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. 2012 Sep 15;118(18):4579-88.
doi: 10.1002/cncr.26649. Epub 2012 Mar 26.

Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer

Joseph M Letourneau  1 , James F Smith, Erin E Ebbel, Amaranta Craig, Patricia P Katz, Marcelle I Cedars, Mitchell P Rosen
Affiliations

Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer

Joseph M Letourneau et al. Cancer. .

Abstract

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.

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Figures

Figure 1
Figure 1
Prevalence of Counseling for Fertility Preservation and Utilization of Fertility Preservation from 1993 to 2007 among Young Female Cancer Survivors
See this image and copyright information in PMC

References

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