title: Documentation of Fertility Preservation Discussions for Young Adults With Cancer: Examining Compliance With Treatment Guidelines.
abstract: Professional guidelines have been developed to promote discussion between providers and newly diagnosed young adults with cancer about the possibility of cancer treatment-related infertility, but previous research suggests many young adults fail to receive this information. The aim of this study was to examine rates of and factors predictive of oncologists' compliance with national guidelines for discussing potential treatment-related infertility with newly diagnosed young adults with cancer seen at an NCI-designated comprehensive cancer center.
  
  
  
  We reviewed data from the electronic medical record for new clinic encounters between medical oncologists and young adults with cancer (ages 18-39 years) from 2010 to 2012. Data from oncologist discussions of fertility preservation were abstracted, as were patient (age, sex, race, ethnicity, cancer type) and oncologist (gender, graduation year from fellowship) characteristics.
  
  
  
  A total of 1,018 cases were reviewed, with 454 patients (mean, 31.5 years; 67.8% women) meeting inclusion criteria. Overall, 83% of patients were informed about potential treatment-related infertility, with patients with breast cancer (85% informed), Hodgkin lymphoma (95% informed), non-Hodgkin's lymphoma (94% informed), leukemia (88% informed), or testicular cancer (100% informed) more likely to be informed than those with other cancer types (60%-74% informed). There was a significant effect for patient sex (odds ratio, 3.57; CI, 1.33, 9.60; P=.012), with women being more likely to be informed than men.
  
  
  
  Reported compliance with fertility preservation guidelines was greater than published rates. Higher compliance rates in female patients and in patients with cancers more common among young adults may reflect greater awareness of fertility-related concerns among these patients and their providers.
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine|The Robert H. Lurie Comprehensive Cancer Center of Northwestern University
authors.forename: John M
authors.initials: JM
authors.lastname: Salsman
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine|The Robert H. Lurie Comprehensive Cancer Center of Northwestern University
authors.forename: Betina
authors.initials: B
authors.lastname: Yanez
authors.affiliation: The Robert H. Lurie Comprehensive Cancer Center of Northwestern University|Department of Obstetrics and Gynecology, Division of Fertility and Reproductive Medicine, Northwestern Medical Group
authors.forename: Kristin N
authors.initials: KN
authors.lastname: Smith
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.affiliation: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
authors.forename: Mallory A
authors.initials: MA
authors.lastname: Snyder
authors.affiliation: Illinois School of Professional Psychology
authors.forename: Khouri
authors.initials: K
authors.lastname: Barnes
authors.affiliation: The Robert H. Lurie Comprehensive Cancer Center of Northwestern University|Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
authors.forename: Marla L
authors.initials: ML
authors.lastname: Clayman
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004282:Documentation; D057286:Electronic Health Records; D005260:Female; D005298:Fertility / Q000187:drug effects; D059247:Fertility Preservation / Q000592:standards*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007246:Infertility / Q000209:etiology*; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D016017:Odds Ratio; D010353:Patient Education as Topic / Q000592:standards* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents