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Smith E, Drizin JH, Harvey SM, Gorman JR. Dyadic support across contraceptive decision-making among young adult breast cancer survivors and their partners. J Psychosoc Oncol 2021; 40:724-742. [PMID: 34872463 DOI: 10.1080/07347332.2021.2000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study is to explore the role of dyadic support across the contraceptive decision-making process between young adult breast cancer (YABC) survivors and their partners. RESEARCH APPROACH Semi-structured interviews with YABC survivors and their partners. PARTICIPANTS Twenty-five young adult breast cancer survivors and their partners (n = 50). Survivors reported an average age of 36.9 years (SD = 4.30) and the majority self-identified as white (86.2%). METHODOLOGICAL APPROACH Thematic analysis approach with dyads as the primary unit of analysis, guided by the dyadic decision-making framework and the Theory of Gender and Power. RESULTS Perceived lack of contraceptive options due to a history of hormone-sensitive cancer, perceived infertility, and contraception as a result of cancer treatment (e.g., hysterectomy) contributed to the contraceptive decision context for survivors and their partners. Contraceptive support varied across couples depending on the cancer-specific context, where communication, sharing responsibility, and respecting bodily autonomy revealed as supportive behaviors. Other social influences including survivors' desire to conceive biologically and family planning desires also related to partner supportive behaviors. INTERPRETATIONS YABC survivors face specific challenges to contraceptive decision-making where partners can offer supportive behaviors. Health care providers can also support couples by engaging in triadic communication about contraception and family planning. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY Psychosocial providers can support couples by encouraging them to talk together about contraception and highlighting the importance of triadic communication with a healthcare provider to support shared decision-making and alignment of contraceptive decisions with family planning desires.
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Affiliation(s)
- Ellie Smith
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Julia H Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - S Marie Harvey
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jessica R Gorman
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
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2
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Esch M. Sexual Health: A Nursing Approach to Supporting the Needs of Young Adult Cancer Survivors. Clin J Oncol Nurs 2021; 25:501-506. [PMID: 34533525 DOI: 10.1188/21.cjon.501-506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sexual health is an important aspect of survivorship for young adult (YA) cancer survivors, who frequently experience physical and psychosocial changes related to sexuality and intimacy during and after treatment for cancer. This article provides an overview of common sexual issues in this population, reviews the integral role that oncology nursing assessment and intervention can play in optimizing patients' sexual well-being and quality of life, and describes specific strategies for incorporating the sexual health needs of YA cancer survivors into the nursing plan of care.
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Affiliation(s)
- Marloe Esch
- Froedtert and the Medical College of Wisconsin
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3
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Debiec KE, Todd N. Gynecologic Care for Pediatric and Adolescent Patients Undergoing Hematopoietic Stem Cell Transplantation. J Pediatr Adolesc Gynecol 2021; 34:112-116. [PMID: 33338627 DOI: 10.1016/j.jpag.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Abstract
Hematopoietic stem cell transplantation is used to treat many chronic and acute malignant and nonmalignant conditions. We review hematopoietic stem cell transplantation and its effect on the gynecologic health of pediatric and adolescent patients, including pretransplantation evaluation, contraception, menstrual suppression, sexual health, fertility, primary ovarian insufficiency, and graft vs host disease. Comprehensive and team-based care provides optimal anticipatory counseling, evaluation, and management of acute and ongoing gynecologic issues.
