Many young cancer patients may have limited awareness of fertility preservation options

A new study points to the need for increased awareness of fertility preservation options for young patients with cancer. Published in CANCER (2015; doi:10.1002/cncr.29328), the study found that factors such as gender, education, and insurance status may impact whether patients and their physicians have discussions and take actions to preserve fertility during cancer treatment.

Cancer and the therapies used to treat it can cause some patients to become infertile. Therefore, discussions between clinicians and young cancer patients about this issue and available fertility preservation techniques are an important part of patient education. Little is known about the extent to which these discussions take place, or patient and physician characteristics associated with these interactions.

To investigate, Margarett Shnorhavorian, MD, MPH, FAAP, FACS, of the University of Washington, Seattle Children's Hospital, and her colleagues asked 459 adolescents and young adults whose cancer was diagnosed in 2007 or 2008 to complete questionnaires.

More than 70% of the patients reported being told that treatment may affect their fertility; however, male patients were more than twice as likely as female patients to report that fertility preservation options were discussed. Most striking, almost one-third of males reported making arrangements for fertility preservation, which was 4 to 5 times higher than the rate for females. The investigators also found that between 2007 and 2008, males and females both reported an increase in discussions regarding the impact of cancer therapy on fertility and fertility preservation options.

The questionnaires also revealed that discussion and action surrounding fertility preservation may be linked with medical factors, patient socioeconomic status, and child-rearing status. For example, people without insurance, those who were raising children, and, among males only, those who received treatment that posed no or low risk to fertility were more likely not to discuss fertility preservation with clinicians.

In addition, males without a college degree, who lacked private insurance, and were raising children were more likely to not make fertility preservation arrangements; too few females had made fertility preservation arrangements for similar analyses.

"The access and health-related reasons for not making arrangements for fertility preservation reported by participants in this study further highlight the need for decreased cost, improved insurance coverage, and partnerships between cancer health care providers and fertility experts to develop strategies that increase awareness of fertility preservation options and decrease delays in cancer therapy as fertility preservation for adolescent and young adult cancer patients improves," said Shnorhavorian.

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