title: Validity of self-reported fertility-threatening cancer treatments in female young adult cancer survivors.
abstract: OBJECTIVE
  Detailed cancer treatment information is important to fertility and pregnancy care of female young adult cancer survivors. Accuracy of self-report of treatments that impact fertility and pregnancy is unknown. This study assessed agreement between self-report and medical records on receipt of fertility-threatening treatments.
  
  
  METHODS
  A national cohort study of female young adult cancer survivors reported cancer treatments via Web-based questionnaires. Primary cancer treatment records were abstracted. Self-reported exposure to fertility-threatening therapies (alkylating chemotherapy, stem cell transplant, pelvic radiation, hysterectomy, and/or oophorectomy) was compared to medical records. Logistic regression models estimated odds ratios (OR) for characteristics associated with inaccurate self-report of fertility-threatening therapies.
  
  
  RESULTS
  The study included 101 survivors (mean age 28.2, SD 6.3). Lymphoma (33%), breast cancer (26%), and gynecologic cancers (10%) were the most common cancers. Accuracy of self-report was 68% for alkylating chemotherapy and 92-97% for radiation, surgery, and transplant. Significant proportions of survivors who were treated with transplant (8/13, 62%), alkylating chemotherapy (18/43, 42%), pelvic radiation (4/13, 31%), or hysterectomy and/or oophorectomy (3/13, 23%) did not report undergoing these therapies. In adjusted analysis, age ≤ 25 at diagnosis (OR 3.4, 95% CI 1.3-8.7) and recurrence (OR 6.0, 95% CI 1.5-24.4) were related to inaccurate self-report.
  
  
  CONCLUSIONS
  Female young adult cancer survivors have limited recall of fertility-threatening cancer treatment exposures. Reproductive health providers and researchers who need this information may require primary medical records or treatment summaries.
  
  
  CONCLUSIONS
  Additional patient education regarding treatment-related reproductive risks is needed to facilitate patient engagement in survivorship. Obtaining a cancer treatment summary will help survivors communicate their prior treatment exposures to reproductive healthcare providers.
authors.affiliation: Department of Reproductive Medicine and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-090, USA.
authors.forename: Samantha C
authors.initials: SC
authors.lastname: Roberts
authors.affiliation: Department of Reproductive Medicine and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-090, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Knight
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, 408 Arnold House, 715 North Pleasant Street , University of Massachusetts, Amherst, MA, 01003-9304, USA.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Whitcomb
authors.affiliation: School of Social and Behavioral Health Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Gorman
authors.affiliation: Department of Pediatrics Division of Hematology/Oncology/BMT, Children's Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Dietz
authors.affiliation: Department of Reproductive Medicine and Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-090, USA. hisu@ucsd.edu.
authors.forename: H
authors.initials: H
authors.lastname: Irene Su
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D011247:Pregnancy; D057566:Self Report; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult
keywords: Cancer survivorship; Cancer treatment; Fertility; Medical records; Pregnancy; Self-report; Young adults