title: If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records.
abstract: OBJECTIVE
  The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers.
  
  
  METHODS
  All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist.
  
  
  RESULTS
  Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001).
  
  
  CONCLUSIONS
  The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation.
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI gwen.quinn@moffitt.org.
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Block
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Marla L
authors.initials: ML
authors.lastname: Clayman
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kelvin
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Arvey
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Joyce
authors.initials: J
authors.lastname: Reinecke
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Ivana
authors.initials: I
authors.lastname: Sehovic
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Damon
authors.initials: D
authors.lastname: Reed
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Luis
authors.initials: L
authors.lastname: Gonzalez
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Vadaparampil
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Julio
authors.initials: J
authors.lastname: Pow-Sang
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Susan
authors.initials: S
authors.lastname: Eggly
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Anna
authors.initials: A
authors.lastname: Franklin
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Bijal
authors.initials: B
authors.lastname: Shah
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.affiliation: Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Brandon
authors.initials: B
authors.lastname: Hayes-Lattin
mesh_terms: D000293:Adolescent; D000328:Adult; D002173:Cancer Care Facilities; D004282:Documentation; D005260:Female; D058015:Health Communication; D006801:Humans; D007246:Infertility; D008297:Male; D008499:Medical Records; D009369:Neoplasms; D010361:Patients; D012306:Risk; D055815:Young Adult