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早发性结直肠癌的生育咨询及患者特征的影响

Fertility counseling in early-onset colorectal cancer and the impact of patient characteristics.

作者信息

Peng Chengwei, Littman Dalia, Masri Lena, Sherman Scott, Makarov Danil V, Becker Daniel J

机构信息

Feinberg School of Medicine, Chicago, IL, USA.

NYU Grossman School of Medicine, New York, NY, USA.

出版信息

Support Care Cancer. 2025 May 10;33(6):466. doi: 10.1007/s00520-025-09517-3.

DOI:10.1007/s00520-025-09517-3
PMID:40347312
Abstract

PURPOSE

This study evaluated how frequently patients with early onset colorectal cancer received fertility counseling and whether patient characteristics affected the likelihood of receiving such counseling.

METHODS

We conducted a single-center retrospective review of all new patients seen by medical oncology for colorectal cancer who were age 55 years or younger for men and 50 years or younger for women. Associations between patient demographics and clinical characteristics with receipt of fertility counseling were explored using univariate analyses and multivariable logistical regression analyses.

RESULTS

A total of 194 patients were included, of whom 15.5% received fertility counseling. Using multivariate analysis, we found that age < 40 (OR 15.587, p < 0.0001, 95% CI 4.841-50.191) and female sex (OR 3.979, p = 0.0292, 95% CI 1.150-13.770) were correlated with increased likelihood of fertility counseling. Patients living in areas of higher household income were more likely to receive fertility counseling, with a statistically significant difference between the 3rd and 1st quartiles of income (p = 0.0369, 95% CI 1.161-115.940).

CONCLUSION

A majority of patients with EOCRC did not receive fertility counseling despite the known toxicities of CRC treatment modalities on fertility. Older age, male sex, and residence in areas of lower income were associated with decreased likelihood of receiving fertility counseling.

摘要

目的

本研究评估了早发性结直肠癌患者接受生育咨询的频率,以及患者特征是否会影响接受此类咨询的可能性。

方法

我们对肿瘤内科诊治的所有年龄在55岁及以下(男性)或50岁及以下(女性)的结直肠癌新患者进行了单中心回顾性研究。使用单因素分析和多变量逻辑回归分析探讨患者人口统计学和临床特征与接受生育咨询之间的关联。

结果

共纳入194例患者,其中15.5%接受了生育咨询。通过多变量分析,我们发现年龄<40岁(OR 15.587,p<0.0001,95%CI 4.841 - 50.191)和女性(OR 3.979,p = 0.0292,95%CI 1.150 - 13.770)与接受生育咨询的可能性增加相关。生活在家庭收入较高地区的患者更有可能接受生育咨询,收入第三四分位数和第一四分位数之间存在统计学显著差异(p = 0.0369,95%CI 1.161 - 115.940)。

结论

尽管已知结直肠癌治疗方式对生育有不良影响,但大多数早发性结直肠癌患者未接受生育咨询。年龄较大、男性以及居住在低收入地区与接受生育咨询的可能性降低有关。

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本文引用的文献

1
Fertility preservation in reproductive-aged female patients with colorectal cancer: a scoping review.结直肠癌生殖期女性患者的生育力保存:范围综述。
Support Care Cancer. 2023 Oct 5;31(10):612. doi: 10.1007/s00520-023-08081-y.
2
Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN.2020年和2040年全球结直肠癌负担:来自全球癌症负担(GLOBOCAN)的发病率和死亡率估计
Gut. 2023 Feb;72(2):338-344. doi: 10.1136/gutjnl-2022-327736. Epub 2022 Sep 8.
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Addressing Barriers to Fertility Preservation for Cancer Patients: The Role of Oncofertility Patient Navigation.
解决癌症患者生育力保存的障碍:生育力保护患者导航的作用。
J Oncol Navig Surviv. 2021 Oct;12(10):332-348.
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Current state of fertility preservation for adolescent and young adult patients with gynecological cancer.妇科癌症青少年和年轻患者生育力保存的现状。
Int J Clin Oncol. 2022 Jan;27(1):25-34. doi: 10.1007/s10147-021-02063-y. Epub 2021 Nov 15.
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Fertility and breast cancer: A literature review of counseling, preservation options and outcomes.生育能力与乳腺癌:咨询、保留选择和结局的文献回顾。
Crit Rev Oncol Hematol. 2021 Oct;166:103461. doi: 10.1016/j.critrevonc.2021.103461. Epub 2021 Aug 27.
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A Coordinated Clinical Center for Young Onset Colorectal Cancer.青年起病型结直肠癌协作临床中心
Oncologist. 2021 Aug;26(8):625-629. doi: 10.1002/onco.13849. Epub 2021 Jun 17.
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Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.结肠癌临床实践指南(2021 年第 2 版),NCCN 肿瘤学临床实践指南。
J Natl Compr Canc Netw. 2021 Mar 2;19(3):329-359. doi: 10.6004/jnccn.2021.0012.
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Rising incidence of early-onset colorectal cancer - a call to action.结直肠癌发病年轻化——行动的召唤。
Nat Rev Clin Oncol. 2021 Apr;18(4):230-243. doi: 10.1038/s41571-020-00445-1. Epub 2020 Nov 20.
9
Clinicians' Perspectives on Barriers to Discussing Infertility and Fertility Preservation With Young Women With Cancer.临床医生对与年轻癌症女性讨论不孕不育和生育力保存的障碍的看法。
JAMA Netw Open. 2019 Nov 1;2(11):e1914511. doi: 10.1001/jamanetworkopen.2019.14511.
10
Fertility preservation in chemo-radiotherapy for rectal cancer: A combined approach.直肠癌放化疗中的生育力保护:一种联合方法。
Clin Transl Radiat Oncol. 2019 Sep 12;19:77-79. doi: 10.1016/j.ctro.2019.09.002. eCollection 2019 Nov.