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A new study published in the on line version of the journal
Cancer March
26, 2012 shows that there are disparities in counseling and
treatment to
protect women’s fertility when they go through treatment for various types of
cancers.
"Although more women are getting counseled regarding
reproductive
health risks, many women are still not receiving adequate
information about their options at the time of cancer diagnosis,"
according to Dr Mitchell Rosen, of the University of California, San Francisco
(UCSF) who co-authored the study.
Rosen and colleagues surveyed women diagnosed with cancer between the ages
of 18 and 40 years, who were registered in the California Cancer Registry
between 1993 and 2007.
They found that 61% of the women received counseling on the risks that
cancer
treatment can have on their fertility from their
doctor or other clinician. However, only 4% of women took up the option of
fertility preservation. Rates showed a tendency to increase over time. In 1993,
the take up rate was 1%, whereas in 2005 to 2007 it was between 6% and 10%.
Younger, Caucasian, childless, heterosexual, and college educated women were
the most likely to receive counseling about the effects of cancer treatment on
their fertility, and also most likely to preserve fertility beforehand.
Disparities in sociodemographic health characteristics and economics likely
affect women's access to fertility preservation services.
Early findings from the study include:
- The percentage of women
reporting acute ovarian failure was 8 percent, 10 percent, 9 percent and 5
percent for Hodgkin's disease, non-Hodgkin lymphoma, breast cancer,
and gastrointestinal cancers respectively. Acute ovarian failure increased
significantly with age at diagnosis.
- In women without acute
ovarian failure, the incidence of infertility increased significantly with
age at diagnosis. For instance, the proportion of infertile women with
Hodgkin's disease was 18 percent at 20 years old and 57 percent at 35
years old.
- The estimated probability of
early menopause increased significantly with younger age at diagnosis. For
example, using age as a predictor of early menopause in non-Hodgkin
lymphoma, 56 percent of women 20 years old at diagnosis may experience
menopause early, compared to 16 percent of those who were 35 years old at
diagnosis.
"An opportunity lies ahead to explore educational
and policy interventions to ameliorate health disparities that may exist in the
growing use of fertility preservation," said Rosen.
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