title: Patient counselling on the risk of infertility and its impact on childhood cancer survivors: results from a national survey.
abstract: Fertility can be impaired by radiation and chemotherapy among childhood cancer survivors. Therefore, timely and adequate patient counselling about the risk of infertility and preservation methods is needed. The primary study objective was to assess remembered counselling among childhood cancer survivors. As a second objective, the impact of lacking patient counselling on offspring-related attitudes and behaviour was examined. Counselling regarding the late effects of gonadotoxicity that could be recalled by patients was assessed using a questionnaire sent by the German Childhood Cancer Registry. The questionnaire was answered by 2754 adult childhood cancer survivors (53.1% female, mean = 25.7 years). The proportion of patients who could not remember patient counselling about the late effects of chemo-/radiotherapy on fertility decreased significantly over time. In 1980 to 1984 67%, in 2000 to 2004 50% of the patients reported no memories of counselling (p < .001). Counselled patients feared significantly less that their children may have an increased cancer risk (4.4% vs. 6.7%, p = .03). They were also more likely to undergo fertility testing than patients who could not recall counselling (odds ratio = 2.91, 95% confidence interval [2.12, 3.99]). Patients reported an increased memory of patient counselling over the past 25 years. Still, a 50% rate of recalled counselling shows an ongoing need for adequate and especially sustainable counselling of paediatric cancer patients about infertility and other long-term adverse treatment effects. Those who reported a lack of counselling had offspring-related fears more frequently, which stopped them from having children.
authors: Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätmedizin Berlin, Berlin, Germany. cynthia.hohmann@charite.de
authors: Cynthia
authors: C
authors: Hohmann
authors: Anja
authors: A
authors: Borgmann-Staudt
authors: Rosa
authors: R
authors: Rendtorff
authors: Simone
authors: S
authors: Reinmuth
authors: Steve
authors: S
authors: Holzhausen
authors: Stefan N
authors: SN
authors: Willich
authors: Guenter
authors: G
authors: Henze
authors: Lutz
authors: L
authors: Goldbeck
authors: Thomas
authors: T
authors: Keil