Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer
Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer
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DOI：
10.1002/cncr.26649
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发表时间：
2012-09-15
期刊：
影响因子：
6.2
通讯作者：
Rosen, Mitchell P.
中科院分区：
文献类型：
--
作者：
Letourneau, Joseph M.;Smith, James F.;Rosen, Mitchell P.
背景：本研究旨在探讨诊断为癌症的育龄妇女的社会人口学特征与生育保留服务的利用之间的关系。方法：对1041名年龄在18岁至40岁之间诊断为癌症的女性进行了人口统计信息和生殖健康史的回顾性调查。包括五种癌症类型：白血病、霍奇金病、非霍奇金淋巴瘤、乳腺癌和胃肠道癌。918名妇女报告了可能影响生育的治疗（化疗、盆腔放疗、盆腔手术或骨髓移植）。在适当的情况下，使用学生t检验、线性回归和多元逻辑回归来确定社会人口学特征与使用生育保留服务的几率之间的关系。结果：61%的女性接受了肿瘤团队关于癌症治疗对生育风险的咨询。总体而言，4%的女性寻求保留生育能力。在多变量分析中，未获得学士学位的女性（优势比[OR]， 0.7； 95%可信区间[CI]， 0.5-0.9）接受咨询的可能性较小。趋势还表明，诊断时年龄大于35岁（OR, 0.1; 95% CI, 0.0-1.4）或既往子女（OR, 0.3; 95% CI, 0.1-1.1）在获得生育能力保存方面可能存在差异。还观察到基于种族和性取向的保留生育能力方面的差异。结论：社会人口健康差异可能影响生育保护服务的获得。尽管对保留生育能力的认识在过去十年中有所提高，但诊断患有癌症的育龄妇女在生殖健康咨询和保留生育能力方面的需求仍未得到满足。2012年癌症。(c) 2012年美国癌症协会。
BACKGROUND: This study seeks to examine the relation between sociodemographic characteristics and the utilization of fertility preservation services in reproductive age women diagnosed with cancer. METHODS: A total of 1041 women diagnosed with cancer between the ages of 18 and 40 years responded to a retrospective survey on demographic information and reproductive health history. Five cancer types were included: leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancer. Nine hundred eighteen women reported treatment with potential to affect fertility (chemotherapy, pelvic radiation, pelvic surgery, or bone marrow transplant). Student t test, linear regression, and multivariate logistic regression were used where appropriate to determine the relation between sociodemographic characteristics and the odds of using fertility preservation services. RESULTS: Sixty-one percent of women were counseled on the risk of cancer treatment to fertility by the oncology team. Overall, 4% of women pursued fertility preservation. In multivariate analysis, women who had not attained a bachelor's degree (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.5-0.9) were less likely to be counseled. Trends also suggested possible disparities in access to fertility preservation with age older than 35 years (OR, 0.1; 95% CI, 0.0-1.4) or previous children (OR, 0.3; 95% CI, 0.1-1.1) at diagnosis. Disparities in access to fertility preservation based on ethnicity and sexual orientation were also observed. CONCLUSIONS: Sociodemographic health disparities likely affect access to fertility preservation services. Although awareness of fertility preservation has improved in the past decade, an unmet need remains for reproductive health counseling and fertility preservation in reproductive age women diagnosed with cancer. Cancer 2012. (c) 2012 American Cancer Society.