Young adult female cancer survivors' unmet information needs and reproductive concerns contribute to decisional conflict regarding posttreatment fertility preservation
Open Access
- 23 May 2016
- Vol. 122 (13), 2101-2109
- https://doi.org/10.1002/cncr.29917
Abstract
BACKGROUND Many young adult female cancer survivors (YAFCS) are at risk of experiencing premature menopause. The current study characterized the posttreatment fertility information needs, reproductive concerns, and decisional conflict regarding future options for posttreatment fertility preservation (FP) among YAFCS. METHODS Participants completed a Web‐based, anonymous survey between February and March 2015. The survey included investigator‐designed questions of perceived information needs, the Reproductive Concerns After Cancer Scale, and the Decisional Conflict Scale. Analyses included Pearson correlation coefficients, independent‐sample Student t tests, and multiple regression. RESULTS There was a total of 346 participants with an average age of 29.9 years (SD = 4.1 years) who were 4.9 years from treatment (SD = 5.4 years [range, 0‐27 years]). The main analyses focused on a subgroup of YAFCS with uncertain fertility status who had not previously undergone/attempted FP and either wanted future children or were unsure (179 women). Across fertility information topics, 43% to 62% of participants reported unmet information needs. The greatest reproductive concerns were related to fertility potential and the health of future offspring. The regression model controlled for a priori covariates including current age, age at treatment completion, income, relationship status, nulliparity, and prior fertility evaluation. Greater unmet information needs were found to be related to greater decisional conflict (β = .43; p<.001); greater reproductive concerns were associated at the trend level (β = .14, p = .08; F[8,118] = 6.42, p<.001). CONCLUSIONS YAFCS with limited awareness or knowledge of their risk of experiencing premature menopause and FP options reported higher levels of decisional conflict regarding future FP. Posttreatment survivorship care should include comprehensive reproductive health counseling, including posttreatment FP options and family‐building alternatives. Cancer 2016;122:2101–9. © 2016 American Cancer Society.Keywords
Funding Information
- Memorial Sloan Kettering Cancer Center (P30 CA008748)
- National Institutes of Health/National Center for Advancing Translational Sciences (KL2TR000458, UL1TR000457-06)
This publication has 47 references indexed in Scilit:
- Mothering and Self-Othering: The Impact of Uncertain Reproductive Capability in Young Women After Hematological MalignancyHealth Care for Women International, 2013
- Why Healthcare Providers Should Focus on the Fertility of AYA Cancer Survivors: It’s Not Too Late!Frontiers in Oncology, 2013
- Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancerBritish Journal of Cancer, 2012
- Decision aids for people facing health treatment or screening decisionsPublished by Wiley ,2011
- Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancerCancer, 2011
- Assessing the Reproductive Concerns of Children and Adolescents with Cancer: Challenges and Potential SolutionsJournal of Adolescent and Young Adult Oncology, 2011
- Male and female experiences of having fertility matters raised alongside a cancer diagnosis during the teenage and young adult yearsEuropean Journal of Cancer Care, 2009
- Psychological aspects of fertility preservation in men and women affected by cancer and other life-threatening diseasesHuman Reproduction Update, 2009
- Information and service needs for young adult cancer survivorsSupportive Care in Cancer, 2008
- A Qualitative Analysis of Reproductive Issues Raised by Young Australian Women with Breast CancerHealth Care for Women International, 2006