Fertility counseling and sperm banking among adolescents and adults treated for cancer with curative intent in a developing country

2020 ◽  
Vol 28 (8) ◽  
pp. 3915-3919
Author(s):  
Nayef Abdel-Razeq ◽  
Khawlah Ammar ◽  
Ahmad Mahadeen ◽  
Razan Mansour ◽  
Hashem Abdalwahed ◽  
...  
Keyword(s):  
Developing Country ◽  
Curative Intent ◽  
Sperm Banking ◽  
Adolescents And Adults ◽  
Fertility Counseling

scholarly journals Significant Unmet Need in Fertility Counseling and Sperm Cryopreservation in Young Males with Cancer: A Single-Center Analysis

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4488-4488
Author(s):  
Natalie S. Grover ◽  
Allison M. Deal ◽  
Jennifer E. Mersereau ◽  
William A. Wood
Keyword(s):  
Cancer Patients ◽  
Young Male ◽  
Hematologic Malignancies ◽  
Reproductive Age ◽  
Insurance Status ◽  
Sperm Cryopreservation ◽  
Curative Intent ◽  
Sperm Banking ◽  
Fertility Counseling ◽  
Male Patients

Abstract Background: Due to improved cancer survival rates as well as the current trend of delaying childbirth, fertility has become a growing issue among cancer patients. The American Society of Clinical Oncology recommends that oncologists discuss fertility preservation with all patients of reproductive age who are about to initiate treatment that may cause infertility. The purpose of this study was to evaluate the incidence of fertility counseling and sperm banking referral in male cancer patients of reproductive age at our center and to assess whether counseling is influenced by demographics or disease specific factors. Methods: We used the University of North Carolina (UNC) Cancer Registry to identify male patients between the ages of 13-50 who received a new diagnosis of cancer between 1/1/2013 and 1/1/2015 and planned to initiate chemotherapy with curative intent. We excluded patients who initiated chemotherapy outside of UNC. We queried the electronic medical record (EMR) for demographic information such as age, race, insurance status, number of children, marital status, sexual orientation and disease-related variables such as type of cancer, type of treatments, and comorbidities. We reviewed the EMR for documentation of fertility counseling and identified patients who banked sperm at UNC since 1/1/2013. Fisher's Exact and Wilcoxon Rank Sum tests were used to compare characteristics between groups. Additionally, multivariable logistic regression modeling was used to evaluate associations after controlling for age. Results: There were initially 594 male patients identified with new cancer diagnoses, of whom 160 received chemotherapy with curative intent. Of this final cohort of 160 patients, 76 had hematologic malignancies (33 with lymphoma, 30 with acute leukemia, and 13 with other hematologic malignancies). The median age was 42 (40 for hematologic malignancies). 41% of patients had children and 46% were married. Based on chart documentation, 28% of patients were counseled regarding fertility and 13% of patients attempted to bank sperm (46% of those receiving fertility counseling). Rates of counseling and sperm banking were similar for hematologic malignancy patients. Younger patients were significantly more likely to be counseled (p <0.001). Among patients with hematologic malignancies, 51% of patients under 30 years were counseled while 18% of patients ≥ 30 years were counseled (p=0.001). Across all cancer types, insurance type was not associated with fertility counseling (p=0.38) but was associated with attempted sperm banking (p=0.03). Having children, being married, and having a comorbidity were associated with a lower rate of counseling in univariate analysis, but not in multivariate analysis after controlling for age. Conclusions: We found a significant unmet opportunity for fertility counseling and referral for sperm banking in young male cancer patients receiving chemotherapy with curative intent at our center. Low rates of counseling and sperm banking were particularly notable in patients over the age of 30. In addition to barriers in clinical practice, the association between insurance status and sperm banking also suggests a financial barrier to sperm cryopreservation. Further work is needed to develop interventions to improve rates of fertility counseling and opportunities for sperm banking in young male cancer patients. Disclosures Wood: Inform Genomics: Consultancy; Best Doctors: Consultancy.