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Affiliation(s)
- Katherine E Debiec
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington.
| | - Nicole Todd
- Division of General Gynecology and Obstetrics, Division of Gynecologic Specialties, University of British Columbia, Vancouver, British Columbia, Canada
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4
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Telles CM. A scoping review of literature: What has been studied about adolescents and young adults (AYAs) with cancer? Cancer Treat Res Commun 2021; 27:100316. [PMID: 33545568 DOI: 10.1016/j.ctarc.2021.100316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To map, organize and analyze the articles published in the last five years about AYAs with cancer. METHODS CAPES database and Google Scholar were searched to identify relevant studies from 2015 to February 2020. Eligible articles included empirical or theoretical research, quantitative and/or qualitative studies, targeted AYAs with cancer, addressed different topics related to AYAs such as unmet needs, hospital challenges, interventions or tools based on evidence, as well as political and socioeconomic aspects. RESULTS Of the 161 articles analyzed, 74 (46%) discussed the health system, including hospital dynamics, treatment and interventions during treatment; 63 (39.1%) discussed aspects or interventions that influence the quality of life and mental health of AYAs with cancer; 14 (8.7%) discussed issues related to sexual health; and 10 (6.2%) addressed social, economic and demographic problems of AYAs with cancer. Three types of purposes have been identified in the articles: 118 (73.3%) investigated variables in areas related to AYAs with cancer, aiming to increase the understanding of the phenomenon and the needs of AYAs; 18 (11.2%) intervened on the needs of AYAs with cancer through pilot studies or evidence-based interventions; and 22 (13.7%) aimed to evaluate an intervention previously performed or to evaluate an intervention based on evidence. CONCLUSION There is still much to be researched within the last two categories. In the last three years, these categories have been growing gradually and on a small scale.
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Affiliation(s)
- Camila M Telles
- Graduating in Psychology - Senior year, Positivo University - Curitiba, Paraná, Brazil (Student); Teen Cancer America - Los Angeles, California, the United States of America (Intern Pro Cancer).
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5
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Reed DR, Naghavi A, Binitie O. Sarcoma as a Model for Adolescent and Young Adult Care. J Oncol Pract 2020; 15:239-247. [PMID: 31075215 DOI: 10.1200/jop.18.00684] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Sarcomas occur across all ages and are relatively abundant in the adolescent and young adult populations compared with older adults. Because of an overall rarity combined with a broad diversity of diagnoses, expertise is often concentrated in comprehensive cancer centers. The sarcoma model of care is an excellent model for overall adolescent and young adult care. We summarize some of the natural advantages of the field for developing adolescent and young adult programs, review management and referral touchpoints, and summarize recent biologic and clinical trial insights that have affected sarcoma management recently.
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Affiliation(s)
- Damon R Reed
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Arash Naghavi
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Odion Binitie
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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6
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Frederick NN, Fine E, Michaud A, Recklitis CJ, Bober SL. Pediatric hematology and oncology fellow education in sexual and reproductive health: A survey of fellowship program directors in the United States. Pediatr Blood Cancer 2020; 67:e28245. [PMID: 32147938 DOI: 10.1002/pbc.28245] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/04/2020] [Accepted: 02/21/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Pediatric oncology clinicians identify a need for increased sexual and reproductive health (SRH) education with adolescent and young adult (AYA) cancer patients. By surveying pediatric oncology fellowship directors, this study clarifies the state of current fellowship education about SRH for the AYA patient. METHODS A survey was sent to all pediatric oncology fellowship program directors (PDs) in the United States consisting of 13 questions pertaining to three primary SRH domains: sexual health, fertility, and safe sex practices. Descriptive statistics and χ2 were used in data analyses. RESULTS Sixty-three PDs responded to the survey (91% response rate). Of these, 88% reported having formal instruction regarding fertility, 41% reported curriculum regarding contraception and 30% reported some education regarding sexual health. The curriculum "being too full" was identified as a barrier to education on fertility (29%), sexual health (40%), and safe sex practices (38%). Not being a required or expected part of the program was more likely to be endorsed as a barrier for sexual health (26%) and safe sex practices (30%) compared with fertility (8%) (P < 0.005). Lack of experts to teach was a more frequently endorsed barrier to education on sexual health (47%) compared with either fertility (23%) or safe sex practices (25%) (P < 0.005). CONCLUSIONS This study identifies important gaps in oncology fellow education about SRH. Future research must explore optimal education strategies that are feasible and acceptable by PDs and fellow learners, and effective in optimizing AYA SRH care.
