title: The role of in-depth reproductive health counseling in addressing reproductive health concerns in female survivors of nongynecologic cancers.
abstract: The purpose of this study was to characterize reproductive concerns among female cancer survivors and determine the role of targeted counseling in improving overall reproductive quality of life (QOL). A survey was administered to women from the California Cancer Registry, ages 18-40, with nongynecologic cancers diagnosed from 1993 to 2007, who received fertility-compromising treatments. In total, 356 women completed the survey, which included questions regarding their reproductive health counseling history and the reproductive concerns scale (RCS), a validated reproductive QOL tool. Factors independently associated with higher RCS scores included a desire for children at the time of diagnosis, posttreatment infertility, treatment with chemoradiation or bone marrow transplant, and income less than $100,000 per year at diagnosis. Among the highest reported reproductive concerns were those related to loss of control over one's reproductive future and concerns about the effect of illness on one's future fertility. Across our population and independent of age, in-depth reproductive health counseling prior to cancer treatment was associated with significantly lower RCS scores. Our findings highlight the importance of early counseling and targeting high-risk groups for additional counseling after completion of cancer treatment. This approach may be an effective strategy for optimizing long-term reproductive QOL in this vulnerable population.
authors.affiliation: a Department of Obstetrics, Gynecology , and Reproductive Sciences, University of California San Francisco , San Francisco , CA , USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Shah
authors.affiliation: a Department of Obstetrics, Gynecology , and Reproductive Sciences, University of California San Francisco , San Francisco , CA , USA.|b Department of Obstetrics and Gynecology , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Letourneau
authors.affiliation: a Department of Obstetrics, Gynecology , and Reproductive Sciences, University of California San Francisco , San Francisco , CA , USA.|c Department of Obstetrics and Gynecology , Cornell University , New York , NY , USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Niemasik
authors.affiliation: d Department of Epidemiology and Biostatistics , University of California San Francisco , San Francisco , CA , USA.
authors.forename: M
authors.initials: M
authors.lastname: Bleil
authors.affiliation: d Department of Epidemiology and Biostatistics , University of California San Francisco , San Francisco , CA , USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.affiliation: a Department of Obstetrics, Gynecology , and Reproductive Sciences, University of California San Francisco , San Francisco , CA , USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003376:Counseling; D005260:Female; D005298:Fertility; D006801:Humans; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D060728:Reproductive Health; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: cancer survivorship; quality of life; reproductive age cancer; reproductive concerns; reproductive health counseling; women