Clinical and demographical factors associated with fertility counseling in colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24047-e24047
Author(s):  
Chengwei Peng ◽  
Lena Masri ◽  
Stefanie Roman ◽  
Scott Sherman ◽  
Daniel Jacob Becker
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Univariate Analysis ◽  
Cancer Center ◽  
Survivorship Care ◽  
Demographic Shift ◽  
Curative Intent ◽  
Younger Patients ◽  
Future Fertility ◽  
Fertility Counseling

e24047 Background: The incidence of colorectal cancer in patients younger than 50 has been increasing over the past 2 decades. This demographic shift has important implications for survivorship care, in particular regarding issues of future fertility especially in light of USPSTF’s recommendation for colorectal cancer screening to begin at 45. Although ASCO has longstanding recommendations for fertility counseling in patients with cancer, the rates of fertility counseling in younger patients with colorectal cancer are unknown. Methods: Records for new patient visits for colorectal cancer in patients younger than age 55 in a large academic cancer center between 2012 and 2019 were queried for patient demographics, disease characteristics, and documentation of fertility counseling. Associations between demographic/clinical characteristics and fertility counseling were explored. Univariate and multivariable logistical regression analyses were performed using SAS v9.4. Results: Among 194 patients who met inclusion criteria, 39.2% of patients were female, 10.4% were African American, 31.4% had rectal cancer, and 69.6% were treated with curative intent. Approximately 14.5% of patients had Medicaid insurance. Age ranged from 22-55. The overall rate of fertility counseling among all patients was 15.5%. Of these patients, 43.3% were male. In univariate analysis, age less than or equal to 40 (p < 0.01), female gender (p = 0.03) and curative intent therapy (p = 0.03) were associated with fertility counseling. These factors were again statistically significant in multivariate analysis: age < 40, female, and curative intent therapy (Table). Race, stage of cancer, insurance status, prior exposure to chemotherapy, year of diagnosis and colon vs rectal cancer were not associated with counseling. Conclusions: The rate of fertility counseling was very low among patients with colorectal cancer, and exceptionally low among men. Despite changes in the demographics of colorectal cancer, it does not appear that appropriate changes have been made in fertility counseling. Increases in fertility counseling were not seen in more recent years despite recognition of increasing incidence in younger patients. Additional studies to identify barriers to counseling and strategies to improve survivorship care are urgently needed.[Table: see text]

Fertility counseling in young patients with colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24081-e24081
Author(s):  
Chengwei Peng ◽  
Lena Masri ◽  
Scott Sherman ◽  
Daniel Jacob Becker
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Cancer Center ◽  
Curative Intent ◽  
Future Fertility ◽  
Fertility Counseling ◽  
Logistical Regression ◽  
Chi Square Analysis

e24081 Background: The incidence of colorectal cancer in patients younger than 50 has been increasing over the past two decades. This demographic shift has important implications for survivorship care, in particular regarding issues of future fertility. Although ASCO has a longstanding recommendation for fertility counseling in patients with cancer, the rates of fertility counseling in younger patients with colorectal cancer are unknown. Methods: Records for new patient visits for colorectal cancer in patients younger than age 55 in a large academic cancer center between 2016 and 2019 were retrospectively queried for patient demographics, disease characteristics, and documentation of fertility counseling. Associations between patient demographic/clinical characteristics and receipt of fertility counseling were explored. Univariate analyses and multivariable logistical regression analyses were performed using SAS v9.4. Results: Among the 136 patients who met inclusion criteria, 37.5% of patients were female, 16.2% were African American, 31.6% had rectal cancer, 20.7% of patients had Medicaid insurance. 63.7% were treated with curative intent. Age ranged from 22-55 (median = 46). Among all patients, 21/136 (15.4%) had documented fertility counseling. Of these, 11/51 (21.6%) patients were female and 10/85 (11.8%) were men. In univariate chi-square analysis, age less than or equal to 40 was associated with fertility counseling (p < 0.001) and curative intent therapy was numerically but not statistically associated with fertility counseling (p = 0.07). In multivariable analysis with logistical regression, age less than 40 (OR = 3.90, 95% CI [1.95, 7.81]), female gender (OR = 2.37, 95% CI [1.16, 4.84]), and curative intent therapy (OR = 3.26, 95% CI [1.14, 9.35]) were associated with fertility counseling. Race, stage of cancer, insurance status, prior exposure to chemotherapy, and colon vs rectal cancer were not associated with fertility counseling. Conclusions: The rate of fertility counseling was very low among patients with colorectal cancer, and exceptionally low among men with colorectal cancer. Despite changes in the demographics of colorectal cancer, it does not appear that appropriate changes have been made in fertility counseling. Additional studies to identify barriers and implementation strategies for fertility counseling are urgently needed in a disease that affects more young patients each year.