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Affiliation(s)
- Natasha N Frederick
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Elizabeth Fine
- Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Alexis Michaud
- Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Sharon L Bober
- Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts
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7
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Perez GK, Salsman JM, Fladeboe K, Kirchhoff AC, Park ER, Rosenberg AR. Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship. Am Soc Clin Oncol Educ Book 2020; 40:1-15. [PMID: 32324424 PMCID: PMC7328818 DOI: 10.1200/edbk_279787] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs' health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients' future health. Oncology clinicians are well positioned to address AYA patients' concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs' quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.
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Affiliation(s)
- Giselle K. Perez
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA
| | - John M. Salsman
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Kaitlyn Fladeboe
- Seattle Children’s Research Institute, University of Washington, Seattle, WA
| | - Anne C. Kirchhoff
- Huntsman Cancer Institute and Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Elyse R. Park
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA
| | - Abby R. Rosenberg
- Seattle Children’s Research Institute, University of Washington, Seattle, WA
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8
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Lindsay SF, Woodhams EJ, White KO, Drainoni ML, Johnson NL, Yinusa-Nyahkoon L. Understanding Barriers to Contraception Screening and Referral in Female Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 9:63-71. [PMID: 31634022 DOI: 10.1089/jayao.2019.0074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Contraception screening and referral occur infrequently in cancer care for young women of reproductive age. Barriers to contraception screening and referral in this setting have not been thoroughly identified. Objectives: We sought to understand oncology clinicians' current practices and perceptions of barriers to screening and referring young women for adequate contraception during cancer treatment. Methods: We conducted individual semi-structured interviews with 19 oncology clinicians whom we recruited from an urban, northeast medical center. Participants included physicians, advanced practice clinicians, and nurses in surgical and medical oncology. The interview guide addressed core components of the Promoting Action on Research Implementation in Health Services framework, and subsequent directed content analysis identified themes indicative of barriers to contraception screening and referral. Findings: Participants varied significantly in their current contraception screening practices; many conflated early pregnancy diagnosis or pregnancy avoidance counseling with contraception, whereas others described inaccurate contraceptive recommendations for specific clinical scenarios. Participants also lacked clarity of roles and responsibilities within the oncologic care team for contraception and assumed that another team member had addressed contraception. Participants perceived themselves to lack adequate education about contraception, which precluded contraception discussions. Conclusion: We recommend cancer centers consider these possible barriers to contraception screening and referral by promoting development of institutional guidelines to standardize contraception screening and referral, clarifying roles and responsibilities for contraception discussions within the care team, and expanding oncology clinician education on contraception. National professional organizations should work to expand guidelines to inform and support this process in clinical practice.
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Affiliation(s)
- Sarah F Lindsay
- Department of Obstetrics and Gynecology, Hartford Healthcare Medical Group, Hartford, Connecticut.,Department of Obstetrics and Gynecology, UConn Health, Farmington, CT
| | - Elisabeth J Woodhams
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, Massachusetts
| | - Katharine O White
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, Massachusetts
| | - Mari-Lynn Drainoni
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Natrina L Johnson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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9
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Frederick NN, Revette A, Michaud A, Bober SL. A qualitative study of sexual and reproductive health communication with adolescent and young adult oncology patients. Pediatr Blood Cancer 2019; 66:e27673. [PMID: 30767372 DOI: 10.1002/pbc.27673] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Adolescent and young adult patients with cancer (AYAs) identify sexual and reproductive health (SRH) as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to explore AYA perceptions and experiences of SRH communication with oncology clinicians. METHODS Twenty-three AYA patients and survivors ages 15-25 years from a large academic oncology center participated in semistructured qualitative interviews investigating their experiences discussing SRH issues, including specific topics discussed, conversation barriers and facilitators, suggestions for clinicians on how to improve conversations, and education and resource needs. Interviews were audio recorded, transcribed, and coded using a thematic analysis approach. RESULTS Interviews with AYAs revealed two primary themes-a need for oncology clinicians to discuss SRH and critical gaps in current SRH communication practices. AYAs reported a need for improved SRH communication for the purposes of general education, addressing specific SRH issues experienced, and understanding the long-term impact of cancer and treatment on SRH. The current communication gaps are exacerbated by patient discomfort initiating conversations and the presence of family members. AYAs shared six key recommendations for clinicians on how to improve SRH communication. CONCLUSIONS AYAs identify a role for oncology clinicians in discussing SRH as a primary aspect of comprehensive health care during cancer treatment and in survivorship; however, multiple gaps and barriers interfere with such discussions. Future efforts must focus on clinician education and training in SRH as well as education and intervention opportunities for AYAs to optimize the care provided.
