Physician referral for fertility preservation in oncology patients: a national study of practice behaviors.
OBJECTIVE
Cancer survival rates are improving, and the focus is moving toward quality survival. Fertility is a key aspect of quality of life for cancer patients of childbearing age. Although cancer treatment may impair fertility, some patients may benefit from referral to a specialist before treatment. However, the majority of studies examining patient recall of discussion and referral for fertility preservation (FP) show that less than half receive this information. This study examined the referral practices of oncologists in the United States.


METHODS
This study examined oncologists' referral practice patterns for FP among US physicians using the American Medical Association Physician Masterfile database. A 53-item survey was administered via mail and Internet to a stratified random sample of US physicians.


RESULTS
Forty-seven percent of respondents routinely refer cancer patients of childbearing age to a reproductive endocrinologist. Referrals were more likely among female physicians (P = .004), those with favorable attitudes (P = .043), and those whose patients routinely ask about FP (odds ratio = 2.09; 95% CI, 1.31 to 3.33).


CONCLUSIONS
Less than half of US physicians are following the guidelines from the American Society of Clinical Oncology, which suggest that all patients of childbearing age should be informed about FP.
Quinn
Gwendolyn P
GP
H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA. gwen.quinn@moffitt.org
Vadaparampil
Susan T
ST
Lee
Ji-Hyun
JH
Jacobsen
Paul B
PB
Bepler
Gerold
G
Lancaster
Johnathan
J
Keefe
David L
DL
Albrecht
Terrance L
TL
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005298:Fertility / Q000187:drug effects* / Q000528:radiation effects*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011878:Radiotherapy / Q000009:adverse effects; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
D000970:Antineoplastic Agents