Just 50% of patients with early-onset cancers may report discussing fertility preservation options with their physicians prior to receiving oncology treatments, according to a recent study published by Keller et al in JAMA Network Open.
Background
“From an early-onset cancer diagnosis through to surveillance and survivorship, we know there are unique care needs for patients and their families that must be considered,” stressed senior study author Andreana Holowatyj, PhD, MSCI, Assistant Professor of Medicine at the Vanderbilt-Ingram Cancer Center. “That said, we do not yet have the ‘best’ strategies to deliver comprehensive oncology care to all young patients, regardless of age, geographic location, access to care, self-identified race and ethnicity, sex, or gender identity,” she added.
Study Methods and Results
The recent study was led by researchers with the REACT study—which aims to improve physicians’ and researchers’ understanding of the unmet care needs of patients aged 18 to 49 with a cancer diagnosis. These needs include fertility, sexual health, body esteem, physical activity, and personal relationships. The researchers recruited 473 patients aged 18 to 49 who were diagnosed with 30 types of early-onset cancers between 2013 and 2021 and participated in REACT worldwide.
“The REACT study was developed in partnership with patients to capture some of these important insights into what young patients experience, feel, and discuss with their cancer care provider—so we can work to effectively address these unmet needs moving forward,” Dr. Holowatyj emphasized.
Young patients with thyroid, lung, ovarian, and colorectal cancers reported the lowest prevalence of a fertility preservation discussion with a health-care professional involved in their cancer care. The researchers found that just 21.4% of patients with ovarian cancer reported a discussion about fertility preservation. The percentages reporting a discussion were 44.2% among patients with colorectal cancer, 21% among patients with lung cancer, and 3.6% among patients with thyroid cancer.
Conclusions
“We want all young patients diagnosed with cancer to get comprehensive, high-quality oncology care, which includes reproductive health care,” Dr. Holowatyj highlighted. “Our discovery that [50% of] patients in REACT reported not having had a discussion on fertility preservation options with their health-care professional before starting early-onset cancer treatment is alarming. Notwithstanding the potential drawback that not all patients may have remembered this conversation, our clinically significant findings shed light on the crucial need to tailor strategies that will deliver concordant reproductive health care to this growing patient population,” she concluded.
Disclosure: The research in this study was supported in part by the National Cancer Institute, the American Cancer Society, the National Institute of Child Health and Human Development, the National Center for Advancing Translational Sciences, and the Drs. Sidney and Becca Fleischer Undergraduate Summer Research Fund. For full disclosures of the study authors, visit jamanetwork.com.