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Affiliation(s)
- Natasha N Frederick
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Anna Revette
- Survey and Data Management Core, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Alexis Michaud
- Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sharon L Bober
- Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts
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10
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Soanes L, White I. Sexuality and cancer: The experience of adolescents and young adults. Pediatr Blood Cancer 2018; 65:e27396. [PMID: 30216642 DOI: 10.1002/pbc.27396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/08/2018] [Accepted: 07/09/2018] [Indexed: 12/30/2022]
Abstract
There are many components affecting the experience of sexuality for adolescents and young adults living with and beyond cancer. For patients, the interruption to normal socialization creates gaps in information and experience that potentially hinder development. In clinical practice, conversations relating to sexual consequences of illness or treatment are rare, as are age-appropriate assessment and intervention. In service design, the collaborative approach of oncofertility has yet to be replicated for sexuality. This paper considers how these obstacles can be overcome through local service development to address unmet need and promote sexual well-being for this group of patients.
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Affiliation(s)
- Louise Soanes
- Children and Young People's Cancer Services, University College Hospital NHS Foundation Trust, London, UK
| | - Isabel White
- The Royal Marsden NHS Foundation Trust, London, UK
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11
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Frederick NN, Campbell K, Kenney LB, Moss K, Speckhart A, Bober SL. Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective. Pediatr Blood Cancer 2018; 65:e27087. [PMID: 29697189 DOI: 10.1002/pbc.27087] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. PROCEDURE Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi-structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty-two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. RESULTS Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of "sexual health" as safe sex and contraception only, clinician-reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. CONCLUSIONS Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population.
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Affiliation(s)
- Natasha N Frederick
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Kevin Campbell
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Lisa B Kenney
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Kerry Moss
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | | | - Sharon L Bober
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
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12
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ACOG Committee Opinion No. 747: Gynecologic Issues in Children and Adolescent Cancer Patients and Survivors. Obstet Gynecol 2018; 132:e67-e77. [DOI: 10.1097/aog.0000000000002763] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Nichols HB, Anderson C, Ruddy KJ, Black KZ, Luke B, Engel SM, Mersereau JE. Childbirth after adolescent and young adult cancer: a population-based study. J Cancer Surviv 2018; 12:592-600. [PMID: 29785559 PMCID: PMC6511987 DOI: 10.1007/s11764-018-0695-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 05/07/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE Annually, > 45,000 US women are diagnosed with cancer during adolescence and young adulthood (AYA). Since 2006, national guidelines have recommended fertility counseling for cancer patients. We examined childbirth after AYA cancer by calendar period, cancer diagnosis, and maternal characteristics. METHODS We identified a cohort of women with an incident invasive AYA cancer diagnosis at ages 15-39 during 2000-2013 in North Carolina. Cancer records were linked with statewide birth certificates through 2014. Hazard ratios (HR) and 95% confidence intervals (CI) for first post-diagnosis live birth were calculated using Cox proportional hazards regression. RESULTS Among 17,564 AYA cancer survivors, 1989 had ≥ 1 birth after diagnosis during 98,397 person-years. The 5- and 10-year cumulative incidence of live birth after cancer was 10 and 15%, respectively. AYA survivors with a post-diagnosis birth were younger at diagnosis, had lower stage disease, and had less often received chemotherapy than those without a birth. The 5-year cumulative incidence of post-diagnosis birth was 10.0% for women diagnosed during 2007-2012, compared to 9.4% during 2000-2005 (HR = 1.01; 0.91, 1.12), corresponding to periods before and after publication of American Society of Clinical Oncology fertility counseling guidelines in 2006. CONCLUSIONS Despite advances in fertility preservation options and recognition of fertility counseling as a part of high-quality cancer care, the incidence of post-diagnosis childbirth has remained stable over the last 15 years. IMPLICATIONS FOR CANCER SURVIVORS Our study uses statewide data to provide recent, population-based estimates of how often AYA women have biological children after a cancer diagnosis.
