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J Cancer Surviv. 2017 Aug;11(4):517-523. doi: 10.1007/s11764-017-0610-7. Epub 2017 Mar 6.

Validity of self-reported fertility-threatening cancer treatments in female young adult cancer survivors.

Author information

1
Department of Reproductive Medicine and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-090, USA.
2
Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, 408 Arnold House, 715 North Pleasant Street , University of Massachusetts, Amherst, MA, 01003-9304, USA.
3
School of Social and Behavioral Health Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, USA.
4
Department of Pediatrics Division of Hematology/Oncology/BMT, Children's Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
5
Department of Reproductive Medicine and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-090, USA. hisu@ucsd.edu.

Abstract

PURPOSE:

Detailed cancer treatment information is important to fertility and pregnancy care of female young adult cancer survivors. Accuracy of self-report of treatments that impact fertility and pregnancy is unknown. This study assessed agreement between self-report and medical records on receipt of fertility-threatening treatments.

METHODS:

A national cohort study of female young adult cancer survivors reported cancer treatments via Web-based questionnaires. Primary cancer treatment records were abstracted. Self-reported exposure to fertility-threatening therapies (alkylating chemotherapy, stem cell transplant, pelvic radiation, hysterectomy, and/or oophorectomy) was compared to medical records. Logistic regression models estimated odds ratios (OR) for characteristics associated with inaccurate self-report of fertility-threatening therapies.

RESULTS:

The study included 101 survivors (mean age 28.2, SD 6.3). Lymphoma (33%), breast cancer (26%), and gynecologic cancers (10%) were the most common cancers. Accuracy of self-report was 68% for alkylating chemotherapy and 92-97% for radiation, surgery, and transplant. Significant proportions of survivors who were treated with transplant (8/13, 62%), alkylating chemotherapy (18/43, 42%), pelvic radiation (4/13, 31%), or hysterectomy and/or oophorectomy (3/13, 23%) did not report undergoing these therapies. In adjusted analysis, age ≤ 25 at diagnosis (OR 3.4, 95% CI 1.3-8.7) and recurrence (OR 6.0, 95% CI 1.5-24.4) were related to inaccurate self-report.

CONCLUSIONS:

Female young adult cancer survivors have limited recall of fertility-threatening cancer treatment exposures. Reproductive health providers and researchers who need this information may require primary medical records or treatment summaries.

IMPLICATIONS FOR CANCER SURVIVORS:

Additional patient education regarding treatment-related reproductive risks is needed to facilitate patient engagement in survivorship. Obtaining a cancer treatment summary will help survivors communicate their prior treatment exposures to reproductive healthcare providers.

KEYWORDS:

Cancer survivorship; Cancer treatment; Fertility; Medical records; Pregnancy; Self-report; Young adults

PMID:
28265843
PMCID:
PMC5501745
DOI:
10.1007/s11764-017-0610-7
[Indexed for MEDLINE]
Free PMC Article

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