PD52-11 EFFICACY OF STANDARDIZED NURSING FERTILITY COUNSELING ON SPERM BANKING RATES IN CANCER PATIENTS

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Katherine Rotker ◽  
Hari Vigneswaran ◽  
Danly Omil-Lima ◽  
Grayson Baird ◽  
Mark Sigman ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Sperm Banking ◽  
Fertility Counseling

Changes in health-related quality of life of oral cancer patients treated with curative intent: experience of a developing country

2017 ◽  
Vol 46 (6) ◽  
pp. 687-698 ◽  
Author(s):  
J.G. Doss ◽  
W.M.N. Ghani ◽  
I.A. Razak ◽  
Y.H. Yang ◽  
S.N. Rogers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Cancer ◽  
Cancer Patients ◽  
Developing Country ◽  
Health Related Quality ◽  
Curative Intent ◽  
Related Quality ◽  
Health Related ◽  
Oral Cancer Patients

Re: Efficacy of Standardized Nursing Fertility Counseling on Sperm Banking Rates in Cancer Patients

2018 ◽  
Vol 199 (4) ◽  
pp. 879-880
Author(s):  
Craig Niederberger
Keyword(s):  
Cancer Patients ◽  
Sperm Banking ◽  
Fertility Counseling

scholarly journals Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma: experience from a developing country

2018 ◽  
Vol Volume 10 ◽  
pp. 977-988 ◽  
Author(s):  
Danijel Galun ◽  
Aleksandar Bogdanovic ◽  
Jelena Djokic Kovac ◽  
Predrag Bulajic ◽  
Zlatibor Loncar ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Developing Country ◽  
Neutrophil To Lymphocyte Ratio ◽  
Curative Intent ◽  
Prognostic Predictor ◽  
Lymphocyte Ratio

scholarly journals Young Men With Cancer Experience Low Referral Rates for Fertility Counseling and Sperm Banking

2016 ◽  
Vol 12 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Natalie S. Grover ◽  
Allison M. Deal ◽  
William A. Wood ◽  
Jennifer E. Mersereau
Keyword(s):  
Logistic Regression ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Current Trend ◽  
Young Men ◽  
Reproductive Age ◽  
Median Income ◽  
Sperm Banking ◽  
Multivariable Logistic Regression ◽  
Fertility Counseling

Purpose: With improved cancer survival rates and the current trend of delaying parenthood, fertility is a growing issue among cancer patients. The purpose of this study was to evaluate the incidence of fertility counseling and sperm banking in reproductive-age male cancer patients and to assess factors that influence counseling and banking. Materials and Methods: Male patients ages 13 to 50 years who received a new cancer diagnosis from January 1, 2013, to May 1, 2015, and planned to initiate curative chemotherapy at our center were identified. Documentation of fertility counseling and sperm cryopreservation was abstracted from the medical record. Univariable and multivariable logistic regression modeling was used to examine variables associated with fertility counseling and sperm banking. Results: Of 201 patients who fit the study criteria, 59 (29%) received fertility counseling and 23 (11%) attempted sperm banking. All patients who banked sperm had documentation of fertility counseling. Younger patients were significantly more likely to be counseled, with mean ages of 27.4 and 40.4 years for counseled and noncounseled patients, respectively (P < .001). Among counseled patients, those with a lower median income (P = .038) or who had Medicaid or no insurance (P = .042) were less likely to bank sperm. In a multivariable logistic regression model, older age (5-year odds ratio, 0.61; P < .001) and presence of comorbidities (odds ratio, 0.15; P = .03) remained significantly associated with a lower counseling rate. Conclusion: There is a low rate of fertility counseling and referral for sperm banking in young men with cancer receiving chemotherapy. Further work is needed to develop interventions to improve fertility counseling rates and opportunities for sperm banking.

Efficacy of Standardized Nursing Fertility Counseling on Sperm Banking Rates in Cancer Patients

Urology ◽  
2017 ◽  
Vol 104 ◽  
pp. 90-96 ◽  
Author(s):  
Katherine Rotker ◽  
Hari Vigneswaran ◽  
Danly Omil-Lima ◽  
Mark Sigman ◽  
Kathleen Hwang
Keyword(s):  
Cancer Patients ◽  
Sperm Banking ◽  
Fertility Counseling

scholarly journals Efficacy of standardized nursing fertility counseling on sperm banking rates in cancer patients

2015 ◽  
Vol 104 (3) ◽  
pp. e90 ◽  
Author(s):  
K.L. Rotker ◽  
H.T. Vigneswaran ◽  
D. Omil-Lima ◽  
G. Baird ◽  
M. Sigman ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Sperm Banking ◽  
Fertility Counseling
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