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Affiliation(s)
- Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 2104F McGavran Greenberg, Chapel Hill, NC, 27599, USA.
| | - Chelsea Anderson
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 2104F McGavran Greenberg, Chapel Hill, NC, 27599, USA
| | | | - Kristin Z Black
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, MI, USA
| | - Stephanie M Engel
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 2104F McGavran Greenberg, Chapel Hill, NC, 27599, USA
| | - Jennifer E Mersereau
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
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14
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Reed DR, Oshrine B, Pratt C, Fridgen O, Elstner C, Wilson L, Soliman H, Lee MC, McLeod HL, Shah B, Donovan KA, Pabbathi S, Turney M, Binitie O, Healy C, Nieder M, Shaw PH, Galligan A, Letson GD, Stern M, Quinn GP, Davies S. Sink or Collaborate: How the Immersive Model Has Helped Address Typical Adolescent and Young Adult Barriers at a Single Institution and Kept the Adolescent and Young Adult Program Afloat. J Adolesc Young Adult Oncol 2017; 6:503-511. [PMID: 28777007 PMCID: PMC5725631 DOI: 10.1089/jayao.2017.0051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Damon R Reed
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida.,5 Department of Individualized Cancer Management, Personalized Medicine Institute , Moffitt Cancer Center, Tampa, Florida
| | - Benjamin Oshrine
- 3 Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital , St. Petersburg, Florida
| | - Christie Pratt
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Olivia Fridgen
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida
| | - Cathy Elstner
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Leila Wilson
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Hatem Soliman
- 4 Breast Oncology, Moffitt Cancer Center , Tampa, Florida
| | - Marie C Lee
- 4 Breast Oncology, Moffitt Cancer Center , Tampa, Florida
| | - Howard L McLeod
- 5 Department of Individualized Cancer Management, Personalized Medicine Institute , Moffitt Cancer Center, Tampa, Florida
| | - Bijal Shah
- 6 Malignant Hematology, Moffitt Cancer Center , Tampa, Florida
| | | | - Smitha Pabbathi
- 8 Internal Medicine Department and Survivorship Program, Moffitt Cancer Center , Tampa, Florida
| | - Mary Turney
- 9 Patient and Family Services, Moffitt Cancer Center , Tampa, Florida
| | - Odion Binitie
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Christine Healy
- 9 Patient and Family Services, Moffitt Cancer Center , Tampa, Florida
| | | | - Peter H Shaw
- 3 Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital , St. Petersburg, Florida
| | - Andrew Galligan
- 11 Department of Pediatrics, University of South Florida , Tampa, Florida
| | | | - Marilyn Stern
- 12 Department of Child and Family Studies, University of South Florida , Tampa, Florida.,13 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida
| | - Gwendolyn P Quinn
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,13 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida
| | - Simon Davies
- 14 Teen Cancer America , Los Angeles, California
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