Factors influencing the documentation of fertility-related discussions for adolescents and young adults with cancer

G Skaczkowski; V White; K Thompson; H Bibby; M Coory; R Pinkerton; W Nicholls; L M Orme; R Conyers; M B Phillips; M Osborn; R Harrup; A Anazodo

doi:10.1016/j.ejon.2018.02.007

Factors influencing the documentation of fertility-related discussions for adolescents and young adults with cancer

Eur J Oncol Nurs. 2018 Jun:34:42-48. doi: 10.1016/j.ejon.2018.02.007. Epub 2018 Mar 8.

Authors

G Skaczkowski¹, V White², K Thompson³, H Bibby⁴, M Coory⁵, R Pinkerton⁶, W Nicholls⁶, L M Orme⁷, R Conyers⁸, M B Phillips⁹, M Osborn¹⁰, R Harrup¹¹, A Anazodo¹²

Affiliations

¹ Center for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia; School of Psychology and Public Health, La Trobe University, Bundoora Campus, Bundoora, 3086 VIC, Australia; Olivia Newton-John Cancer Wellness & Research Center, Austin Health, Level 4, 145 Studley Road, Heidelberg, 3084 VIC, Australia.
² Center for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia; School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC 3125, Australia. Electronic address: Vicki.White@cancervic.org.au.
³ Peter MacCallum Cancer Center, 305 Grattan Street, Melbourne, VIC 3000, Australia.
⁴ Center for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia.
⁵ Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan St, Melbourne, VIC 3010, Australia.
⁶ Children's Health Queensland Hospital and Health Service, PO Box 3474, South Brisbane, Queensland 4101, Australia.
⁷ Peter MacCallum Cancer Center, 305 Grattan Street, Melbourne, VIC 3000, Australia; Children's Cancer Center, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia.
⁸ Peter MacCallum Cancer Center, 305 Grattan Street, Melbourne, VIC 3000, Australia; Children's Cancer Center, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC 3052, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia.
⁹ Princess Margaret Hospital for Children, Roberts Rd, Subiaco, WA 6008, Australia.
¹⁰ Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
¹¹ Royal Hobart Hospital, 48 Liverpool St, Hobart, TAS 7000, Australia.
¹² Kids Cancer Center, Sydney Children's Hospital, High Street, Randwick, NSW 2031, Australia; Nelune Comprehensive Cancer Center, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia; School of Women's and Children's Health University of New South Wales, NSW 2052, Australia.

PMID: 29784137
DOI: 10.1016/j.ejon.2018.02.007

Abstract

Purpose: A cancer diagnosis and treatment may have significant implications for a young patient's future fertility. Documentation of fertility-related discussions and actions is crucial to providing the best follow-up care, which may occur for many years post-treatment. This study examined the rate of medical record documentation of fertility-related discussions and fertility preservation (FP) procedures for adolescents and young adults (AYAs) with cancer in Australia.

Methods: A retrospective review of medical records for 941 patients in all six Australian states. Patients were identified through population-based cancer registries (four states) and hospital admission lists (two states). Trained data collectors extracted information from medical records using a comprehensive data collection survey. Records were reviewed for AYA patients (aged 15-24 years at diagnosis), diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, central nervous system (CNS) tumours, soft tissue sarcomas (STS), primary bone cancer or Ewing's family tumours between 2007 and 2012.

Results: 47.2% of patients had a documented fertility discussion and 35.9% had a documented FP procedure. Fertility-related documentation was less likely for female patients, those with a CNS or STS diagnosis and those receiving high-risk treatments. In multivariable models, adult hospitals with an AYA focus were more likely to document fertility discussions (odds ratio[OR] = 1.60; 95%CI = 1.08-2.37) and FP procedures (OR = 1.74; 95%CI = 1.17-2.57) than adult hospitals with no AYA services.

Conclusions: These data provide the first national, population-based estimates of fertility documentation for AYA cancer patients in Australia. Documentation of fertility-related discussions was poor, with higher rates observed in hospitals with greater experience of treating AYA patients.

Keywords: Adolescents and young adults; Cancer; Documentation; Fertility.

MeSH terms

Adolescent
Adult
Australia
Documentation / methods*
Female
Fertility / drug effects*
Fertility / radiation effects*
Fertility Preservation / psychology*
Fertility Preservation / statistics & numerical data*
Humans
Male
Neoplasms / psychology*
Neoplasms / therapy*
Retrospective Studies
Surveys and Questionnaires
Young Adult