More Attention Needed to Reproductive Preservation for Cancer Survivors
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A new study published in the on line version of the journal Cancer March 26, 2012 shows that there are disparities in counseling and treatment to protect women’s fertility when they go through treatment for various types of cancers.
“Although more women are getting counseled regarding reproductive health risks, many women are still not receiving adequate information about their options at the time of cancer diagnosis,” according to Dr Mitchell Rosen, of the University of California, San Francisco (UCSF) who co-authored the study.
Rosen and colleagues surveyed women diagnosed with cancer between the ages of 18 and 40 years, who were registered in the California Cancer Registry between 1993 and 2007.
They found that 61% of the women received counseling on the risks that cancer treatment can have on their fertility from their doctor or other clinician. However, only 4% of women took up the option of fertility preservation. Rates showed a tendency to increase over time. In 1993, the take up rate was 1%, whereas in 2005 to 2007 it was between 6% and 10%.
Younger, Caucasian, childless, heterosexual, and college educated women were the most likely to receive counseling about the effects of cancer treatment on their fertility, and also most likely to preserve fertility beforehand. Disparities in sociodemographic health characteristics and economics likely affect women’s access to fertility preservation services.
Early findings from the study include:
* The percentage of women reporting acute ovarian failure was 8 percent, 10 percent, 9 percent and 5 percent for Hodgkin’s disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancers respectively. Acute ovarian failure increased significantly with age at diagnosis.
* In women without acute ovarian failure, the incidence of infertility increased significantly with age at diagnosis. For instance, the proportion of infertile women with Hodgkin’s disease was 18 percent at 20 years old and 57 percent at 35 years old.
* The estimated probability of early menopause increased significantly with younger age at diagnosis. For example, using age as a predictor of early menopause in non-Hodgkin lymphoma, 56 percent of women 20 years old at diagnosis may experience menopause early, compared to 16 percent of those who were 35 years old at diagnosis.
“An opportunity lies ahead to explore educational and policy interventions to ameliorate health disparities that may exist in the growing use of fertility preservation,” said Rosen.
Medical News Today “Women Not Preserving Fertility During Cancer Treatment” in Medical News Today March 28, 2012.
Rush-Monroe, Karin “UCSF Study Shows Greater Impact of Chemotherapy on Fertility” in UCSF National Center for Excellence in Women’s Health August 24, 2011.