title: Contraceptive use and the role of contraceptive counseling in reproductive-aged women with cancer.
abstract: OBJECTIVE
  Few data on contraceptive choices in women with cancer exist. Contraception is challenging for women with cancer, particularly those with breast cancer, who are limited to nonhormonal methods. This study characterized contraceptive use during cancer treatment in a group of reproductive-aged women with a recent cancer diagnosis and assessed the impact of contraceptive counseling on the methods they selected.
  
  
  METHODS
  Cross-sectional, survey study of reproductive-aged women at a large tertiary care health system with a recent cancer diagnosis.
  
  
  RESULTS
  A total of 107 women completed the survey. Eighty-two women reported 101 contraceptive choices. Twenty-seven percent (27/101) of all methods selected were Tier I/II, and 35% (35/101) were Tier III/IV. Only 4 used an intrauterine device (IUD). Among women reporting sexual activity after diagnosis, 19 (27%) of 71 reported using Tier I/II methods, 21 (30%) of 71 reported using Tier III/IV methods, 16 (23%) of 71 reported abstinence and 10 (14%) of 71 reported using no method. Factors significantly associated with Tier I/II use in the multivariable model included not having a college degree [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.05-0.92, p=.038], intercourse during treatment (OR 5.92, 95% CI 1.48-23.66, p=.012) and non-breast cancer (OR 3.60, 95% CI 1.03-12.64, p=.046). Report of contraceptive counseling was positively associated with Tier I/II contraceptive use during cancer treatment (OR 6.92, 95% CI 1.14-42.11, p=.036).
  
  
  CONCLUSIONS
  Reproductive-aged women diagnosed with cancer underutilized Tier I/II contraceptive agents, especially IUDs. Contraceptive counseling by physicians increases contraceptive use, particularly methods most effective at preventing pregnancy.
  
  
  CONCLUSIONS
  The study uniquely described the contraceptive practices of over 100 women with cancer. The study sample commonly reported abstinence and use of contraceptive methods with high failure rates. Our data suggest that contraceptive counseling from a health care provider may increase use of more effective methods among women with cancer.
authors.affiliation: Division of Reproductive Endocrinology and Infertility. Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, CT 06030, USA. Electronic address: maslow@uchc.edu.
authors.forename: Bat-Sheva L
authors.initials: BS
authors.lastname: Maslow
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, WA 98195, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Morse
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Schanne
authors.affiliation: Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Loren
authors.affiliation: Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Domchek
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior / Q000523:psychology*; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology*; D055815:Young Adult
keywords: Cancer; Contraception; Contraceptive counseling; IUD