Fertility counseling in early-onset colorectal cancer and the impact of patient characteristics

Abstract

Purpose: This study evaluated how frequently patients with early onset colorectal cancer received fertility counseling and whether patient characteristics affected the likelihood of receiving such counseling.

Methods: We conducted a single-center retrospective review of all new patients seen by medical oncology for colorectal cancer who were age 55 years or younger for men and 50 years or younger for women. Associations between patient demographics and clinical characteristics with receipt of fertility counseling were explored using univariate analyses and multivariable logistical regression analyses.

Results: A total of 194 patients were included, of whom 15.5% received fertility counseling. Using multivariate analysis, we found that age < 40 (OR 15.587, p < 0.0001, 95% CI 4.841-50.191) and female sex (OR 3.979, p = 0.0292, 95% CI 1.150-13.770) were correlated with increased likelihood of fertility counseling. Patients living in areas of higher household income were more likely to receive fertility counseling, with a statistically significant difference between the 3rd and 1st quartiles of income (p = 0.0369, 95% CI 1.161-115.940).

Conclusion: A majority of patients with EOCRC did not receive fertility counseling despite the known toxicities of CRC treatment modalities on fertility. Older age, male sex, and residence in areas of lower income were associated with decreased likelihood of receiving fertility counseling.

Keywords: Early onset colorectal cancer; Fertility counseling; Fertility preservation; Oncofertility.