Assisted Reproductive Technology Use After Adolescent and Young Adult Cancer in North Carolina

北卡罗来纳州青少年和年轻人癌症后辅助生殖技术的使用

• 批准号: 10230020
• 负责人: Clare E Meernik
• 金额: $ 3.59万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10230020
• 关键词: Accounting; Address; Adolescent and Young Adult; Aftercare; Age; Assisted Reproductive Technology; Birth Certificates; Birth Rate; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Characteristics; Clinical; Clinical Research; Data; Data Analyses; Data Linkages; Decision Making; Development; Diagnosis; Distress; Ensure; Environment; Ethics; Face; Fellowship; Female; Fertility; Goals; Health Personnel; Income; Infertility; Institution; Insurance Coverage; Knowledge; Lead; Live Birth; Malignant Neoplasms; Medical; Neighborhoods; North Carolina; Not Hispanic or Latino; Outcome; Outcomes Research; Patients; Population; Pregnancy; Pregnancy Rate; Provider; Psychological reinforcement; Quality of life; Reporting; Research; Research Personnel; Resources; Sample Size; Societies; System; Time; Training; Woman; aged; base; cancer diagnosis; cancer survival; cancer therapy; career; clinically relevant; community engaged research; disadvantaged population; ethnic minority population; evidence base; experience; fertility preservation; improved; infertility treatment; innovation; low socioeconomic status; neoplasm registry; population based; psychosocial; racial and ethnic; reproductive; reproductive outcome; reproductive success; sociodemographic factors; sociodemographic predictors; stem; survivorship; tenure track; treatment comparison; treatment risk; trend

PROJECT SUMMARY/ABSTRACT Improving cancer survival trends among adolescent and young adults (AYAs) present an urgent need to address their unique survivorship concerns and strive toward NCI's scientific priority to “ensure that cancer survivors have the highest possible quality of life.” This fellowship will address the fertility challenges faced by females with cancer and provide me with training and expertise to become an emerging cancer outcomes researcher. Current gaps in cancer outcomes research related to assisted reproductive technology (ART)— and specifically ART for fertility preservation—may contribute to lack of patient and provider knowledge and low utilization rates, particularly among marginalized groups. Key evidence gaps include: (1) the extent to which disparities exist in use of fertility preservation; (2) the impact of fertility preservation on time to cancer treatment; and (3) reproductive success after ART, accounting for fertility preservation prior to cancer treatment. Study aims will address these gaps by utilizing innovative and generalizable population-based data linkages between the North Carolina (NC) Central Cancer Registry, the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System, and NC birth certificates. This linkage captures AYA (aged 15-39 years) females diagnosed with cancer in NC during 2004-2015 who utilized ART (with or without fertility preservation prior to cancer treatment) through 2016 (n=370 estimated women). To examine disparities in fertility preservation utilization (Aim 1), sociodemographic factors will be compared between AYA females with cancer who underwent fertility preservation prior to cancer treatment and AYA females with cancer who did not, accounting for clinical cancer characteristics. To examine the effect of fertility preservation on cancer treatment delay (Aim 2), time to initiation of gonadotoxic cancer treatment will be compared between AYA females with cancer who initiated ART for fertility preservation prior to cancer treatment and AYA females with cancer who did not, accounting for clinical cancer characteristics. Lastly, pregnancy and birth rates will be compared between AYA females with cancer who initiated ART for fertility preservation prior to cancer treatment and AYA females with cancer who initiated ART after treatment (Aim 3). Study results can enhance the evidence-base available to health care providers and patients to guide fertility-related decisions after cancer. The fellowship training will take place in a supportive, resource-rich environment and will provide me with clinical- and research-focused perspectives related to ART; active involvement with community-engaged research; expertise in multilevel data analysis; diverse opportunities to disseminate my research; reinforcement of ethical research conduct; and will promote my development as an emerging cancer outcomes researcher. This fellowship will be an invaluable contribution to my career goal of becoming a tenure track researcher focused on improving survivorship care, particularly among disadvantaged populations.

项目摘要/摘要 青少年和年轻人（AYA）的癌症生存趋势改善了迫切需要 解决他们独特的生存问题，并努力努力努力“确保癌症 幸存者的生活质量最高。”该奖学金将解决面临的生育挑战 患有癌症的女性，为我提供培训和专业知识，成为新兴的癌症结果 研究员。与辅助生殖技术（ART）有关的癌症结果研究的当前差距 - 特别是用于保存生育的艺术 - 可能导致缺乏患者和提供者知识以及 低利用率，特别是在边缘化组中。主要证据差距包括：（1） 使用生育能力保存中存在哪些分布； （2）生育能力的影响准时取消 治疗; （3）艺术后的生殖成功，在取消之前考虑生育能力 治疗。研究目的将通过使用创新和可推广的基于人群的数据来解决这些差距 北卡罗来纳州（NC）中央癌症注册表之间的联系，辅助生殖学会 技术临床结果报告系统和NC出生证明。这种连接捕获了Aya（老年） 15-39岁）在2004 - 2015年期间，在NC诊断出患有癌症的女性使用艺术（有或没有生育 在癌症治疗之前保存）至2016年（n = 370个估计的女性）。检查分布 生育能力保存利用率（AIM 1），将比较有社会人口统计学因素 在癌症治疗之前接受生育的癌症和患有癌症的aya女性的癌症 不，考虑临床癌症的特征。检查生育对癌症的影响 治疗延迟（AIM 2），将比较AYA之间的性腺毒性癌治疗的时间 癌症的女性在癌症治疗前开始生育艺术，而Aya女性则 没有考虑临床癌症特征的癌症。最后，怀孕和出生率将是 比较癌症的AYA女性在癌症之前启动了生育能力的艺术 治疗和AYA女性患有癌症，后者在治疗后开始艺术（AIM 3）。研究结果可以增强 医疗保健提供者和患者可用于指导与生育有关的决定的证据基础 癌症。奖学金培训将在支持性的资源丰富的环境中进行，并将为我提供 具有与艺术有关的临床和研究的观点；积极参与社区参与 研究;多层数据分析方面的专业知识；潜水员有机会传播我的研究；加强 道德研究行为；并将促进我作为新兴的癌症结果研究人员的发展。 这项奖学金将是我成为任期田径研究员的职业目标的宝贵贡献 专注于改善生存护理，尤其是在受到干扰的人群中。