Kassem Loay, Mellas Nawfel, Tolba Marwan, Lambertini Matteo, Oualla Karima
Clinical Oncology Department, Faculty of medicine, Cairo University, Giza 12555, Egypt.
Medical Oncology Department, Hassan II University Hospital, Mohamed Ben Abdellah University, Fes, Morocco.
Ecancermedicalscience. 2022 May 12;16:1388. doi: 10.3332/ecancer.2022.1388. eCollection 2022.
Cancer in young women is a major health problem in the Middle Eastern and North African population. We explored the awareness, barriers and practice of Arab oncologists towards oncofertility.
Oncologists from Arab countries treating female cancer patients were invited to complete a 30-item web-based questionnaire that explores oncologists' demographics, available techniques and barriers to oncofertility.
170 oncologists working in 9 different Arab countries responded to the questionnaire. Among the responders, 89 (52.4%) were from Egypt and the central region, 60 (35.3%) were from North Africa and 21 (12.4%) were from the Gulf region.While most participants considered a dedicated training 'necessary', only 43 oncologists (25.3%) received a formal training. Only 17 participants (10%) had a fertility clinic in their centre, 44 (25.9%) and 13 (7.6%) had to refer patients to other centres or other cities, respectively. A total of 96 oncologists (56.5%) did not have access to a fertility preservation service.Out of 147 responders, 79 (53.7%) offered fertility preservation only in patients presenting with early disease and 38 (25.9%) did not offer fertility preservation. In terms of proposed strategies, 50 responders (29.4%) offered embryo cryopreservation, 79 (46.5%) oocyte cryopreservation and 48 (28.2%) ovarian tissue cryopreservation.
A large gap exists between international clinical practice guidelines and current practices of fertility preservation in Arab countries. Barriers to optimum service delivery include the lack of physician awareness/training, unavailability of some advanced techniques and a lack of dedicated fertility clinics within the cancer centres.
年轻女性患癌是中东和北非人群面临的一个重大健康问题。我们探讨了阿拉伯肿瘤学家对肿瘤生育学的认知、障碍及实践情况。
邀请来自阿拉伯国家治疗女性癌症患者的肿瘤学家完成一份30项的网络调查问卷,该问卷旨在探究肿瘤学家的人口统计学特征、可用技术及肿瘤生育学的障碍。
9个不同阿拉伯国家的170名肿瘤学家回复了问卷。在回复者中,89名(52.4%)来自埃及和中部地区,60名(35.3%)来自北非,21名(12.4%)来自海湾地区。虽然大多数参与者认为专门培训“有必要”,但只有43名肿瘤学家(25.3%)接受过正规培训。只有17名参与者(10%)所在中心设有生育诊所,44名(25.9%)和13名(7.6%)分别不得不将患者转诊至其他中心或其他城市。共有96名肿瘤学家(56.5%)无法获得生育力保存服务。在147名回复者中,79名(53.7%)仅为早期疾病患者提供生育力保存,38名(25.9%)不提供生育力保存。在提出的策略方面,50名回复者(29.4%)提供胚胎冷冻保存,79名(46.5%)提供卵母细胞冷冻保存,48名(28.2%)提供卵巢组织冷冻保存。
阿拉伯国家在国际临床实践指南与当前生育力保存实践之间存在巨大差距。提供最佳服务的障碍包括医生缺乏认知/培训、一些先进技术不可用以及癌症中心内缺乏专门的生育诊所。