TOPLINE

In a study of adults diagnosed with cancer before age 50, 30% said they were never informed that treatments could affect their fertility. Awareness was especially low among patients from racial and ethnic minority groups and those with prior pregnancies.

METHODOLOGY

• Fertility counseling has long been recommended for patients of reproductive age diagnosed with cancer, but communication between doctors and patients about those issues remains inconsistent.
• To investigate the patient perspective, researchers analyzed data from 636 patients aged 18-49 years diagnosed with a first primary cancer (mean age at diagnosis, 37 years; 80% women). All were part of the REACT Study, conducted between 2006 and 2021.
• Participants completed an electronic survey covering reproductive health, awareness of potential cancer-related infertility risk, and sources of information.
• The researchers examined associations between awareness of cancer-related infertility risk and patient-level factors, including race/ethnicity, age at diagnosis, sex, insurance coverage, marital status, and pregnancy history.

TAKEAWAY

• Among 636 patients, 29% (n = 184) reported never being told that their cancer treatments might affect their fertility. The highest rates of unawareness were among patients with thyroid cancer (56%), lung and bronchial cancer (55%), or colorectal cancer (37%).
• Overall, 71% of patients who were aware of cancer-related infertility risk received this information from a mean of two sources. Nearly all information sources (91%) were clinical interactions or settings — showing, the authors noted, that there are “multiple, existing touchpoints” to address these issues.
• Patients from racial or ethnic minority groups were more likely to report unawareness of infertility risk than non-Hispanic White patients, after adjusting for age at diagnosis, year of diagnosis, sex, insurance coverage, marital status, and pregnancy history (odds ratio [OR], 1.70; P = .03).
• Older age at diagnosis of early-onset cancer (OR, 1.09; P < .0001) and a history of pregnancy, including with a partner (OR, 2.01; P = .005), were independently associated with greater odds of lacking awareness of cancer-related infertility risk.

IN PRACTICE

The finding that many patients had never been told about potential fertility risks is “alarming,” the study authors wrote. As the incidence of early-onset cancer rises, they added, these results “highlight an imminent need for providers to manage timely fertility preservation consultation referrals for all reproductive age patients as early as possible at/after cancer diagnosis and the need to understand the barriers patients experience in raising concerns about their fertility to cancer care providers.”

SOURCE

This study, led by Allison D. Morris, MD, of Vanderbilt University School of Medicine in Nashville, Tennessee, was published online in JCO Oncology Advances.

LIMITATIONS

The recruitment strategy may have favored patients with stronger social connections or higher education. Electronic medical records were not available to confirm treatment details, stage, or documented counseling. Community, health system, and geographic factors could not be assessed.

DISCLOSURES

This study was supported by grants from the American Cancer Society, the National Institutes of Health, Vanderbilt University, and the Sandra G. and Samuel K. Welborn Cancer Scholars Fund. Several authors reported financial relationships with various pharmaceutical companies. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.