碍。在肿瘤学家中，癌症治疗对生育能力的影响是一个被广泛接受的咨询责任。尽管如此，自我报告的生育力保护知识差异很大。在实践中，生育问题在一定程度上得到了讨论，这受到多种障碍的影响，并取决于预后和医院类型。提高肿瘤学护理人员对癌症治疗生育影响的认识，可以使患者受益。在医学院、住院医师培训和在职肿瘤学家中进行教育，可以提高认识，并增强转介的可能性。
