title: Physicians' practice of discussing fertility preservation with cancer patients and the associated attitudes and barriers.
abstract: The aim of this study is to describe physicians' clinical practice of discussing fertility issues with cancer patients and determine the factors associated with such discussion.
  
  
  
  In this cross-sectional study, a nationwide Internet survey was conducted among physicians who provided daily medical care to cancer patients at hospitals or clinics. Participants answered a questionnaire assessing characteristics, discussion practices, attitudes, and barriers regarding fertility preservation.
  
  
  
  Among the 180 participants, 42% discussed fertility issues with patients daily, and 30% had experience in referring patients to fertility preservation specialists. A multivariate logistic regression analysis showed that those who agreed or strongly agreed with the statements "physicians are responsible for discussing fertility preservation" (OR = 2.04, 95% CI 1.14-3.63, p < 0.05) and "patients who have an exceedingly aggressive disease and need immediate cancer treatment should not be told about fertility issues" (OR =1.84, 95% CI 1.09-3.10, p < 0.05) were nearly twice as likely to discuss fertility issues with patients.
  
  
  
  Compared to Western countries, fertility issues are less likely to be discussed in Japan. To increase opportunities for patients to discuss fertility issues, the ASCO guidelines should be widely understood. Additionally, these results suggest that physicians who are more likely to discuss fertility issues might feel more conflicted about whether they in fact should discuss such issues with patients with poor prognosis or insufficient time for cancer treatment.
authors.affiliation: Department of Consultation, Counseling and Support Service Center, National Cancer Center Hospital, Tokyo, Japan. etakeuch@ncc.go.jp.|Center of Palliative Medicine, Keio University Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. etakeuch@ncc.go.jp.
authors.forename: Emi
authors.initials: E
authors.lastname: Takeuchi
authors.affiliation: Department of Consultation, Counseling and Support Service Center, National Cancer Center Hospital, Tokyo, Japan.|Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.|Department of Psycho-oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Psycho-oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Saho
authors.initials: S
authors.lastname: Wada
authors.affiliation: Graduate School of Education/Faculty of Education, Tohoku University, Sendai, Japan.
authors.forename: Saran
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Department of Pediatrics, Osaka University School of Medicine, Osaka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyoshi
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D059247:Fertility Preservation / Q000379:methods* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Attitude; Barrier; Cancer survivor; Discussion; Fertility