Equity Team: Team Labeled by the French League Against Cancer, UMR1295 CERPOP, Toulouse, France.
Tarn Cancer Registry, Claudius Regaud Institute, Toulouse, France.
Front Public Health. 2023 Mar 3;11:1129198. doi: 10.3389/fpubh.2023.1129198. eCollection 2023.
Too few women with invasive breast cancer are informed of the risk of hypofertility after chemotherapy. However, this risk can be prevented by offering gamete preservation by a specialized team. We believe that if more women were informed about gamete preservation, more of them would accept it.
The primary objective is to describe each step of the oncofertility care pathway from provision of information to gamete preservation. The secondary objective is to estimate the impact of not receiving information by determining the proportion of women who would have undergone gamete preservation if they had been informed.
575 women aged 18-40 years treated with chemotherapy for breast cancer between 2012 and 2017 in the Ouest-Occitanie region (~3 million inhabitants) were included. We first constructed a multivariate predictive model to determine the parameters influencing the uptake of the offer of gamete preservation among women who were informed and then applied it to the population of uninformed women.
Only 39% of women were informed of the risks of hypofertility related to chemotherapy and 11% ultimately received gamete preservation. If all had been informed of the risk, our model predicted an increase in gamete preservation of 15.35% in the youngest women (<30 years), 22.88% in women aged between 30 and 35 years and zero in those aged ≥36 years. We did not find any association with the European Deprivation Index (EDI).
Oncologists should be aware of the need to inform patients aged ≤ 35 years about gamete preservation. If all received such information, the impact in terms of gamete preservation would likely be major.
接受化疗的浸润性乳腺癌女性中，很少有人被告知化疗后生育力低下的风险。然而，通过专业团队提供配子保存可以预防这种风险。我们认为，如果更多的女性了解配子保存，更多的女性会接受它。
主要目的是描述从提供信息到配子保存的整个生育力保存路径的各个步骤。次要目的是通过确定如果告知妇女配子保存，则接受配子保存的妇女比例来估计未收到信息的影响。
纳入了 2012 年至 2017 年间在奥克西坦尼地区（约 300 万居民）接受化疗治疗乳腺癌的 575 名 18-40 岁的女性。我们首先构建了一个多变量预测模型，以确定在接受信息的妇女中接受配子保存的提议的影响因素，然后将其应用于未接受信息的妇女群体。
只有 39%的女性被告知与化疗相关的生育力低下的风险，最终只有 11%的女性接受了配子保存。如果所有女性都被告知风险，我们的模型预测在最年轻的女性（<30 岁）中，配子保存的增加将为 15.35%，在 30-35 岁之间的女性中增加 22.88%，而在≥36 岁的女性中则没有增加。我们没有发现与欧洲贫困指数（EDI）之间存在任何关联。
肿瘤学家应该意识到有必要告知≤35 岁的患者关于配子保存的信息。如果所有女性都收到这样的信息，配子保存的影响可能会很大。
